Endothelial function of internal mammary artery in patients with coronary artery disease and in cardiac transplant recipients

Berkenboom, Guy; Crasset, Vincent; Giot, Christophe; Unger, Philippe; Vachiéry, Jean‐Luc; Leclerc, Jean Louis

doi:10.1016/s0002-8703(98)70326-6

Cited by 21 publications

(17 citation statements)

References 21 publications

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“…Endothelial dysfunction and impaired regulation of vasomotor tone were commonly seen in patients with chronic heart failure [10,38], and these conditions persisted after HTx [39,40,41]. They have been associated with cardiovascular-related complications such as hypertension, atherosclerosis and clinical events in heart failure patients [41,42].…”

Section: Discussionmentioning

confidence: 99%

Effects of Exercise Training in Heart Transplant Recipients: A Meta-Analysis

Hsieh

Chao

2011

Cardiology

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Objectives: Muscle wasting and exercise intolerance are common in heart transplant recipients. Most studies on the effects of exercise training have used relatively small sample sizes and are heterogeneous in nature. The purpose of this meta-analysis was to systematically review the relevant studies and investigate the effects of exercise training on exercise capacity and muscle strength in heart transplant recipients. Methods: A systematic search was adopted from electronic databases and relevant references, using medical subject heading key words related to heart transplantation and exercise. Only randomized controlled trials with exercise intervention versus usual care were included. The data were expressed as the weighted mean differences with 95% confidence intervals (CIs). Results: Altogether 6 studies were included. Peak oxygen consumption (VO₂) was reported in 4 trials (117 patients), and muscle strength was reported in 3 trials (67 patients). Peak VO₂ was significantly increased by 2.34 ml/kg/min (95% CI 0.63–4.05). One-repetition maxima of the chest press (23.28 kg, 95% CI 0.64–45.91) and leg press (28.84 kg, 95% CI 5.70–51.98) were significantly improved by exercise training. Conclusion: Exercise training is recommended for heart transplant recipients to improve peak VO₂ and muscle strength despite the small number of trials included in this meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Effects of Exercise Training in Heart Transplant Recipients: A Meta-Analysis

Hsieh

Chao

2011

Cardiology

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“…Furthermore, FMD was also reduced at 2 and 3 min post-wrist-cuff release, further indicating endothelial dysfunction rather than delayed vascular smooth muscle responsiveness to NO. Impaired FMD with preserved GTN-mediated endothelium-independent dilatation is well described in the presence of both overt vascular disease and many identified vascular risk factors (13,28). Since GTN donates NO directly to vascular smooth muscle, then GTN causes vasodilatation irrespective of endothelial integrity, as this is an endothelium-independent mechanism.…”

Section: Discussionmentioning

confidence: 99%

The effect of GH replacement therapy on endothelial function and oxidative stress in adult growth hormone deficiency

Evans

Davies

Anderson

et al. 2000

European Journal of Endocrinology

103

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Objectives: Controversy persists with regard to the atherogenic risk associated with adult growth hormone deficiency (GHD). Endothelial dysfunction and enhanced oxidative stress are early features of atherogenesis. Therefore, we have studied the effect of three months of low dose GH replacement therapy (0.03 IU/kg/day) on these parameters in GHD adults. Subjects and Methods: Eight hypopituitary GHD adults (4 male, 4 female), who were receiving conventional hormone replacement therapy, were studied before and after 3 months of GH replacement (0.03 IU/kg/day). All observations obtained were compared with similar measurements made in 8 matched control subjects. All study subjects were non-smokers, normotensive and gave no personal or family history of premature vascular disease. Endothelial function was assessed using a specialised vessel wall tracking system to measure endothelium-dependent, flow-mediated, brachial artery dilatation (FMD). Measurements were repeated following glyceryl-trinitrate (GTN) (endotheliumindependent dilatation). Oxidative stress was assessed by directly measuring lipid-derived free radicals in venous blood by electron paramagnetic resonance spectroscopy. Fasting lipids, insulin, plasma glucose and IGF-I were also measured at baseline and following GH replacement. Results: FMD, expressed as a percentage change from resting base-line diameter, was significantly impaired in the pre-treatment GHD patients compared with controls (3.1 Ϯ 2.1% vs 6.1 Ϯ 0.9%, P < 0.001; means Ϯ S.D.) indicating endothelial dysfunction. Significant increase in FMD was noted following GH therapy (3.1 Ϯ 2.1% vs 6.5 Ϯ 1.9%, P < 0.001). Free radicals (arbitrary units) were elevated in the pre-treatment GHD patients compared with controls (0.36 Ϯ 0.09 vs 0.11 Ϯ 0.12, P < 0.05) and fell significantly following GH therapy (0.23 Ϯ 0.03 vs 0.36 Ϯ 0.09, P < 0.05), although they remained elevated compared with controls. Fasting insulin was significantly higher (25.9 Ϯ 18.8 vs 13.9 Ϯ 6.7 mu/l, P < 0.05) and IGF-I concentrations lower (10.8 Ϯ 4.7 vs 20.2 Ϯ 6.3 nmol/l, P < 0.05) in the pre-treatment GHD subjects. After treatment there were no changes in insulin concentration, although IGF-I levels were normalised (10.8 Ϯ 2.3 vs 23.6 Ϯ 11.4 nmol/l, P < 0.05). Conclusions: Endothelial dysfunction and enhanced oxidative stress are features of adult GHD. This study suggests plausible mechanisms underlying any proatherogenic tendency in adult GHD and demonstrates improvement of these factors following GH replacement.

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“…Recently, endothelial dysfunction has been reported in muscle blood vessels 1-13 years after transplantation (Berkenboom et al 1998;Holm et al 2000;Schmidt et al 2002). Hypertension, increased levels of proinflammatory cytokines (Holm et al 2000) and/or prolonged use of cyclosporin may contribute to the gradual decline in endothelial function.…”

Section: Muscle Limitationsmentioning

confidence: 99%

Exercise after heart transplantation

Marconi¹,

Marzorati²

2003

European Journal of Applied Physiology

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Exercise intolerance in heart transplant recipients (HTR) has a multifactorial origin, involving complex interactions among cardiac, neurohormonal, vascular, skeletal muscle and pulmonary abnormalities. However, the role of these abnormalities may differ as a function of time after transplantation and of many other variables. The present review is aimed at evaluating the role of cardiac, pulmonary and muscular factors in limiting maximal aerobic performance of HTR, and the benefits of chronic exercise. Whereas pulmonary function does not seem to affect gas exchange until a critical value of diffusing lung capacity is attained, cardiac and skeletal muscle function deterioration may represent relevant factors limiting maximal and submaximal aerobic performance. Cardiac function is mainly limited by chronotropic incompetence and diastolic dysfunction, whereas muscle activity seems to be limited by impaired oxygen supply as a consequence of the reduced capillary network. The latter may be due to either immunosuppressive regimen or deconditioning. Endurance and strength training may greatly improve muscle function and maximal aerobic performance of HTR, and may also reduce side effects of immunosuppressive therapy and control risk factors for cardiac allograft vasculopathy. For the above reasons exercise should be considered an important therapeutic tool in the long-term treatment of heart transplant recipients.

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Endothelial function of internal mammary artery in patients with coronary artery disease and in cardiac transplant recipients

Cited by 21 publications

References 21 publications

Effects of Exercise Training in Heart Transplant Recipients: A Meta-Analysis

Effects of Exercise Training in Heart Transplant Recipients: A Meta-Analysis

The effect of GH replacement therapy on endothelial function and oxidative stress in adult growth hormone deficiency

Exercise after heart transplantation

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