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This included circumvention of the complex downhill syndrome, as well as a sudden decrease of blood supply, decreased NO levels in the inferior caval vein tissue, an immediate heavy loss of endothelial cells from the vascular wall, a lower eNOS production ability (Berra-Romani et al., 2013), and finally, the elimination of oxidative stress due to endothelial cell lysis (Rangan and Bulkley, 1993

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It plays an essential role in cellular energy production, metabolism, and DNA repair

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Some patients may interpret this plateau as treatment failure when it actually reflects normal physiological adaptation