Assessment of endothelial damage and dysfunction: observations in relation to heart failure

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Abstract
More than 150 years ago, Virchow proposed that abnormalities in blood flow, vessel wall and blood components predispose to thrombosis, constituting what is now known as ‘Virchow's triad’ for thrombogenesis.1 This rather simplistic view has been continually modified by new discoveries and concepts, as we now know that the process of thrombus formation requires complex interactions involving injury to the vascular endothelium, platelet adherence, aggregation and release, and clotting factor activation, eventually leading to thrombin generation and fibrin formation.2