Assessment of endothelial function by EndoPAT technology
By regulating homeostatic mechanisms, the vascular endothelium is the key modulator of blood vessel function. Impaired responses of the endothelial cells to vasodilatory stimuli are commonly termed “endothelial dysfunction”. This pathological state of the endothelium is associated with an early stage in the development of atherosclerosis and has been recognized as a link to cardiovascular disease risk factors and as a prognostic marker of future cardiovascular events.
A noninvasive method for evaluation of endothelial function is the assessment of peripheral artery tonometry (PAT). Established in recent years and patented as EndoPAT (Itamar Medical Ltd.), this technology is based on detection of the digital arterial pulse wave amplitude with the help of a plethysmographic device. EndoPAT evaluates the peripheral flow induced arterial dilation after provocation of reactive hyperemia in an operator-independent manner. The reactive hyperemia index can be calculated as the ratio of the mean pulse wave amplitude post deflation to the baseline pulse wave amplitude.
FDA approved EndoPAT for use as a diagnostic aid in patients with signs and symptoms of ischemic heart disease. The medical device further received CE certification in Europe as well as Shonin-approval by Japan’s Pharmaceutical and Medical devices Agency and CFDA-approval in China.
It has been successfully applied in diverse clinical trials with natural health products, e.g. for evaluation of the effects on endothelial function by supplementation with lycopenes1, or consumption of high-polyphenol dark chocolate2 and plant stanol esters3.
a&r has recently established EndoPAT in its own study site in Berlin.
a&r comment: This noninvasive and automated technology is a valuable tool for clinical evaluation of endothelial function that may provide supporting evidence for beneficial effects of (nutritional) heart health products.
1 Kim et al. Effects of lycopene supplementation on oxidative stress and markers of endothelial function in healthy men. Atherosclerosis (2011)
2 Nogueria et al. Consumption of high-polyphenol dark chocolate improves endothelial function in individuals with stage 1 hypertension and excess body weight. International Journal of Hypertension (2012)
3 Gylling et al. The effects of plant stanol ester consumption on arterial stiffness and endothelial function in adults: a randomised controlled clinical trial. BMC Cardiovascular Disorders 2013, 13:50