Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in the pathogenesis of atherosclerosis. Thus, the assessment of endothelial function in people without overt CVD allows for a more accurate estimate of the risk of developing CVD and cardiovascular events. The assessment of endothelial function is primarily used in scientific research, and to a lesser extent in clinical practice. Among the tools for assessing endothelial function, we can distinguish biochemical and physical methods, while physical methods can be divided into invasive and non-invasive methods. Flow-mediated dilation (FMD) is based on the ultrasound assessment of changes in the diameter of the brachial artery as a result of increased blood flow. FMD is a non-invasive, safe, and repeatable test, but it must be performed by qualified and experienced medical staff. The purpose of this paper is to present the literature review results on the assessment of endothelial function using the FMD method, including its methodology, applications in clinical practice and research, limitations, and future perspectives.

Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components.

Introduction: Transthoracic echocardiography (TTE) and cardiovascular magnetic resonance (CMR) are the most important modalities used in clinical practice to assess cardiac chambers. However, different imaging techniques may affect their results and conclusions. The aim of our study was to compare left-ventricle (LV) remodeling assessed using TTE and CMR in the context of various cardiovascular diseases. Methods: A total of 202 consecutive patients sent for an elective cardiovascular diagnosis were scheduled for a 2D TTE and CMR, performed within 2 weeks. The study group was divided and analyzed based on the clinical indications for CMR, including coronary artery disease, heart failure, native aortic valve regurgitation or paravalvular leak after aortic valve replacement, or cardiomyopathies. Results: The mean LV mass index (LVMi) values calculated using TTE were significantly larger (127.1 ± 44.5 g/m²) compared to the LVMi assessed using CMR (77.1 ± 26.2 g/m²; p < 0.001). The LV end-diastolic volumes assessed using TTE were underestimated for all the study patients (78.6 ± 43 mL vs. 100.5 ± 39 mL; p < 0.0001) and subgroups, but a statistical trend was observed in patients with cardiomyopathy. Those differences in single parameters led to differences in LV remodeling and the final treatment decision. CMR and TTE provided similar conclusions on LV systolic dysfunction in 68% of the patients. Conclusions: Our results showed that the greater the degree of LV remodeling and dysfunction, the greater the difference between the modalities. Therefore, CMR should be introduced into routine clinical practice, especially for patients undergoing LV remodeling, which may change clinical decisions in a considerable number of cases.

Background: High-sensitivity cardiac troponin T serum concentration (hs-cTnT) measurement is a well-established tool in the diagnosis of acute cardiovascular (CV) disease. It remains unclear whether resting hs-cTnT could be useful for screening the status of the CV system. The purpose of this study was to compare the correlation between hs-cTnT, determined in patients without clinical symptoms of acute illness, and selected parameters of subclinical CV dysfunction in relation to the coexistence of arterial hypertension (AH). Methods: In total, 101 patients were included in the analysis. The following methods were used to assess the CV system: transthoracic echocardiography, Doppler ultrasonography of the carotid and lower extremity arteries with intima–media thickness (IMT) measurement, pulse wave velocity (PWV), central blood pressure measurement, ankle–brachial index (ABI), and toe–brachial index (TBI). Results: In patients with AH, significant correlations were found between hs-cTnT and maximal velocity of tricuspid regurgitation (R = 0.397; p = 0.003), left atrium volume index (LAVI) (R = 0.39; p = 0.002), and IMT in carotid arteries (cIMT) (R = 0.4; p = 0.001), common femoral arteries (cfIMT) (R = 0.384; p = 0.004), and superficial femoral arteries (sfIMT) (R = 0.352; p = 0.01), as well as PWV (R = 0.63; p < 0.001), central systolic blood pressure (cSBP) (R = 0.34; p = 0.006), central pulse pressure (cPP) (R = 0.354; p = 0.004), and ankle–brachial index (ABI) (R = −0.28; p = 0.024). In multivariate analysis, the relationship between subclinical CV dysfunction and hs-cTnT remained significant for LAVI, cSBP, cPP, and ABI, as well as showing borderline significance for sfIMT. In patients without AH, only the relationship between hs-cTnT and ABI was significant. According to interaction analysis, AH significantly influenced the relationship between hs-cTnT and cSBP, cPP, and sfIMT. Conclusions: Resting hs-cTnT correlates significantly with selected parameters of subclinical CV dysfunction in patients with AH. This relationship is clearly weaker in patients without AH. Further research is needed, especially prospective studies on a larger group of patients.

Background: Metabolic syndrome (MetS) comprises coexisting risk factors enhancing the likelihood of developing cardiovascular disease (CVD). The aim of this study was to investigate the correlation between the number of MetS components and subclinical cardiac dysfunction, assessed via transthoracic echocardiography (TTE), in individuals without overt CVD. Methods: A retrospective analysis was performed using data from 100 patients (63% female; mean age 58.8 ± 16.81 years) hospitalized in the Department of Internal Medicine, Angiology and Physical Medicine at the Medical University of Silesia in Katowice, Poland, between June 2022 and February 2024. The inclusion criteria were the absence of diagnosed atherosclerotic CVD and no evidence of acute illness or exacerbation of chronic diseases. Each participant was evaluated for MetS components and underwent TTE. Results: Univariate analysis revealed significant correlations between the number of MetS components and selected TTE parameters, including left ventricular mass (LVM) (R = 0.406; p < 0.001), left ventricular mass index (LVMI) (R = 0.248; p = 0.013), left ventricular ejection fraction (LV EF) (R = −0.261; p = 0.009), left atrial volume (LAV) (R = 0.312; p < 0.001), and left atrial volume index (LAVI) (R = 0.273; p = 0.007). These correlations did not remain significant after adjusting for age, sex, and body mass index (BMI). Among patients not meeting the full diagnostic criteria for MetS, LAV and LAVI values remained significantly correlated with the number of MetS components, independent of confounding variables. Conclusions: The selected echocardiographic parameters were significantly correlated with the number of MetS components; however, most associations were explained by age, sex, and BMI.

Background: Metabolic syndrome (MetS) refers to the coexistence of cardiometabolic disorders, such as hyperglycemia, elevated blood pressure, visceral obesity, or features of atherogenic dyslipidemia. A diagnosis of MetS significantly increases the risk of cardiovascular disease (CVD). However, the exact relationship between the number of MetS components, regardless of their constellation, and features of subclinical cardiovascular dysfunction remains unclear. This study aimed to explore the relationship between the number of MetS components and features of subclinical atherosclerosis and arterial stiffness (AS) in patients without clinically overt CVD. Methods: This retrospective study included 100 patients (mean age: 58.8 ± 16.81 years), without signs of acute illness or diagnosed atherosclerotic CVD, who were admitted to a clinic for scheduled internal medicine diagnostics. Participants were assessed for MetS components and underwent cardiovascular tests, including Doppler ultrasonography of the carotid, vertebral, and lower limb arteries; measurement of intima–media thickness (IMT) in the carotid (cIMT), common femoral (cfIMT), and superficial femoral (sfIMT) arteries; and assessment of AS using carotid–femoral pulse wave velocity (cfPWV) and pulse wave analysis (PWA). Results: Univariate analysis revealed significant correlations between the number of MetS components and IMT in all vascular beds: cIMT (R = 0.371; p < 0.001), cfIMT (R = 0.343; p < 0.001), and sfIMT (R = 0.516; p < 0.001). Significant correlations were also found for several AS and PWA parameters: cfPWV (R = 0.398; p < 0.001), central pulse pressure (cPP) (R = 0.223; p < 0.026), and end-systolic pressure (ESP) (R = 0.241; p = 0.016). Meanwhile, in the multivariable analysis adjusted for sex, age, and body mass index (BMI), only the association between the subendocardial viability ratio (SEVR) and the number of MetS components was significant (β = 0.33; 95% CI 0.084–0.577; p = 0.009); however, this association does not remain significant after Benjamini–Hochberg correction (p = 0.108). Conclusions: Although the number of MetS components correlated significantly with several parameters of subclinical atherosclerosis and AS, most associations were explained by confounding variables. These results do not support the use of a simple count of MetS components as an indicator of subclinical cardiovascular dysfunction related to atherosclerosis and AS.