Non-invasive assessment of endothelial function — a review of available methods

The key role of the endothelium in vascular-dependent diseases led to an increase in scientific interest in examining the endothelial function as a tool for screening, as well as for monitoring of the disease and its treatment. In the period from 2016 till 2019, a high level of scientific interest in the assessment of endothelial function has been observed, as expressed in the number of published clinical trials between 369 and 477 per year with the total number of subjects between 49,634 and 75,934. Currently, none of the known methods of assessing vascular endothelial function is widely used in clinical practice. This may be a result of various factors: scientific (lack of standardization in terms of quantitative indicators of endothelial function), formal (lack of official recommendations for endothelial assessment), financial (the best-validated methods and devices are costly, which renders it unsustainable to use them in screening diagnostics) and technological (high susceptibility of many measurement methods to errors). Nevertheless, it can be expected that non-invasive methods for the early detection of endothelial dysfunction in screening programs will gradually gain importance.