Abstract-Endothelial dysfunction that can be detected as impaired flow-mediated dilation by ultrasonography is an early event in atherogenesis and has been demonstrated in healthy subjects with risk factors for atherosclerosis many years before the appearance of atheromatous plaques. We examined the influence of physical training on flow-mediated dilation in patients with the polymetabolic syndrome. Twenty-nine asymptomatic men aged 40 to 60 years with the polymetabolic syndrome were randomly divided between the control group and the training group, which trained 3 times a week for 12 weeks. On high-resolution ultrasound images, the diameter of the brachial artery was measured at rest, after reactive hyperemia (causing flow-mediated, endothelium-dependent dilation), and after sublingual glyceryltrinitrate (causing endothelium-independent vasodilation) in all subjects before and after the training period. The training program induced an increase of 18% in physical fitness. Flow-mediated dilation increased from 5.3Ϯ2.8% to 7.3Ϯ2.7% (PϽ0.05). There was no change in body mass index, blood pressure, insulin resistance, lipids, and big endothelin-1 in either group. Flow-mediated dilation measured before training was negatively correlated with resting heart rate, waist-to-hip ratio, and insulin resistance. Resting heart rate emerged as the only independent determinant, which explained 22% of the variation in flow-mediated dilation. In conclusion, our findings suggest that a 3-month physical training program, which improved maximal exercise capacity, enhances flow-mediated dilation in patients with the polymetabolic syndrome. Key Words: physical training Ⅲ flow-mediated dilation Ⅲ polymetabolic syndrome Ⅲ ultrasonography Ⅲ conduit arteries E xercise has well-known benefits regarding the reduction in cardiovascular morbidity and mortality. [1][2][3] The results of many studies have shown beneficial effects of physical training on several risk factors for atherosclerosis. 4 -7 However, there also seems to be a direct effect of training on the vascular endothelium. Endothelial cells play an important role in the modulation of vascular tone by releasing an endothelium-derived relaxing factor, identified as nitric oxide (NO). 8 The endothelial dysfunction, which is marked by an impaired ability of the artery to dilate in response to increased shear stress and several pharmacological stimuli, has been found in asymptomatic subjects with risk factors for atherosclerosis. 9 -11 There is considerable evidence that increased shear stress via increased blood viscosity, 12 heart rate and pulse pressure, 13 and blood flow, 14 which can all be a result of exercise, increases the production of NO from the arterial endothelium. Recent evidence suggests that these factors may contribute to persistent NO production in the period between exercise bouts. Experiments in animal models have demonstrated that chronic exercise caused an increase in NO synthase gene expression and endothelial release of NO, which was associated with improved e...

Objective-To assess the extent of early atherosclerotic changes of the carotid arteries in young patients with familial hypercholesterolaemia (FH) detected as increased intima-media thickness (IMT), and to determine the relations between IMT and some clinical and blood variables such as lipid and lipoprotein(a) (Lp(a)) concentration and haemostatic factors. Design-The IMT of the carotid bifurcation, the proximal 1 cm of the internal carotid artery, and the distal 1 cm of the common carotid artery was determined in all subjects using B mode ultrasonography. Blood lipids, fasting glucose, and several haemostatic variables were also analysed. Subjects-28 patients with FH (12 males and 16 females aged 11 to 27 years, one homozygote, 27 heterozygotes) and 28 sex and age matched normolipidaemic healthy subjects. Results-The mean carotid IMT (the average of six measurements of the maximum far wall IMT in the three carotid segments on each side) was significantly greater in patients with FH than in controls (mean (SD) 0-71 (0.15) v 0 49 (0.08) mm, P < 0.001). In all subjects, the mean IMT was significantly correlated with total cholesterol (r = 0.59), low density lipoprotein (LDL) cholesterol (r = 0.60), triglycerides (r = 0.27), and systolic blood pressure (r = 0 47

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