This review headlights the subject endothelial dysfunction in the paediatric population. Endothelial dysfunction is recognized as en independent risk factor of atherosclerotic disease. Even before macroscopic evidence of the disease, endothelial dysfunction may be present. It is believed that one major mechanism underlying the phenomenon of endothelial dysfunction is decreased bioavailability of endothelium-derived nitric oxide (NO), due to reduced production or increased degradation. This article reviews different methods for evaluating endothelial function, which are believed to reflect the bioavailability of NO, and addresses methods particularly suitable for childhood studies.
Many risk factors for atherosclerosis in adults are well established (e.g. hyperlipidemia, hypertension, cigarette smoking, diabetes mellitus), and new ones are emerging. Evaluation of endothelial dysfunction in children provides a means to investigate the impact of these risk factors at an early age. This article also reviews the available literature on studies of endothelial function in children with both conventional and novel risk factors for atherosclerosis.
Endothelial dysfunction may be a reversible phenomenon. Much work has been performed to evaluate potential management strategies to reduce the risk of future cardiovascular events. This article reviews interventional studies aiming to improve endothelial function in children.