Open AccessNon-Invasive Assessment of Endothelial Dysfunction in Pulmonary Arterial Hypertension
Author(s) -
Athanasia Dara,
Alexandra Arvanitaki,
Marieta Theodorakopoulou,
Christos Athanasiou,
Eleni Pagkopoulou,
Afroditi Boutou
Publication year - 2021
Publication title -
mediterranean journal of rheumatology
Language(s) - English
Resource type - Journals
ISSN - 2529-198X
DOI - 10.31138/mjr.32.1.6
Subject(s) - medicine , cardiology , hypoxia (environmental) , pulmonary hypertension , endothelial dysfunction , microcirculation , endothelium , vasoconstriction , vascular resistance , pulmonary vasculature , thrombosis , peripheral , hypoxic pulmonary vasoconstriction , perfusion , pathology , hemodynamics , chemistry , organic chemistry , oxygen
Pulmonary arterial hypertension (PAH) is characterised by an increased pressure in the pulmonary arterial circulation, resulting in the elevation of pulmonary vascular resistance. Pulmonary endothelial dysfunction and inflammation, triggered by shear stress and hypoxia, constitute the hallmarks of pulmonary vasculopathy by promoting endothelial and smooth muscle cells proliferation, vasoconstriction, and thrombosis. While research was predominantly focused on pulmonary vasculature, the investigation of peripheral endothelial damage in different vascular beds has attracted the interest over the last years. As a result, effective non-invasive methods that can assess the endothelial function and the architectural integrity have been utilized for the evaluation of pulmonary and peripheral vasculature. Non-invasive plethysmography, pulmonary flow reserve, nailfold videocapillaroscopy, near-infrared spectroscopy, and imaging techniques such as magnetic resonance angiography and perfusion imaging coupled by a number of biomarkers can be used for the assessment of peripheral vascular function in PAH individuals. In this review, we summarise and critically approach the current evidence of more systemic derangement of vascular function in PAH defined by novel, non-invasive methods employed for functional and morphological assessment of endothelium and microcirculation.