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Close relation of endothelial function in the human coronary and peripheral circulations
Open accessAbstract
Objectives The relation between endothelium-dependent vasodilator function in the brachial and coronary arteries was determined in the same subjects.Background Coronary artery endothelial dysfunction precedes the development of overt atherosclerosis and is important in its pathogenesis. A noninvasive assessment of endothelial function in a peripheral conduit vessel, the brachial artery, was recently described, but the relation between brachial artery function and coronary artery vasodilator function has not been explored.Methods In 50 patients referred to the catheterization laboratory for the evaluation of coronary artery disease (mean age +/- SD 56 +/- 10 years), the coronary vasomotor response to serial intracoronary infusions of the endothelium-dependent agonist acetylcholine (10(-8) to 10(-6) mol/liter), was studied. Endothelium-dependent vasodilation was also assessed in the brachial artery by measuring the change in brachial artery diameter in response to reactive hyperemia.Results Patients with coronary artery endothelial dysfunction manifested as vasoconstriction in response to acetylcholine had significantly impaired flow-mediated vasodilation in the brachial artery compared with that of patients with normal coronary endothelial function (4.8 +/- 5.5% vs. 10.8 +/- 7.6%, p < 0.01). Patients with coronary artery disease also had an attenuated brachial artery vasodilator response compared with that of patients with angiographically smooth coronary arteries (4.5 +/- 4.6% vs. 9.7 +/- 8.1%, p < 0.02). By multivariate analysis, the strongest predictors of reduced brachial dilator responses to flow were baseline brachial artery diameter (p < 0.001), coronary endothelial dysfunction (p = 0.003), the presence of coronary artery disease (p = 0.007) and cigarette smoking (p = 0.016). The brachial artery vasodilator response to sublingual nitroglycerin was independent of coronary endothelial responses or the presence of coronary artery disease. The positive predictive value of abnormal brachial dilation ( < 3%) in predicting coronary endothelial dysfunction is 95%.Conclusions This study demonstrated a close relation between coronary artery endothelium-dependent vasomotor responses to acetylcholine and flow-mediated vasodilation in the brachial artery. This noninvasive method may become a useful surrogate in assessing the predisposition to atherosclerosis in patients with cardiac risk factors.
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“endothelial dysfunction, which can be defined as a reduced vasodilator response to acetylcholine, is an early prognostic indicator for the onset of cardiovascular disease (168–171).”
From A Critical Review of the Evidence That Metformin Is a Putative Anti-Aging Drug That Enhances Healthspan and Extends Lifespan (2021) · cites this paper as [169]
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Isoflavones improve vascular reactivity in post-menopausal women with hypercholesterolemia
Lissin, L. W., Oka, R. K., Lakshmi, S., & Cooke, J. P. (2004) · Vascular Medicine · doi:10.1191/1358863x04vm531oa · Cited by 63
Dissecting the genetic architecture of the cardiovascular and renal stress response
Snieder, H., Harshfield, G. A., Barbeau, P., Pollock, D. M., Pollock, J. S., & Treiber, F. A. (2002) · Biological Psychology · doi:10.1016/s0301-0511(02)00053-4 · Cited by 63
“…or brachial arteries to reactive hyperemia has been associated with elevated resting BP, smoking, hypercholesterolemia and has differentiated individuals with and without CVD or EH (Anderson and Armstead, 1995; Anderson et al., 1995; Celermajer et al., 1994a,b, 1992; Luscher and Vanhoutte, 1990).”
Takase, B., Hamabe, A., Satomura, K., Akima, T., Uehata, A., Ohsuzu, F., Ishihara, M., & Kurita, A. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2004.12.021 · Cited by 63
Pálinkás, A. (2002) · European Heart Journal · doi:10.1053/euhj.2002.3170 · Cited by 63
“Via Moruzzi, 1 56126 Pisa, Italy. function [5] [6] and can be evaluated non-invasively with brachial ultrasound [7] [8] .”
BackgroundThe Arterial System in Human Hypertension
Duprez, D. A., & Cohn, J. N. (2007) · Elsevier eBooks · doi:10.1016/b978-0-323-03961-1.50015-5 · Cited by 63
Altered Endothelial Function in Asymptomatic Male Adolescents with Type 1 Diabetes
Mahmud, F. H., Earing, M. G., Lee, R. A., Lteif, A. N., Driscoll, D. J. O., & Lerman, A. (2006) · Congenital Heart Disease · doi:10.1111/j.1747-0803.2006.00015.x · Cited by 61
Physiological testosterone replacement and arterial endothelial function in men
Sader, M. A., Griffiths, K. A., Skilton, M. R., Wishart, S. M., Handelsman, D. J., & Celermajer, D. S. (2003) · Clinical Endocrinology · doi:10.1046/j.1365-2265.2003.01796.x · Cited by 62
“Arterial FMD measurements reflect predominantly nitric oxide release (Joannides et al., 1995) and correlate significantly with coronary endothelial function (Anderson et al., 1995) and coronary atherosclerosis (Neunteufl et al., 1997).”
BackgroundEnseleit, F., Hürlimann, D., & Lüscher, T. F. (2001) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-200109011-00004 · Cited by 63
“Endothelium-dependent vasodilation in the human forearm and coronary vascular beds are strongly correlated (75,76).”
BackgroundFelmeden, D. C., Blann, A. D., Spencer, C., Beevers, D. G., & Lip, G. Y. H. (2003) · Blood Coagulation & Fibrinolysis · doi:10.1097/00001721-200307000-00001 · Cited by 62
Ticagrelor Improves Peripheral Arterial Function in Patients with a Previous Acute Coronary Syndrome
Törngren, K., Öhman, J. N., Salmi, H., Larsson, J., & Erlinge, D. (2013) · Cardiology · doi:10.1159/000347122 · Cited by 62
Karatzi, K., Papamichael, C. M., Karatzis, E. N., Papaioannou, T. G., Voidonikola, P. T., Vamvakou, G. D., Lekakis, J. P., & Zampelas, A. (2008) · Journal of the American College of Nutrition · doi:10.1080/07315724.2008.10719724 · Cited by 61
“The method we used (FMD) is a non-invasive, easy to perform method to assess endothelial function, it is closely related to coronary endothelial function [22] and it has been related with several established risk factors [23].”
MethodCampuzano, R., Moya, J. L., García‐Lledó, A., Tomas, J. P., Ruíz, S., Megı́as, A., Balaguer, J., & Asín, E. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000239294.17636.27 · Cited by 61
Fiedorowicz, J. G., Coryell, W. H., Rice, J. P., Warren, L. L., & Haynes, W. G. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000334779 · Cited by 62
Filardi, P. P., Cuocolo, A., Brevetti, G., Silvestro, A., Storto, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Camerino, R., Polimeno, M., et al. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.06.084 · Cited by 61
Limb-specific differences in flow-mediated dilation: the role of shear rate
Nishiyama, S. K., Wray, D. W., Berkstresser, K. A., Ramaswamy, M., & Richardson, R. S. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00273.2007 · Cited by 61
“Predominantly employed in the brachial artery (BA), FMD testing has been widely used as an index of global vascular health and coronary vasoreactivity (1, 33, 34).”
MethodPegge, N. C., Twomey, A. M., Vaughton, K. C., Gravenor, M. B., Ramsey, M. W., & Price, D. E. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01911.x · Cited by 61
Søndergaard, E. V., Møller, J. E., & Egstrup, K. (2003) · American Heart Journal · doi:10.1016/s0002-8703(03)00078-4 · Cited by 61
Measuring FMD in the brachial artery: how important is QRS gating?
Kizhakekuttu, T. J., Gutterman, D. D., Phillips, S. A., Jurva, J. W., Arthur, E. I. L., Das, E., & Widlansky, M. E. (2010) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00532.2010 · Cited by 60
Neukamm, A. M. C., Høiseth, A. D., Einvik, G., Lehmann, S., Hagve, T., Søyseth, V., & Omland, T. (2014) · Journal of Internal Medicine · doi:10.1111/joim.12337 · Cited by 60
Vasoprotective endothelial effects of a standardized grape product in humans
Chaves, A., Joshi, M. S., Coyle, C. M., Brady, J. E., Dech, S. J., Schanbacher, B. L., Baliga, R. S., Basuray, A., & Bauer, J. A. (2008) · Vascular Pharmacology · doi:10.1016/j.vph.2008.08.004 · Cited by 60
ACE Inhibition and Endothelial Function: Main Findings of PERFECT, a Sub-Study of the EUROPA Trial
Bots, M. L., Remme, W. J., Lüscher, T. F., Fox, K. M., Bertrand, M. E., Ferrari, R., Simoons, M. L., Grobbee, D. E., & EUROPA-PERFECT Investigators (2007) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-007-6041-3 · Cited by 61
“It had been argued that in clinical trials the number of subjects needed should be such that at least a 2% difference in FMD is detectable [23].”
BackgroundGevaert, A. B., Lemmens, K., Vrints, C. J., & Craenenbroeck, E. M. V. (2017) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2017/4865756 · Cited by 60
“The peripheral circulation is the preferred organ system for measuring endothelial-dependent vasodilation, because of the easy, noninvasive measurement and the good correlation with “gold standard” invasive coronary vasodilation [60].”
BackgroundScott, S. N., Shepherd, S. O., Hopkins, N. D., Dawson, E. A., Strauss, J. A., Wright, D. J., Cooper, R. G., Kumar, P., Wagenmakers, A. J. M., & Cocks, M. S. (2019) · The Journal of Physiology · doi:10.1113/jp278062 · Cited by 65
“2011) and is a surrogate of coronary artery endothelial function (Anderson et al. 1995).”
BackgroundAssessment of Vascular Endothelial Function With Peripheral Arterial Tonometry
Patvardhan, E. A., Heffernan, K. S., Ruan, J., Soffler, M. I., Karas, R. H., & Kuvin, J. T. (2009) · Cardiology in Review · doi:10.1097/crd.0b013e3181c46a15 · Cited by 60
“Numerous studies have shown that endothelial dysfunction is a diffuse disease process, including coronary and peripheral arteries, and it occurs in patients with cardiovascular risk factors, even in the absence of clinically significant atherosclerotic plaque deposition.(5,6) Neunteufl et al have also shown that perip…”
BackgroundMalik, A. R., Sultan, S., Turner, S. T., & Kullo, I. J. (2007) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1002143 · Cited by 59
Takase, B., Goto, T., Hamabe, A., Uehata, A., Kuroda, K., Satomura, K., Ohsuzu, F., & Kurita, A. (2003) · Journal of Human Hypertension · doi:10.1038/sj.jhh.1001599 · Cited by 58
Evaluación no invasiva de la función endotelial en la práctica clínica
Arrebola-Moreno, A. L., Laclaustra, M., & Kaski, J. C. (2011) · Revista Española de Cardiología · doi:10.1016/j.recesp.2011.09.012 · Cited by 59
Folic acid improves endothelial function in children and adolescents with type 1 diabetes
Peña, A. S., Wiltshire, E. J., Gent, R. J., Hirte, C., & Couper, J. (2004) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2003.12.049 · Cited by 59
The impact of heavy passive smoking on arterial endothelial function in modernized Chinese
Woo, K. S., Chook, P., Leong, H. C., Huang, X. S., & Celermajer, D. S. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00860-3 · Cited by 59
Metadata
- Authors
- Anderson, T. J., Uehata, A., Gerhard, M. D., Meredith, I. T., Knab, S., Delagrange, D., Lieberman, E. H., Ganz, P., Creager, M. A., Yeung, A. C., & Selwyn, A. P.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 1995-11
- Volume
- 26
- Issue
- 5
- Pages
- 1235-1241
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1980445357
- Cited by
- 2,033
- References
- 24
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 26 · 2023: 30 · 2022: 25 · 2021: 50 · 2020: 47 · 2019: 42 · 2018: 41 · 2017: 61 · 2016: 67 · 2015: 72 · 2014: 82 · 2013: 75 · 2012: 66
- FWCI
- 25.71
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k04hl002566-04, 5k08hl002787-05, 5k07hl002663-02)
- National Heart, Lung, and Blood Institute (HL02663, 1K04-HL-02566, 1K08 HL-02787)
- 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, coronary artery disease, brachial artery flow-mediated dilation, coronary vasodilation, acetylcholine, reactive hyperemia, cigarette smoking, nitroglycerin, atherosclerosis risk prediction, coronary artery disease screening, brachial artery diameter, vasoconstriction
- MeSH terms
- Acetylcholine, Adult, Aged, Brachial Artery, Coronary Artery Disease, Coronary Vessels, Endothelium, Vascular, Female, Nitroglycerin, Cardiac Catheterization, Humans, Male, Middle Aged, Predictive Value of Tests, Vasodilation, Vasodilator Agents
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