Mechanisms of Endothelial Dysfunction: Clinical Significance and Preventive Non-Pharmacological Therapeutic Strategies

Taddei, Stefano; Ghiadoni, Lorenzo; Virdis, Agostino; Versari, Daniele; Salvetti, A.

doi:10.2174/1381612033453866

Cited by 115 publications

(97 citation statements)

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“…Because both arterial stiffness 15 and endothelial dysfunction 17 are mechanisms and independent predictors of cardiovascular events, future studies are need to demonstrate that nonpharmacological strategies or pharmacological treatment aimed to prevent these vascular alterations [41][42][43] might modify the cardiovascular prognosis in subjects with MS.…”

Section: Perspectivesmentioning

confidence: 99%

Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus

et al. 2008

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Abstract-We evaluated the possible association between early vascular abnormalities and the metabolic syndrome (MS) in 77 normotensive subjects (mean age: 50 years) at risk of developing diabetes for family history of diabetes, obesity, or impaired fasting glucose. Fifty healthy subjects were recruited as controls. MS was defined according to the ATP III criteria. Brachial artery endothelium-dependent and -independent vasodilation were assessed as flow-mediated dilation (FMD) and response to glyceryl trinitrate (GTN, 25 g sublingual), respectively, by automatic computerized edge detection system. Carotid-femoral pulse wave velocity (PWV) and radial augmentation index (AIx) were assessed by applanation tonometry. PWV was significantly (PϽ0.01) higher in subjects with MS (nϭ29, 9.0Ϯ1.9 m/s) as compared with those without MS (nϭ48, 7.7Ϯ1.2 m/s) and controls (7.2Ϯ1.5 m/s). FMD was significantly (PϽ0.05) reduced in both subjects with (5.8Ϯ2.7%) and without MS (6.1Ϯ3.7%) as compared with controls (6.9Ϯ2.5%). No significant differences were found for response to GTN and AIx. PWV and FMD were significantly (PϽ0.05) affected by increasing number of MS components. Among the components of the MS, only blood pressure significantly affected PWV, whereas blood pressure and fasting glucose influenced FMD. Logistic regression analysis showed that MS was associated with increased risk of altered PVW (odd ratio: 7.95, confidence limits: 1.06 to 69.11), whereas only blood pressure component was significantly related with increased risk of impaired FMD (odd ratio: 3.60, confidence limits: 1.01 to 12.78). In conclusion, in normotensive subjects at risk of developing diabetes mellitus, the presence of MS is associated with a selective alteration of central PWV. Key Words: arterial stiffness Ⅲ pulse wave velocity Ⅲ endothelium Ⅲ metabolic syndrome Ⅲ blood pressure M etabolic syndrome (MS), a clustering of cardiovascular risk factors, such as central obesity, insulin resistance, dyslipidemia, and hypertension, is associated with an increased risk of developing cardiovascular disease and diabetes mellitus. 1,2 Epidemiological studies suggest that MS per se might represent an independent predictor of cardiovascular morbidity and mortality. 3-5 MS has also been associated to early vascular alterations, such as increased arterial stiffness 6 -10 and endothelial dysfunction. [11][12][13] The association with these vascular alterations might account, at least in part, for the cardiovascular risk of patients with MS, 14 because both increased arterial stiffness 15 and endothelial dysfunction 16,17 have been demonstrated to be independent predictors of cardiovascular morbidity and mortality. Indeed, crosssectional studies have shown an association between MS and increased arterial stiffness in unselected populations. 6 -10 However, some of these studies might be biased by the presence in the study populations, beside other factors encompassing the MS, of overt hypertension or diabetes, 2 major and well characterized determinants of increas...

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Section: Perspectivesmentioning

confidence: 99%

Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus

et al. 2008

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“…of coronary artery disease has been described and demonstrated. [5][6][7] When ED occurs, the endothelium loses its protective role and becomes a pro-atherosclerotic player, releasing pro-atherogen and vasoconstrictor substances and mediators, such as endothelin ET-1, thromboxane A2, prostaglandin H2, and reactive oxygen species. …”

Section: From Hypertension To Atherogenesis Due To Mechanical Stressmentioning

confidence: 99%

Editorial. Atherosclerosis-Triggered Hypertension or Hypertension-Triggered Atherosclerosis? A Challenging Hypothesis

Benedek

2017

Journal of Cardiovascular Emergencies

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Figure 1B). In all these patients, repeated episodes of hypertension preceded an angina attack.In the proposed hypothesis, the following are proposed as characteristics associated with a new pattern of acute cardiac patient seen in an emergency setting:• repeated episodes of hypertension;• presenting with chest pain;• ECG changes and positive cardiac enzymes;• coronary angiography indicating slow flow in at least one coronary artery;• OCT revealing the presence of subendothelial dissection. from hypertension to Atherogenesis due to mechAnicAl stressRepeated episodes of a sudden increase in the blood pressure can cause the abrupt dilatation of the coronary wall, which becomes wrinkled on returning to its original shape.This wrinkled surface can lead to the alteration of shear stress and, at the same time, of the circumferential stress inside the coronary lumen, contributing to endothelial dysfunction and the development of turbulent coronary flow at this level.The endothelium that usually protects the coronary wall is exposed to altered luminal forces caused by the in-

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“…This pathological condition is characterized by one or more of the following features: impaired NO bioavailability, increased oxidative stress, enhanced cell turnover, increased production of growth factor, over-expression of adhesion molecules and inflammatory genes, hemodynamic deregulation and increased permeability of the cell layer [15] . Several factors contribute to the outcome of endothelial dysfunction, for example high levels of LDL cholesterol, glucose, insulin, triglycerides and omega-6 to omega-3 ratio, low concentration of HDL and Vitamin D and all wrong life habits [16] .…”

Section: Endothelium Dysfunction and Cardiovascular Diseases: Role Ofmentioning

confidence: 99%

Nutraceuticals and cardiovascular risk: potential role of EPCs modulation

Russo

Lucchesi

Longo

et al. 2015

Stem Cell Transl Investig

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According to WHO cardiovascular diseases (CVDs) are the first cause of death in the world: more people die annually from CVDs than from any other cause. Vascular endothelium plays a pivotal role in the onset and progression of these pathologies and cardiovascular risk factors are frequently associated to the levels of endothelial progenitor cells (EPCs), bone marrow-derived circulating progenitors for the endothelial lineage. Since EPCs not only preserve vascular endothelium homeostasis, but might directly participate to re-endothelization and neovascularization, these cells represent an emerging protagonist in vascular competency and as such a cell model of great interest. An unhealthy diet is one of the main cardiovascular risk factor, while there is a great interest in the potential protective effects of "nutraceuticals", food-derived compounds that exert beneficial effects on human and animal health. The characterization of the endothelial effects of different nutraceuticals may provide fresh insights into their potential role in CVDs prevention. Several studies have already showed the protective effects of natural antioxidants on EPCs levels and functionality; some examples are resveratrol, catechin and folic acid. Fermentation has recently shown interesting roles in cardiovascular prevention since this process gave origin to a new class of foods, rich in bioactive compounds, the fermented foods. Consumption of fermented legumes and cereals, but also fermented beverages (such as beer and wine) was found to protect endothelial function through both lipid-lowering, as well anti-inflammatory and antioxidative mechanisms. Little is known about the effects of fermentation-derived nutraceuticals on EPCs. Given the important role of this cardiovascular biomarker, further analysis in this field can improve opportunities for CVDs prevention and treatment. Vascular endothelium and EPCs: new insightsFor many years vascular endothelium has been considered a mere physical barrier between blood and underlying tissues; recent studies have demonstrated new and interesting roles of endothelium in vascular health [1] .Endothelial cells composing this monolayer have therefore paracrine, endocrine and autocrine functions, by secreting several factors with vasodilatory and antiproliferative effects, such as endothelium-derived hyperpolarization factor (EDHF), nitric oxide (NO) and prostacyclin (PGI 2 ), and others inducing vasoconstrictor response, for instance endothelin-1 (ET-1), angiotensin II and reactive oxygen species (ROS) [2] . These evidences make the vascular endothelium a multifunctional unit that regulates vascular homeostasis by REVIEW

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Mechanisms of Endothelial Dysfunction: Clinical Significance and Preventive Non-Pharmacological Therapeutic Strategies

Cited by 115 publications

References 0 publications

Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus

Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus

Editorial. Atherosclerosis-Triggered Hypertension or Hypertension-Triggered Atherosclerosis? A Challenging Hypothesis

Nutraceuticals and cardiovascular risk: potential role of EPCs modulation

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