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Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis
Open accessAbstract
Endothelial dysfunction is an early event in experimental studies of atherogenesis, preceding formation of plaques. We have devised a non-invasive method for testing endothelial function, to find out whether abnormalities are present in symptom-free children and young adults at high risk of atherosclerosis. With high-resolution ultrasound, we measured the diameter of the superficial femoral and brachial arteries at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation), and after sublingual glyceryl trinitrate (GTN; causing endothelium-independent dilatation) in 100 subjects--50 controls without vascular risk factors (aged 8-57 years), 20 cigarette smokers (aged 17-62 years), 10 children with familial hypercholesterolaemia (FH; aged 8-16 years), and 20 patients with established coronary artery disease (CAD). Adequate scans were obtained in all but 6 cases. Flow-mediated dilatation was observed in arteries from all control subjects. Dilatation was inversely related to baseline vessel diameter (r = -0.81, p < 0.0001); in arteries of 6.0 mm or less, mean dilatation was 10 (SE 2)%. In smokers, FH children, and adults with CAD, flow-mediated dilatation was much reduced or absent (p < 0.001 for comparison with each relevant control group). Dilatation in response to GTN was present in all groups. Endothelial dysfunction is present in children and adults with risk factors for atherosclerosis, such as smoking and hypercholesterolaemia, before anatomical evidence of plaque formation in the arteries studied. This may be an important early event in atherogenesis.
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Metadata
- Authors
- Celermajer, D. S., Sorensen, K. E., Gooch, V. M., Spiegelhalter, D. J., Miller, O. I., Sullivan, I. D., Lloyd, J. K., & Deanfield, J. E.
- Affiliations
- Great Ormond Street Hospital (GB)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1992-11
- Volume
- 340
- Issue
- 8828
- Pages
- 1111-1115
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2063506869
- Cited by
- 4,742
- References
- 32
- Citations by year
- 2026: 40 · 2025: 74 · 2024: 77 · 2023: 105 · 2022: 96 · 2021: 118 · 2020: 133 · 2019: 117 · 2018: 145 · 2017: 144 · 2016: 183 · 2015: 158 · 2014: 198 · 2013: 210 · 2012: 224
- FWCI
- 23.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Hjerteforeningen
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- endothelial dysfunction, atherosclerosis, flow-mediated dilation, reactive hyperemia, nitroglycerin, superficial femoral artery, brachial artery, high-resolution ultrasound, familial hypercholesterolemia, smoking, coronary artery disease, children, atherogenesis, vascular risk factors
- MeSH terms
- Adolescent, Adult, Aged, Arteriosclerosis, Blood Flow Velocity, Brachial Artery, Child, Coronary Disease, Endothelium, Vascular, Female, Femoral Artery, Humans, Hyperlipoproteinemia Type II, Male, Middle Aged, Risk Factors, Smoking, Ultrasonography, Reproducibility of Results
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