LA UTILIDAD DE REALIZAR MEDICIONES NO INVASIVAS DE LA FUNCION VASCULAR EN LA PRACTICA CLINICA





LA UTILIDAD DE REALIZAR MEDICIONES NO INVASIVAS DE LA FUNCION VASCULAR EN LA PRACTICA CLINICA

(especial para SIIC © Derechos reservados)
Se discuten las estrategias disponibles para medir la función arterial y su trascendencia en la práctica clínica.
Autor:
Andrew M Wilson
Columnista Experto de SIIC

Institución:
Stanford University Medical Center, Cardiovascular Medicine Division


Artículos publicados por Andrew M Wilson
Coautor
Marno C Ryan* 
MBBS, MD, Stanford University Medical Center, Cardiovascular Medicine Division, Stanford, EE.UU.*
Recepción del artículo
28 de Abril, 2006
Aprobación
19 de Mayo, 2006
Primera edición
12 de Octubre, 2006
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
Los cambios en la función vascular, como en el funcionamiento endotelial y en la rigidez arterial, son indicadores tempranos fundamentales en la evolución de la enfermedad cardiovascular en los seres humanos, y su medición con métodos no invasivos se utiliza ampliamente en la investigación clínica. Numerosos índices no invasivos se correlacionan adecuadamente con mediciones más directas e invasivas y, por lo tanto, pueden utilizarse en cohortes de gran tamaño, posiblemente fuera del laboratorio. La función arterial puede examinarse por medios no invasivos y está alterada en los sujetos con enfermedad vascular o alto riesgo de padecerla. Se han utilizado diversas mediciones en la detección sistemática en la población, en estudios de casos y controles y en trabajos prospectivos de cohorte debido a que pueden mostrar anormalidades antes de la presentación manifiesta de enfermedad cardiovascular, incluso en las personas con hipercolesterolemia, hipertensión arterial, diabetes e insuficiencia renal crónica. En la presente revisión discutimos una variedad de mediciones de la función arterial que se encuentran disponibles en el contexto de la investigación clínica y su posibilidad de aplicación en el consultorio. Se discute el modo en que las alteraciones en una prueba pueden o no reflejar los cambios observados en otras evaluaciones en el mismo paciente. Finalmente, se mencionan las ventajas y limitaciones de varias técnicas, con especial atención a los factores que actualmente restringen su uso en la práctica diaria.

Palabras clave
Función endotelial, rigidez arterial, riesgo vascular, función arterial


Artículo completo

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Abstract
Changes in vascular function such as endothelial function and arterial stiffness are key early features in the development of human cardiovascular disease, and non-invasive measures of vascular function have been utilized extensively in clinical research. Many non-invasive indices correlate well with more direct and invasive measures and thus can be applied to large cohorts, potentially outside of a laboratory. Arterial function can be assessed non-invasively, and is abnormal in subjects with or at high risk of developing vascular disease. Many measures have been applied to population screening, case control and prospective cohort studies and can be abnormal before overt cardiovascular disease develops including subjects with hypercholesterolemia, hypertension, diabetes, and chronic renal failure. In this review, we discuss a range of arterial function measures that are available in the clinical research setting and the potential for these to be employed in the clinic. We discuss how abnormalities in one measure may or not be reflective of changes seen in other measures in the same patient. Finally, benefits and limitations of various techniques are discussed, particularly focused on factors currently limiting use in a clinical setting.

Key words
Endothelial function, arterial stiffness, vascular risk, arterial function


Full text
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Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Cardiología
Relacionadas: Diagnóstico por Imágenes, Endocrinología y Metabolismo, Medicina Interna



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Enviar correspondencia a:
Andrew Wilson, Stanford University Medical Center, 300 Pasteur Drive, Stanford, EE.UU.
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