Diminished endothelial activity (EA) has been associated with an increased risk of incident cardiovascular disease (CAD) events.
Methods:
Vasodilatory responses (EA and relative distensibility [RD]) were evaluated noninvasively using iontophoresis of acetylcholine (ACH) and sodium nitroprusside (SNP) and recorded by laser Doppler fluxmetry (LDF) and photoplethysmography (PPG) among 324 patients.
Results:
The EA after ACH iontophoresis measured by LDF was significantly higher in the younger (<50 years) group than in the older (>50 years) group, 125.4 versus 103.3 integrated arbitrary unit (P < .005). Compared to the older patients, the EA values recorded by LDF were significantly lower in patients with diabetes mellitus (64.9), hypercholesterolemia (83.3), hypertension (88.7), CAD (61.0), and peripheral artery disease (67.4). The findings of RD were similar.
Conclusions:
The results indicate that measuring EA using the iontophoresis of ACH or SNP and combined with either LDF or PPG is a viable approach that can discriminate between different clinical groups.
BonettiPOLermanLOLermanA. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscl Thromb Vasc Biol. 2003;23(2):169–175.
2.
AndersonTJGerhardMDMeredithIT, et al. Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol.1995;75(6):71B–74B.
3.
TargonskiPVBonettiPOPunpaGMHiganoSTHolmesDRJLermanA. Coronary endothelial dysfunction is associated with an increased risk of cerebrovascular events. Circulation. 2002;107(22):2805–2809.
4.
VitaJAKeaneyJF. Endothelial function: a barometer for cardiovascular risk. Circulation. 2002;106(6):640–642.
5.
WidlanskyMEGokeeNKeaneyJFJrVitaJA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol. 2003;42(7):1149–1160.
6.
KatzSDBalidermajKHommaSWuHWongJMaybaumS. Acute type 5 phosphodiesterase inhibition with Sildenafil enhances flow mediated vasodilation in patients with chronic heart failure. Am Coll Cardiol. 2000;36(3):845–851.
7.
ChenYDuRTraverseJHBacheRJ. Effect of Sildenafil on coronary active and reactive hyperemia. Am J Physiol Heart Circ Physiol. 2000;279(5):H2319–H2325.
8.
TreasureCBKleinLWeintraubWS. Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease. N Engl J Med. 1995;332(8):481–487.
9.
YasueHMatsuyamaKMatsuyamaKOkamuaKYasuhiroMHisaoO.Responses of angiographically normal human coronary arteries to intracoronary injection of acetylcholine by age and segment. Possible role of early coronary atherosclerosis. Circulation. 1990;81(2):482–490.
10.
AndersonTJUehataAGerhardMD. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol. 1995;26(5):1235–1241.
11.
PanzaJACasinoPRBadarDMQuyyumiAA. Effect of increased availability of endothelium derived nitric oxide precursor on endothelium-dependent vascular relaxation in normal subjects and in patients with essential hypertension. Circulation. 1993;87(5):1475–1481.
12.
NabelEGSelwynAPGanzP. Large coronary arteries in humans are responsive to changing blood flow: an endothelium-dependent mechanism that fails in patients with atherosclerosis. J Am Coll Cardiol. 1990;16(2):349–356.
13.
EsperRJVilarinoJCacharronJL. Impaired endothelial function in patients with rapidly stabilized unstable angina: assessment by noninvasive brachial artery ultrasography. Clin Cardiol. 1999;22(11):699–703.
14.
LiebermanEHGerhardMDUehataA. Flow-mediated vasodilation of the human brachial artery is impaired in patients < 40 years of age with coronary artery disease. J Cardiol. 1996;78(11):1210–1214.
15.
MeredithITCurrieKEAndersonTJRoddyMAGanzPCreagerMA. Postischemic vasodilation in human forearm is dependent on endothelium-derived nitric oxide. Am J Physiol. 1996;270(4 pt 2):H1435–H1440.
16.
HigashiYSasakiSNakagawaKMatsuraHKajiymaGOshimaT. A noninvasive measurement of reactive hyperemia that can be used to assess resistance artery endothelial function in humans. Am J Cardiol. 2001;87(1):121–125.
17.
SagachVFTkachenkoMN. On the mechanism of the involvement of endothelium in reactive hyperemia. Experientia. 1991;47(8):828–830.
18.
CelermajerDSSorensenKEGoochVM. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. 1992;340(8828):1111–1115.
19.
FronekADi TomassoDGAllisonM. Noninvasive assessment of endothelial activity in patients with peripheral arterial disease and cardiovascular risk factors. Endothelium. 2008;14(4-5):199–205.
20.
FronekALangerRDAllisonMTranJ. Iontophoretically examined endothelial activity in patients with coronary disease. VASA. 2008;37(2):137–142.
21.
MorrisSJShoreACTookeJE. Response of the skin microcirculation to acetylcholine and sodium nitroprusside in patients with NIDDM. Diabetologia. 1995;38(11):1337–1339.
22.
ArndtJO. Ueber die Mechanik der intakten A.communis des Menschen unter verschiedenen Kreislaufbedingungen. Arch f Kreislaufforschung. 1969;59(1-2):153–197.
23.
AllisonMACriquiMHWrightCM. Patterns and risk factors for systemic calcified Atherosclerosis. Arterioscler Thromb Vasc Biol. 2004;24(2):331–336.
