A Reliable Marker of Endothelial Cell Dysfunction and Vascular Damage: Legend or Reality?

Endothelial dysfunction is considered to be a pre-clinical stage of atherosclerosis and represents an initial step of plaque progression. The aim of this study is to investigate whether the overproduction of biochemical markers is related to vascular damage. We studied 72 patients split into three groups:

• 20 patients had no vessels significant disease;

• 18 patients had multi-vessels disease;

• 34 patients had multi-vessels disease and stenosis >50%.

Patients with known coronary artery disease, stroke, hypertension, diabetes and/or dyslipidemia were excluded from the study.

We measured plasma levels of vWF (a marker of endothelial stress), VEGF (a marker of neointimal proliferation), TF and E-selectin (a marker of endothelial activation), all were measured by ELISA, and we investigated if their increased levels are related to the endothelial damage (table 1).

Table 1.

There is a significant relation between vWF, VEGF, TF and E-Selectin and vessels disease severity; patients with no vessels disease had an average thickness of 0.48 mm, (IMT: 0.6–1.18mm), patients with multi vessels disease had a median atheroma score of 1.12, (IMT:1.18–2.42mm), patients with multi vessels disease and stenosis had a mediam atheroma score of 2.40, (IMT:>2.42mm), indeed we did not find any significant relation between increased arterial stiffness and laminar shear-stress. Healthy endothelium exerts a favourable and athero-protective effects by a numbers of factors.

Table 2. Favorable and Atheroprotective Effects of the Healthy Endothelium

Table 3. Risk factors and predictors of endothelium dysfunction

In conclusion, we demonstrated that high levels of vWF, VEGF, TF, E-Selectin may play a critical role as for the development and the progression of atherosclerosis, even if further and wider studies are needed to confirm this statement.