Plasma Nitric Oxide Level and Its Role in Slow Coronary Flow Phenomenon

Sezgin, Nurzen; Barutçu, İrfan; Sezgin, Alpay Turan; Güllü, Hakan; Türkmen, Muhsin; Esen, Ali Metin; Karakaya, Osman

doi:10.1536/ihj.46.373

Cited by 73 publications

(63 citation statements)

References 28 publications

(35 reference statements)

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“…13) It has been demonstrated that endothelium-derived NO causes vasodilation and an increase in blood flow. The mechanisms responsible for endothelial dysfunction are not completely understood.…”

Section: Discussionmentioning

confidence: 99%

<b>Impaired Systemic Endothelial Function in Patients With Pseudoexfoliation Syndrome</b>

Atalar

Kılıç

et al. 2006

Int. Heart J.

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SUMMARYPseudoexfoliation syndrome (PEX) is the most common clinical precursor of openangle glaucoma. Recent studies have shown that pseudoexfoliative material is widely distributed throughout the body, including blood vessels. The aim of our study was to evaluate endothelial function in the brachial artery of patients with pseudoexfoliation syndrome.We prospectively examined 23 patients with PEX (mean age, 70 ± 8 years) and 20 healthy age-and sex-matched individuals (mean age, 68 ± 9 years) as a control group. Brachial artery endothelial function was assessed by vascular response to reactive hyperemia (flow-mediated dilation (FMD) and sublingual nitroglycerin (NTG-mediated dilation) using high-resolution ultrasound. Flow-mediated and NTG-induced dilation were expressed as the percent change in diameter after reactive hyperemia and after NTG administration relative to the baseline value, respectively. Patients with cardiovascular disease and other conditions associated with endothelial dysfunction were excluded.When compared with controls, patients with PEX had significantly lower flow-mediated dilation (4.5 ± 2.8 versus 8.2 ± 3.7, P = 0.01) and NTG-mediated dilation (10.9 ± 3.1 versus 15.8 ± 3.8, P = 0.0001). Flow-mediated dilation and NTG-mediated dilation were similar in PEX patients with glaucoma (n = 11) and without glaucoma (n = 12). Flow-mediated and NTG-mediated dilation did not correlate with any measured parameter in any patient or control subject.The findings indicate that systemic endothelial function is impaired in PEX syndrome patients. (Int Heart J 2006; 47: 77-84)

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Section: Discussionmentioning

confidence: 99%

<b>Impaired Systemic Endothelial Function in Patients With Pseudoexfoliation Syndrome</b>

Atalar

Kılıç

et al. 2006

Int. Heart J.

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“…All participants completed the IIEF questionnaire. According to questions 1-5 and 15 (six questions that form the so-called 'erectile function domain' 14 ) of the questionnaire, ED severity was classified into five categories as severe (1-10), moderate (11)(12)(13)(14)(15)(16), mild to moderate (17-21), mild (22)(23)(24)(25) and no ED (26)(27)(28)(29)(30) …”

Section: Sexual Function: International Index Of Erectile Functionmentioning

confidence: 99%

“…7 Many etiological factors such as microvascular and endothelial dysfunction have been implicated. [8][9][10][11][12] Impaired endothelial function and reduced plasma level of nitric oxide in SCF have been demonstrated in some studies. [8][9][10][11][12] The aim of this present study was to investigate the degree of erectile dysfunction in patients with SCF.…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction and coronary slow flow: distinct presentations of endothelial disease

et al. 2007

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The aim of the present study was to investigate degree of erectile dysfunction (ED) in males with slow coronary flow (SCF). Endothelial dysfunction was proposed to be the underlying mechanism in both diseases. A total of 29 male patients with slow coronary flow (mean age 4577 years) and 23 male patients with normal coronary arteries (mean age 48712 years) were included in the study. The severity of ED was determined according to the International Index of Erectile Function (IIEF) questionnaire. Mean IIEF scores in patients with SCF and control group were determined as 20.9777.26 and 25.2675.17, P ¼ 0.016. ED was detected in 45% (n ¼ 13) of SCF patients and 35% (n ¼ 8) of the control group (P ¼ 0.035). There was a negative correlation between the mean TIMI frame count and IIEF score between patients with SCF and controls (r ¼ À0.31, P ¼ 0.029). These data suggest that ED is observed more frequently in patients with SCF phenomenon compared to patients with otherwise normal coronary angiograms.

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“…In patients with slow coronary flow, thrombolysis in myocardial infarction (TIMI) frame count 25 was higher, the plasma NO level was lower, and brachial artery endothelium-dependent flow-mediated dilatation was smaller than in subjects with normal coronary flow. 26 Endothelial dysfunction appears to contribute to the pathogenesis of slow coronary flow.…”

Section: 23mentioning

confidence: 99%

Nitric Oxide-Mediated Coronary Flow Regulation in Patients with Coronary Artery Disease: Recent Advances

Toda¹,

Tanabe²,

Nakanishi³

2011

Int J Angiol

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Nitric oxide (NO) formed via endothelial NO synthase (eNOS) plays crucial roles in the regulation of coronary blood flow through vasodilatation and decreased vascular resistance, and in inhibition of platelet aggregation and adhesion, leading to the prevention of coronary circulatory failure, thrombosis, and atherosclerosis. Endothelial function is impaired by several pathogenic factors including smoking, chronic alcohol intake, hypercholesterolemia, obesity, hyperglycemia, and hypertension. The mechanisms underlying endothelial dysfunction include reduced NO synthase (NOS) expression and activity, decreased NO bioavailability, and increased production of oxygen radicals and endogenous NOS inhibitors. Atrial fibrillation appears to be a risk factor for endothelial dysfunction. Endothelial dysfunction is an important predictor of coronary artery disease (CAD) in humans. Penile erectile dysfunction, associated with impaired bioavailability of NO produced by eNOS and neuronal NOS, is also considered to be highly predictive of ischemic heart disease. There is evidence suggesting an important role of nitrergic innervation in coronary blood flow regulation. Prophylactic and therapeutic measures to eliminate pathogenic factors inducing endothelial and nitrergic nerve dysfunction would be quite important in preventing the genesis and development of CAD.KEYWORDS: Nitric oxide, constitutive nitric oxide synthase, endothelial dysfunction, coronary blood flow, coronary artery disease, asymmetric dimethylarginine Coronary blood flow is regulated through complex adjustments in the arteriolar tone and resistance of the microcirculation. Impairment of microvascular function leads to organ dysfunction in any body system including the heart. Recent evidence supports the concept that the impairment of endothelial function is an upstream event in the pathophysiology of atherosclerosis, CAD, and myocardial infarction (MI). Nitric oxide (NO) liberated as a paracrine relaxant from the vascular endothelium is known to play a pivotal role in the modulation of microvascular tone and regional blood flow.1 In addition, NO inhibits platelet aggregation and adhesion, inhibits leukocyte adhesion and migration, and reduces vascular smooth muscle proliferation, thus leading to prevention of atherosclerosis. NO produced via neuronal NO synthase (nNOS) is released from Abundant and varied data from animal and human studies, performed over the course of more than two decades, indicate that depression of synthesis and bioavailability of NO in the endothelium participates in many cardiovascular diseases, including atherosclerosis, 4 coronary heart diseases, 5 stroke, 3 renal failure, 6 and hypertension 5,7 and also in insulin resistance and diabetes mellitus.8 Mechanisms underlying impairment of NO-mediated vasodilatation and blood flow increase include the downregulation of endothelial NOS (eNOS) and nNOS expressions, generation of NOS inhibitors and NO scavengers, and upregulation of vasoconstrictor substances, such as endothelin-1 (ET-1),...

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Plasma Nitric Oxide Level and Its Role in Slow Coronary Flow Phenomenon

Cited by 73 publications

References 28 publications

<b>Impaired Systemic Endothelial Function in Patients With Pseudoexfoliation Syndrome</b>

<b>Impaired Systemic Endothelial Function in Patients With Pseudoexfoliation Syndrome</b>

Erectile dysfunction and coronary slow flow: distinct presentations of endothelial disease

Nitric Oxide-Mediated Coronary Flow Regulation in Patients with Coronary Artery Disease: Recent Advances

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