The role of flow-mediated dilatation in the evaluation and development of antiatherosclerotic drugs

PURPOSE OF REVIEW: The present article reviews the use of flow-mediated dilatation in clinical cardiovascular research. Its value as a surrogate tool for development of antiatherosclerotic drugs and noninvasive assessment of cardiovascular risk is also discussed. RECENT FINDINGS: Atherosclerosis remains the leading cause of cardiovascular morbidity and mortality. Development of new drugs is required to target both the evolution of this disease and its clinical consequences. Noninvasive measures of arterial function and structure have been widely used as intermediate phenotypes in clinical trials. Numerous studies have demonstrated the interplay between vascular risk factors and endothelial function as assessed by flow-mediated dilatation in children and adults. Additionally, a number of studies have documented the prognostic value of the method. SUMMARY: Detection of early arterial changes can prove particularly useful in clinical research for the development of antiatherosclerotic drugs. They permit identification of vascular toxicity as well as characterization of the safety and risk profile of a new cardiovascular treatment modality on vascular health. This approach is likely to prove cost-effective before embarking on large longitudinal studies to assess cardiovascular morbidity and mortality. © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.