BLOG: The Endothelium: Getting to the “Heart” of Cardiovascular Disease

July 29, 2018

Despite positive developments in medication and lifestyle changes to reduce risk factors associated with cardiovascular disease (CVD) and atherosclerosis (plaque build-up in arteries), stroke and heart attack remain the leading cause of death worldwide. Innovation in medical care and medical devices will likely play a central role in improving long term cardiovascular health outcomes. Over the past several years, Lexington Biosciences has focused on the health of the endothelium, which is the critical inner lining covering all blood vessels throughout the body. We are excited to introduce the HeartSentry device as an important endothelial health measurement tool, which can serve as an early predictor in the cardiovascular disease process.

From the heart to the tiniest capillary, endothelial cells form the innermost lining of the entire circulatory system. Cumulatively called the endothelium, it is composed of a single layer of cells which are critical to vascular health, and which may function as a kind-of “built-in” sensor for the vascular system. They act to guide the arteries to dilate or constrict under stress or other external stimuli.

Disruption of normal endothelial function is known to be a precursor to CVD and atherosclerosis. In short, as the vascular system becomes burdened with atherosclerosis, the endothelial cells stop working as well as they did before, which can provide a key signal that the health of the cardiovascular system has been adversely affected. A dysfunctional endothelium can be one of the earliest signs that plaque is accumulating inside arteries, which can be non-invasively observed as an inability to dilate effectively under different flow conditions or environmental stresses.

Once the endothelium is disrupted and plaque starts to accumulate, it’s usually there for good – barring medical intervention. If left untreated over time, plaque will eventually increase until it blocks the artery or breaks free to enter the circulatory system. The result is typically either a heart attack or a stroke.

The good news is that medication can help improve cardiovascular disease and decrease risk of catastrophic events like heart attack or stroke. Therefore monitoring endothelial function may offer an essential approach to prevent cardiovascular disease and guide treatment. This is why we have developed and positioned HeartSentry as a front line cardiovascular diagnostic device.

While the above is widely acknowledged in medical circles, most of the general population aren’t aware of the importance of the endothelium because few people undergo testing for it. Testing modalities are currently limited, and often involve procedures which can be hard to perform such as flow-mediated dilation (FMD) to evaluate endothelial function. FMD measures the endothelial response during reactive hyperemia (changes in blood flow). However, it has shortcomings in that it is difficult to perform and is subject to a high degree of user dependent test variability.

While the literature supports endothelial assessment as being a valuable precursor of CVD and atherosclerosis, many of the tests to evaluate it can be invasive or difficult to perform and, all too often, are not ordered until the disease has undergone significant progression.

We believe that a non-invasive, reproducible, and instantaneous test of endothelial function could be a game-changer for long term cardiovascular disease prevention. Lexington Biosciences has developed an easy-to-use device that will enable users to obtain endothelial function measurements as easily as stepping on a scale or measuring blood pressure or temperature, that can be done in a clinic or potentially even from the comfort of home. We are optimistic that HeartSentry can help to fill this important need, advancing the field to help prevent cardiovascular diseases like heart attack and stroke.

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