Peripheral vascular endothelial function testing as a noninvasive indicator of coronary artery disease

Kuvin, Jeffrey T.; Patel, Adilahmed; Sliney, Kathleen A.

doi:10.1016/s1062-1458(02)00665-7

Cited by 57 publications

(77 citation statements)

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“…Each evaluation consisted of a review of systems and physical exam, anthropometric measurements, cardiovascular risk factor assessment, and blood sampling for measurement of biochemical, metabolic, and inflammatory biomarkers. Vascular reactivity was measured as a surrogate marker for endothelial function by means of a brachial artery reactivity test at baseline and at the final (6 month) assessment [33,34]. The brachial reactivity testing protocol included assessment of both the vasodilator response to reactive hyperemia (endotheliumdependent vasodilation) and the vasodilator response to sublingual nitroglycerin (endothelium-independent vasodilation) using standard methodology [35].…”

Section: Study Protocolmentioning

confidence: 99%

Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients

et al. 2011

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Section: Study Protocolmentioning

confidence: 99%

Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients

et al. 2011

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“…In patients with atherosclerosis NO production and/or bioavailability is diminished leading to decreased FMD in the large conduit arteries too [19]. A possible mechanism of the abnormal FMD in atherosclerotic patients is the excess vascular superoxide production in those patients; superoxide anion has the capacity to react rapidly with NO limiting its biological activity and leading to decreased flowmediated vasodilation of the conduit arteries.…”

Section: Discussionmentioning

confidence: 99%

Effect of Nebivolol and Atenolol on Brachial Artery Flow-Mediated Vasodilation in Patients with Coronary Artery Disease

Lekakis

Protogerou

Papamichael

et al. 2005

Cardiovasc Drugs Ther

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Endothelial dysfunction is considered to be the first step in atherogenesis as well as a predictor of adverse cardiovascular events in patients with coronary artery disease (CAD), while endothelial function improvement is associated with improved clinical outcome. Nebivolol is a beta1-adrenoreceptor antagonist with an independent beneficial action on endothelial function, increasing nitric oxide bioavailability. The aim of the present study was to examine the effects of nebivolol on endothelial function in the brachial artery in patients with CAD compared with another selective beta1 adrenergic receptor antagonist, atenolol. Thirty-five patients with stable CAD were randomized to receive either 5 mg nebivolol (n = 17) or 50 mg atenolol (n = 18) daily for 4 weeks. Each patient underwent measurement of endothelial function by means of flow-mediated dilatation (FMD) of the brachial artery before and after 4 weeks of treatment. All vasoactive drugs and cardiovascular risk factors were comparable in the two groups. No significant differences were observed between the two groups at baseline in FMD. In the atenolol group FMD remained unchanged at the end of the 4-week treatment, but in patients treated with nebivolol FMD showed a significant increase by the end of the treatment period (3.9 +/- 2.7% vs. 5.6 +/- 2.9%, p = 0.047) leading to a significantly higher value compared to patients treated with atenolol (5.6 +/- 2.9% vs. 3.4 +/- 3.2%, p = 0.041).Beta(1) blockade by nebivolol but not atenolol improves endothelial dysfunction in patients with CAD, an effect that might further reduce the risk for cardiovascular events in patients with CAD.

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“…With advancing age, there is pervasive macrovascular and microvascular dysfunction that manifests as stiffening of central elastic arteries, elevation of pressure from wave reflections, increased pressure pulsatility and impaired vascular reactivity. Each of these vascular maladaptations independently contributes to numerous co-morbidities of aging including hypertension, renal demise, left ventricular hypertrophy and future cardiovascular events (Kuvin et al 2001;Weber et al 2005Weber et al , 2010. Identification of a simple, noninvasive tool that can interrogate multiple aspects of vascular aging and target organ damage simultaneously and be applied in large population/clinical settings would prove invaluable.…”

Section: Introductionmentioning

confidence: 99%

Peripheral augmentation index as a biomarker of vascular aging: an invasive hemodynamics approach

et al. 2011

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We compared two measures of vascular function obtained from digital volume waveforms with measures of target organ damage and novel invasive measures of vascular function as they relate to vascular aging. Aortic pulse pressure amplification, pulsatility, form factor and extent of coronary atherosclerosis (modified Gensini score) were obtained invasively in 59 patients undergoing left heart catheterization. Digital volume waveforms were captured via peripheral arterial tone (PAT) and used to derive augmentation index (AIx) and the pulse wave amplitude-reactive hyperemia index (PWA-RHI). AIx was associated with age (r = 0.50, p < 0.05) and aortic pulsatility (r = 0.45, p < 0.05) and inversely associated with estimated glomerular filtration rate (-0.29, p < 0.05) aortic pulse pressure amplification (r = -0.28, p < 0.05) and aortic form factor (r = -0.38, p < 0.05). AIx was slightly higher in patients with left ventricular hypertrophy (LVH) versus those without left ventricular hypertrophy (30 vs. 14%, p = 0.058). There was no association between AIx and Gensini score. PWA-RHI was not associated with age, estimated glomerular filtration rate or invasive vascular parameters and did not differ in patients with versus without LVH (p = ns). PWA-RHI was inversely associated with Gensini score (r = -0.32, p < 0.05). AIx derived from PAT is correlated with age-associated changes in vascular function and target organ damage but not coronary atherosclerotic burden. PWA-RHI is associated with coronary atherosclerotic burden but is not associated with target organ damage or other measures of vascular aging assessed in this study. Each parameter provides distinct insight into systemic vascular aging and target organ damage.

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Peripheral vascular endothelial function testing as a noninvasive indicator of coronary artery disease

Cited by 57 publications

References 0 publications

Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients

Early effects of gastric bypass on endothelial function, inflammation, and cardiovascular risk in obese patients

Effect of Nebivolol and Atenolol on Brachial Artery Flow-Mediated Vasodilation in Patients with Coronary Artery Disease

Peripheral augmentation index as a biomarker of vascular aging: an invasive hemodynamics approach

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