Smooth Muscle Dysfunction in Patients Older than 54 Years of Age with Objective Evidence of Arteriosclerosis

Akamatsu, Daijirou; Satou, Akira; Watanabe, Toshiya; Hashizume, Eiji; Gotou, Hiromi; Satoh, Susumu

doi:10.1016/j.ejvs.2007.07.001

Cited by 5 publications

(7 citation statements)

References 25 publications

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“…NMD3 is suggested to underestimate the extent of vasodilatation induced by the sublingual application of NTG; however, NMD3 was able to predict cardiovascular events in the current study. Our previous report suggested that NMD was associated with atherosclerotic risk factors, but that NMD3 displayed no such association 19) . NMD displays the dilative potency of NTG, while NMD3 provides a measure of the speed of response to NTG, or provides a limited measure of dilatation.…”

Section: Discussionmentioning

confidence: 96%

“…The power of brachial NMD to be used as a clinical marker of cardiovascular disease is unclear. Our previous study showed that brachial responses to NTG reached a maximal limit approximately 7 minutes after the administration, and that NMD correlated with atherosclerotic risk factors in patients displaying evidence of atherosclerosis 19) . The current study was undertaken to investigate whether NMD can provide prognostic information on cardiovascular disease.…”

Section: Introductionmentioning

confidence: 90%

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Nitroglycerin-mediated vasodilatation of the brachial artery may predict long-term cardiovascular events irrespective of the presence of atherosclerotic disease

Akamatsu

Sato

Gotō

et al. 2010

JAT

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Aim: Nitroglycerin-mediated vasodilatation (NMD) provides insight into the NTG-induced bioactivity of smooth muscle. It is plausible that in dysfunctional smooth muscle cells, the response to nitroglycerin may become blunted. The relationship between impaired brachial artery NMD and subsequent cardiovascular events is not well established. Methods: We examined brachial artery flow-mediated dilatation (FMD) and NMD using ultrasound in 93 subjects (71 7 years, including 26 with peripheral artery disease (PAD), 37 with aortic aneurysms, 10 with PAD complicated with aneurysms, and 20 without evident arterial disease). Brachial artery responses to hyperemia and nitroglycerin were measured every minute after cuff deflation and nitroglycerin administration. Time courses of vasodilatation were assessed and maximal FMD and NMD were measured. Results: The time courses in response to NTG were sigmoidal and maximal diameter reached 7.2 1.6 minutes after NTG was administered sublingually. The mean FMD was 2.3±2.0% and the mean NMD was 17.6 7.1%. Subjects were prospectively followed for an average of 47 13 months. Eighteen subjects had an event during follow-up; events included myocardial infarction (five), unstable angina pectoris (four), stroke (two), aortic dissection (one), ruptured aortic aneurysm (three), symptomatic abdominal aortic aneurysm (two), and lower limb ischemia requiring revascularization (one). NMD and FMD were significantly lower in subjects with events than in those without an event. In a Cox proportional-hazards model, lower FMD as well as lower NMD independently predicted future cardiovascular events. Conclusion: Brachial artery nitroglycerin-mediated vasodilatation may add information to conventional risk stratification.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 90%

Nitroglycerin-mediated vasodilatation of the brachial artery may predict long-term cardiovascular events irrespective of the presence of atherosclerotic disease

Akamatsu

Sato

Gotō

et al. 2010

JAT

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“…Because of ethical concerns in a predominantly healthy cohort, we did not administer the medication glyceryl trinitrate to assess nitroglycerinmediated dilation, which provides additional information on the maximum, nonendothelium-dependent vasoreactivity and pulse waveform changes. [33][34][35] We only measured vascular function once in every individual, which does not account for intraindividual variability and circadian rhythms. In addition, recent studies suggest that the maximal increase in diameter occurs Ͼ60 seconds after cuff release.…”

Section: Limitationsmentioning

confidence: 99%

Noninvasive Vascular Function Measurement in the Community

Schnabel

Schulz

Wild

et al. 2011

Circ: Cardiovascular Imaging

164

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“…Impaired FMD has been reported in patients with PAD and IC. [13][14][15][16] However, whether vascular reactivity is related to the severity of the disease in patients with IC remains unclear. Moreover, there is scarce information regarding the relationship between functional decline and vascular reactivity.…”

Section: Introductionmentioning

confidence: 99%

Vascular Reactivity Is Impaired and Associated With Walking Ability in Patients With Intermittent Claudication

2014

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We verified whether vascular reactivity is impaired and whether there is any association between vascular reactivity, walking ability, and peripheral artery disease (PAD) severity in patients with intermittent claudication (IC). We studied 63 patients and 17 age- and sex-matched volunteers without PAD. Vascular reactivity was evaluated in the brachial artery during reactive hyperemia (flow-mediated dilation [FMD]) and after a sublingual single dose of nitroglycerin (nitroglycerin-induced vasodilation [NID]). Walking ability was verified by a 6-minute walk test. Vascular reactivity and walking ability were significantly worse in patients with IC compared with control participants. The ankle-brachial index correlated with FMD, NID, as well as total and pain-free distances. The NID and walking ability progressively decreased as PAD severity increased. Walking ability correlated with NID but not with FMD. In patients with IC, vascular reactivity is impaired and is related to the severity of PAD and to walking ability.

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Smooth Muscle Dysfunction in Patients Older than 54 Years of Age with Objective Evidence of Arteriosclerosis

Cited by 5 publications

References 25 publications

Nitroglycerin-mediated vasodilatation of the brachial artery may predict long-term cardiovascular events irrespective of the presence of atherosclerotic disease

Nitroglycerin-mediated vasodilatation of the brachial artery may predict long-term cardiovascular events irrespective of the presence of atherosclerotic disease

Noninvasive Vascular Function Measurement in the Community

Vascular Reactivity Is Impaired and Associated With Walking Ability in Patients With Intermittent Claudication

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