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Int J Cardiol. 2013 Oct 9;168(4):3183-90. doi: 10.1016/j.ijcard.2013.07.236. Epub 2013 Aug 2.

Methodological considerations and practical recommendations for the application of peripheral arterial tonometry in children and adolescents.

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Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Antwerp, Belgium; Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Pediatrics, University Hospital Antwerp, Wilrijkstraat 10, 2650 Antwerp, Belgium.

Erratum in

  • Int J Cardiol. 2015 Aug 15;193:94.


Endothelial dysfunction is recognized as the primum movens in the development of atherosclerosis. Its crucial role in both cardiovascular morbidity and mortality has been confirmed. In the past, research was hampered by the invasive character of endothelial function assessment. The development of non-invasive and feasible techniques to measure endothelial function has facilitated and promoted research in various adult and paediatric subpopulations. To avoid user dependence of flow-mediated dilation (FMD), which evaluates nitric oxide dependent vasodilation in large vessels, a semi-automated, method to assess peripheral microvascular function, called peripheral arterial tonometry (Endo-PAT(®)), was recently introduced. The number of studies using this technique in children and adolescents is rapidly increasing, yet there is no consensus with regard to either measuring protocol or data analysis of peripheral arterial tonometry in children and adolescents. Most paediatric studies simply applied measuring and analysing methodology established in adults, a simplification that may not be appropriate. This paper provides a detailed description of endothelial function assessment using the Endo-PAT for researchers and clinicians. We discuss clinical and methodological considerations and point out the differences between children, adolescents and adults. Finally, the main aim of this paper is to provide recommendations for a standardised application of Endo-PAT in children and adolescents, as well as for population-specific data analysis methodology.


Endothelial function; Paediatrics; Peripheral arterial tonometry

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