Endothelial Dysfunction Among Woman With Endometriosis
Endothelial Dysfunction Among Woman With Endometriosis
Endometriosis is a chronic disease defined as an ectopic endometrial tissue outside the, and
 associated with chronic inflammatory state and increased risk of atherosclerosis.

 Endothelial dysfunction plays an important and elementary role in the development of
 atherosclerosis.

 There are number of non-invasive tests for evaluating the endothelial function. One of them
 is FMD - "Flow Mediated Dilatation". Clinical studies proved the efficacy of this method in
 predicting cardio-vascular events in patients with established heart disease and also as an
 independent risk factor, better than the traditional ones.

 An alternative method, developed in recent years, is evaluation of peripheral blood vessels
 tone - "Peripheral Arterial Tonometry" - (PAT). It evaluates the pulsatile blood volume of
 the blood vessels in the fingertips during reactive hyperemia. The obtained value "reactive
 hyperemic index" (RHI) correlates well with FMD as well with coronary arteries endothelial
 dysfunction.

 it well suited as a clinical tool or as a test for a large-scale clinical study.

 Endothelial dysfunction has been demonstrated among woman with endometriosis. After surgical
 removal of endometrial implants there was a substantial improvement in the endothelial
 function, by imaging (using FMD) and by inflammatory markers

 In this study the investigators will follow the endothelial function among women undergoing
 endometrial implants surgical removal, before and after the surgery, using PAT technology
 (ENDOPAT system). Inflammatory markers and quality of life parameters will also be evaluated.

 The follow-up will include one meeting 6 weeks after the procedure The investigators expect
 an improvement in the endothelial function among women who had endometriosis implants
 removal.
Endometriosis is a chronic disease defined as an ectopic endometrial tissue outside the
 uterus, mostly in the pelvis. It is related to major morbidity and infertility. It is also
 associated with chronic inflammatory state and increased risk of atherosclerosis.

 Endothelial dysfunction plays an important and elementary role in the development of
 atherosclerosis.

 There are number of non-invasive tests for evaluating the endothelial function. One of them
 is FMD - "Flow Mediated Dilatation". It refers to dilation (widening) of an artery when blood
 flow increases in that artery after An intentional block of the blood flow. Clinical studies
 proved the efficacy of this method in predicting cardio-vascular events in patients with
 established heart disease and also as an independent risk factor, better than the traditional
 ones.

 An alternative method, developed in recent years, is evaluation of peripheral blood vessels
 tone - "Peripheral Arterial Tonometry" - (PAT). It evaluates the pulsatile blood volume of
 the blood vessels in the fingertips during reactive hyperemia. The obtained value "reactive
 hyperemic index" (RHI) correlates well with FMD as well with coronary arteries endothelial
 dysfunction.

 The test is performed by attaching two sensors to the patient's fingertips. Using this method
 requires short training interval, completely user-independent and the accepted result is a
 quantitive index. Because it takes only 15 minute to complete the test it well suited as a
 clinical tool or as a test for a large-scale clinical study.

 Endothelial dysfunction has been demonstrated among woman with endometriosis. After surgical
 removal of endometrial implants there was a substantial improvement in the endothelial
 function, by imaging (using FMD) and by inflammatory markers, so no difference was shown
 between them and healthy women, 2 years thereafter.

 In a large meta-analysis, evaluating 5,547 patients, every 1% improvement in the FMD scale
 resulted in a 13% decrease in the rate of cardio-vascular events.

 In a meta-analysis evaluating 5,547 patients a 13% reduction in the risk to cardio-vascular
 events was demonstrated for every 1% improvement in the FMD score.

 In this study the investigators will follow the endothelial function among women undergoing
 endometrial implants surgical removal, before and after the surgery, using PAT technology
 (ENDOPAT system). Inflammatory markers and quality of life parameters will also be evaluated.

 The follow-up will include one meeting 6 weeks after the procedure the investigators expect
 an improvement in the endothelial function among women who had endometriosis implants
 removal.
Inclusion Criteria:

 -  Women who undergoing surgery for removal of endometriosis implants

 Exclusion Criteria:

 -  Women under 18 or above 60 years of age

 -  Women with known vascular disease

 -  Women with chronic disease which effect the endothelial function (Diabetes mellitus,
 Hypertension, Obesity (Defined as BMI≥30), Atherosclerosis, Kidney disease, Collagen
 disease, Chronic inflammatory disease, and Etc.

 -  History of Cardio-vascular event or venous thromboembolism (VTE)

 -  Smoking

 -  Pregnant women or gave birth in the past 3 months