Skip to main content

Archived Comments for: Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study

Back to article

  1. Bedside Evaluation endothelial Function in Hypertensives.

    Sergio Stagnaro, Quantum Biophysical Semeiotics Research Laboratory

    18 August 2008

    I find the paper fascinating and interesting. In addition, Authors’s data agree with my clinical results. The endothelium is notoriously the main regulator of vascular wall homeostasis. Physiologically, endothelial cells maintain a relaxed vascular tone, physiological chaotic movements of both macro- and micro-vessels (2, 3), and low levels of oxidative stress (eNO is a radical!), in part by releasing mediators, including NO, prostacyclin (PGI2), and endothelin (ET-1), and controlling local angiotensin II activity. In addition, the endothelium actively regulates vascular permeability to plasma constituents, platelet and leukocyte adhesion and aggregation, and thrombosis. This state of balanced endothelial regulation of blood vessel function is, however, altered by a number of conditions. Thus, in response to a variety of noxious stimuli, the endothelium undergoes a phenotypic modulation to a nonadaptive state, commonly termed "endothelial dysfunction," characterized by loss or dysregulation of homeostatic mechanisms operative in healthy endothelial cells. This pathophysiological condition is associated with increased expression of adhesion molecules, increased synthesis of proinflammatory and prothrombotic factors, increased oxidative stress, and abnormal modulation of vascular tone, which may lead to different functional manifestations, including impaired endothelium-dependent vasodilation1).

    Based on my 52-year-long clinical experience (See, I state that the evaluation of endothelial function, in every biological system, is realized nowadays also clinically with a simple stethoscope, thanks to Quantum Biophysical Semeiotics (2-10)( In fact, among different techniques to evaluate the endothelium functional capacity, that depend on the amount of “radical” NO produced and the vasoactive effects, nowadays there are biophysical-semeiotic methods, applicable on very large scale in a few minutes, even under stress tests. In fact, doctors may assess the intensity of endothelial cell “radical” NO synthesis in order to recognize both artery alteration and ALL other disorders, in simple way (1-5). The percentage of vasodilation immediately after Valsalva’s Manoeuvre, confronting it with the basal value, represents the endothelial functional capacity, that is in relation to the local parenchymal cell functions, according to my Angiobiopathy theory, which complete that of Tischendorf's Angiobiotopy (11). Taking into account that shear stress is one of the most important stimulants for the synthesis and release of “radical” NO, the non invasive technique most often used is the transient flow-modulate “endothelium-dependent” post-ischemic vasodilatation, performed on conductance arteries such as the brachial, radial or femoral arteries. Certainly shear-stress stimulates e-NO synthesis in healthy individual, as allows me to state Biophysical Semeiotics (1-5, 8-10). In addition doctors gather a lot of other information, e.g., after drugs administration (4-8). In fact, such as vasodilatation is compared with the vasodilatation produced by drugs that are NO donors, such as nitroglycerine, called “endothelium independent”. The vasodilatation is quantified by measuring the arterial diameter with high resolution ultrasonography. Laser-Doppler techniques are now starting to be used that also consider tissue perfusion. One must admitt that such as methods cannot be applied neither in apparently "healthy" individual in order to perform primary prevention, neither on very large scale even in diseased subjects. All that accounts for the reason that Microcirculation and Clinical Microangiology under both physiological and pathological conditions, are scarsely known by physicians all around the world, also at universities, unfortunately.

    Finally, thanks to Quantum Biophysical Semeiotics, as well as the unknown knowledge of non local realm in biological systems beside the local realm, I recently demonstrated (12-15), doctors are able in 1 second to bedside exclude macro- and micro-vessels alteration: in health, “intense” digital pressure, applied upon an artery do not bring about simultaneously aspecific gastric reflex, whereas such as reflex appears in presence of whatever vascular disorder Inherited Real Risk in individuals involved by well-defined Biophysical-Semeiotic Constitutions (12-14)


    1) Barac A; Campia U.; Panza J A. Methods for Evaluating Endothelial Function in Humans. Hypertension. 2007;49:748

    2). Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004.

    3) . Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione della compliance arteriosa e delle resistenze arteriose periferiche. Atti del XVII Cong. Naz. Soc. Ital. Studio Microcircolazione, Firenze Ott. 1995, Biblioteca Scient. Scuola Sanità Militare, 2, 93, 1995.

    4) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale – Acta Med. Medit. 13, 99, 1997.

    5) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. Acta Med. Medit. 13, 125, 1997.

    6) Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 , 1993[Medline]

    7) Stagnaro Sergio Endothelial cell function can ameliorate under safer drugs, such as Melatonin-Adenosine. BMC Cardiovascular disorders, 10 October 2004.

    8) Stagnaro S., Percussione Ascoltata degli Attacchi Ischemici Transitori. Ruolo dei Potenziali Cerebrali Evocati. Min. Med. 76, 1211, 1985 [Medline]

    9) Stagnaro-Neri M., Stagnaro S., La sindrome percusso-ascoltatoria da carenza di Carnitina. Clin. Ter. 145, 135, 1994 [Medline]

    10) Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617 [Medline]

    11) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. 2007

    12) Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica: Realtà non-locale in Biologia. Dicembre 2007,,

    13) Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica Quantistica.

    14) Stagnaro Sergio. Non Local Realm. Response to Selection for Social Signalling Drives the Evolution of Chameleon Colour Change. (01 February 2008).,

    Competing interests

    None declared