The association of endothelial dysfunction and cardiovascular events in healthy subjects and patients with cardiovascular disease.

Abstract

BACKGROUND:

Endothelial dysfunction is recognized as a major factor in the development of atherosclerosis and it has a prognostic value.

OBJECTIVES:

To detect the long-term association of peripheral vascular endothelial function and clinical outcome in healthy subjects and patients with cardiovascular disease.

METHODS:

We prospectively assessed brachial artery flow-mediated dilatation in 110 consecutive subjects (46 CVD patients and 64 healthy controls), mean age 57 +/- 11 years; 68 were men. After an overnight fast and discontinuation of all medications for > or = 12 hours, percent improvement in FMD and nitroglycerin-mediated vasodilatation were assessed using high resolution ultrasound.

RESULTS:

%FMD but not %NTG was significantly lower in CVD patients (9.5 +/- 8.0% vs. 13.5 +/- 8.0%, P = 0.012) compared to healthy controls (13.4 +/- 8.0% vs. 16.7 +/- 11.0%, P = 0.084; respectively). In addition, an inverse correlation between %FMD and the number of traditional CVD risk factors was found among all study participants (r = -0.23, P = 0.015) and healthy controls (r = -0.23, P = 0.036). In a mean follow-up of 15 +/- 2 months, the composite CVD endpoints (all-cause mortality, myocardial infarction, hospitalization for heart failure or angina pectoris, stroke, coronary artery bypass grafting and percutaneous coronary interventions) were significantly more common in subjects with FMD < 6% compared to subjects with FMD > 6% (33.3% vs. 12.1%, P < 0.03, respectively).

CONCLUSIONS:

Thus, brachial artery %FMD provides important prognostic information in addition to that derived from traditional risk factor assessment.

• Authors: Michael Shechter, Ibrahim Marai, Saed Marai, Yaniv Sherer, Ben-Ami Sela, Micha S Feinberg, Ardon Rubinstein, Yehuda Shoenfeld
• Journal: The Israel Medical Association journal : IMAJ (Isr Med Assoc J) Vol. 9 Issue 4 Pg. 271-6 (Apr 2007) ISSN: 1565-1088 [Print] Israel
• PMID: 17491220 (Publication Type: Journal Article)

Chemical References

• Vasodilator Agents
• Nitroglycerin

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Brachial Artery (diagnostic imaging, drug effects, physiology)
• Cardiovascular Diseases (diagnostic imaging, physiopathology)
• Echocardiography
• Electrocardiography
• Endothelium, Vascular (diagnostic imaging, drug effects, physiology)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Nitroglycerin
• Prognosis
• Prospective Studies
• Risk Factors
• Time Factors
• Ultrasonography, Doppler, Pulsed
• Vasodilation (drug effects, physiology)
• Vasodilator Agents