Early biomarkers of endothelial dysfunction: clinical implications for the diagnosis and management of cardiovascular disease
Annotatsiya
This review synthesizes current evidence on early biomarkers of endothelial dysfunction (ED) in cardiovascular disease (CVD), emphasizing their role in diagnosis, prognosis, and management. ED, characterized by reduced nitric oxide bioavailability and increased inflammation, serves as a reversible precursor to atherosclerosis, thrombosis, and events like myocardial infarction. Established biomarkers, including adhesion molecules, cytokines, and inflammatory markers, reflect endothelial activation and predict CVD risk, with recent studies confirming their utility in hypertension. Emerging focus on L-arginine derivatives, particularly asymmetric dimethylarginine (ADMA), highlights its specificity as an endogenous nitric oxide synthase inhibitor, associated with vascular impairment in hypertension, diabetes, and CVD. Clinical trials, such as the AtheroGene and Framingham Offspring studies, demonstrate ADMA’s prognostic value for major adverse events. Future directions advocate integrating ADMA into multi-biomarker panels with AI and omics for personalized medicine, addressing gaps in standardization and early detection. Non-invasive techniques like flow-mediated dilation and ultrasound-derived markers complement biomarkers for subclinical CVD assessment. Overall, biomarker-driven strategies promise enhanced CVD prevention and tailored therapies.