Part III - Non-invasive Assessments of Endothelial Function (FMD, PWA, cIMT)

Part III discusses the importance of several non-invasive assessments of vascular health including flow-mediated dilatation, pulse wave analysis and carotid ultrasound.
Link for Part IV: • Part IV - The Importan...
More information can be found in my review paper:
www.ncbi.nlm.n...

[@roberth9441]

At the 12:00 minute mark you said “Impairment in function, lots of nitric oxide”. Did you mean less nitric oxide with impairment? In other words, does impairment lead to increased nitric oxide? In June 2022 I had an NStEMI. I fortunately got to a fire department within a few hours of symptoms and was given aspirin and nitroglycerin and taken by ambulance to hospital. They did a cath and found one vessel 70% blocked but said there was no muscle damage. I’m being treated with meds but no stint. I’m very stable, underwent cardio rehabilitation and am doing very well. Increase dietary intake of plant foods rich in nitrates. PS. Your video are extremely helpful to me and have taught me, a layman non medical professional, a lot. You break everything down to my level. Thank you for sharing your knowledge Dr. Sandoo!

[@physiologymadeeasy216]

Hi Robert, Firstly, I am very pleased to hear you are doing well following the MI. You are certainly taking the right approach with exercise and a Mediterranean style diet. To clarify the point around 12 minutes, what I am saying is that the impairment leads to a loss in nitric oxide. This in turn reduces the vasodilatory (widening) capability of the vessel and can impair blood flow going to tissues. The good news is that the scientific evidence suggests exercise (especially cardiac rehab type programs) and a plant-based diet are effective approaches in increasing nitric oxide levels. Also make sure you get adequate sleep, keep stress levels low, and avoid putting on too much weight. Keep doing what you are doing and hopefully you will maintain a good quality of life. Thanks also for the positive comments. I am just happy that this small channel gets across to a wide audience and benefits people. All the best for the future!

[@roberth9441]

Dr. Sandoo, I was mistaken in what I thought I heard on the video. You correctly said “loss” of nitric oxide not “lots” as I thought I heard, when there’s impairment of function with atherosclerosis and significant narrowing. I understand!! Thank you for addressing my question and well wishes for me. Take care sir!!

[@EduardoSoriano9]

Very thorough, you are a great teacher.

[@physiologymadeeasy216]

I appreciate that! Thanks very much for the comment.

[@syncro16se]

Thank you so much ! 🌟🌟🌟🌟🌟 Your straight to the point easy to understand teaching abilities are astounding ! Great videos. I am a 52 y o type 1 diabetic since the age if 15, and have got a real eureka moment after an acute pneumonia and a bit of a scary experience with moderately heightened blood pressure. I am now reevaluating my whole dietary intake, exercise, weight training, and my lay-man research has led ne through a great number of talks, texts and presentations on the subject of NO, citrulline, arginine, B12 C OPC, nitrates and the nutritional side of this. It would be very interesting to learn more about (if you could do a breakdown of) the processes of NO in the body. Thanks again! Greetings from Sweden

[@physiologymadeeasy216]

Hi Syncro16se, firstly, thank you very much for taking time to leave such a positive comment. I really appreciate that, and glad the video's are of use even from a 'lay man's' perspective. I will plan to do a video summarising the impact of nitrate supplementation on blood pressure and vessel health (via an increased production of NO), and will put this on my list of planned videos. In the meantime, I do want to say that there is not enough strong evidence yet that nitrate supplementation exerts positive effects on blood pressure or vessel health. In other words, we need more research studies to understand more about how a glass of beetroot juice or plate of green leafy veg actually causes a long-term and meaningful reduction in blood pressure (and atherosclerosis). Keep an eye out for this video soon. All the best in life and health.

[@Divya736]

I didn't realize you were going to talk about ultrasound assessment! Very cool, and relevant to me as a sonographer! Thanks again!

[@physiologymadeeasy216]

Your welcome Rose! These assessments are currently used a lot in cardiovascular research, with carotid ultrasound particularly useful for diagnosis. It is therefore very important for Sonographers like yourself to be aware of them. Good luck in your studies!

[@Divya736]

Very interesting stuff! I am doing a research project and presentation in November at BCIT. I would like to pitch the idea to my team, if that is alright with you (of course, we would reference you and give you the proper credit). These are not applications I was exposed to as part of my generalist, cardiac, or vascular (carotid, lower, and upper venous extremity) training. I only stumbled across your videos because I take an interest in cardiovascular physiology, so this is exciting for me to learn of! I even mentioned it to a few sonographers at my clinical site, but they were not aware of these assessment techniques, either, and I hope to ask some of the cardiologists about it, as well! November is quite a while off, but I thought you might be interested to know! And thank you for the well wishes!

[@physiologymadeeasy216]

Hi Rose, it is perfectly fine with me. I am pleased that you might consider using these techniques. I am more than happy to provide any further help and guidance if needed. Good luck with the pitch and please keep me updated with your progress. All the best!

[@Divya736]

Thank you very much, and I will do!!

[@luckssj]

What they don't talk about is the Glycocalyx by destroying the Glycocalyx the Endothelial cells will be damaged and the mitochondria dies and cell dies.

[@ragsdoc]

Dr. Sandoo, you are amazing.

[@physiologymadeeasy216]

Thanks for this lovely comment ragsdoc. I am pleased the information is useful for your knowledge.

[@namrita4]

FMD: 1. Obstruct distal end 2. Release it, blood flow increases 3. Nitric oxide senses it and leads to increase in vascular diameter 4. Quantification of nitric oxide mediated vasodilation

[@HerbalistintheHood369]

Fantastic information for my herbal course

[@physiologymadeeasy216]

Glad it was helpful!

[@eviczeynepbasar8263]

hello, thank you for nice presentation. I wonder which ECG phase you use when making the measurements between before and after. R wave or T wave

[@hero-gl4zy]

Can ultravist (iopromide) cause endothelial cell dysfunction in xray exam? And if there is damage is it reversable? And if it is reversable did new endothelial act normally function?

[@劉佳星]

Is it possible to have a wearable continuous endothelial function monitor?

[@physiologymadeeasy216]

Not to my knowledge!

[@G88-r4y]

this is very useful, thank you

[@physiologymadeeasy216]

Glad it was helpful!

[@kevinho4504]

Is there any supplements to repair endothelium ? I heard pomegranates can repair this and then the endothelium can do its job of producing nitric oxide

[@physiologymadeeasy216]

Yes, pomegranates are good, as is beetroot, spinach and other high-nitrate containing vegetables.

[@kevinho4504]

@@physiologymadeeasy216 If I understand correctly , ED could be caused by endothelium dysfunction and if this can be repaired, it will be restore nitric oxide production and ED can be reserved , is this true ?