Vascular Physiology Unit, Great Ormond Street Hospital for Children, NHS Trust, University College London, 30 Guilford Street, London WC1N 3EH, UK.
Eur Heart J. 2010 Dec;31(23):2854-61. doi: 10.1093/eurheartj/ehq340. Epub 2010 Sep 23.
Evidence suggests that endothelial dysfunction is on the causal pathway for both atherogenesis and destabilization of established plaques. In this review, the role of flow-mediated dilatation (FMD) as a non-invasive method to assess endothelial function is discussed. Technical modifications and development of analysis software have significantly improved the variability of the method. Following a strict standardized protocol enables reproducible measurements to be achieved and export of the technique from specialized laboratories to population studies and multicentre settings. Endothelial function assessed by FMD has been shown to be affected by cardiovascular risk factors, to be related to structural arterial disease and to cardiovascular outcome, validating its use for studying the pathophysiology of arterial disease. Numerous studies have also demonstrated that it is responsive to physiological and pharmacological interventions. Flow-mediated dilatation provides unique opportunities in drug development programmes to assess an early rapidly responsive signal of risk or benefit, complementing endpoints of structural arterial disease and cardiovascular outcomes that take much longer and are more expensive.
有证据表明，内皮功能障碍是动脉粥样硬化形成和已形成斑块不稳定的因果途径。在这篇综述中，讨论了血流介导的扩张（FMD）作为一种评估内皮功能的非侵入性方法的作用。技术改进和分析软件的开发显著降低了该方法的变异性。遵循严格的标准化方案可以实现可重复的测量，并将该技术从专门的实验室推广到人群研究和多中心环境中。通过 FMD 评估的内皮功能受心血管危险因素的影响，与结构性动脉疾病和心血管结局相关，验证了其用于研究动脉疾病病理生理学的用途。许多研究还表明，它对生理和药理学干预有反应。血流介导的扩张为药物开发计划提供了独特的机会，可以评估风险或获益的早期快速反应信号，补充结构性动脉疾病和心血管结局的终点，这些终点需要更长时间且更昂贵。
