Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction

Celermajer, David S.; Sørensen, Keld E.; Bull, Catherine; Robinson, JH; Deanfield, John

doi:10.1016/0735-1097(94)90141-4

Cited by 1,132 publications

(760 citation statements)

References 28 publications

Supporting

Mentioning

672

Contrasting

Unclassified

Order By: Relevance

“…Sample size calculations were performed based on the FMD component of the study. In previous studies of healthy subjects, reported mean FMD values have ranged from 106% to 112% (SD 3-6.5%), while in subjects with vascular risk factors such as cigarette smoking, hypertension, or hypercholesterolemia, mean FMD ranged from 100% to 106.5% (20,36,37). For the purpose of sample size calculations we estimated a mean Ϯ SD FMD of 108 Ϯ 4% in our healthy controls.…”

Section: Methodsmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

127

View full text Add to dashboard Cite

Objective. Inflammation appears to play a central role in atherosclerosis, and endothelial damage mediated by systemic inflammation may contribute to the increased cardiovascular mortality in rheumatoid arthritis (RA). Brachial artery flow-mediated dilatation (FMD) and pulse wave analysis (PWA) are measures of vascular function. The aim of this study was to determine if FMD and PWA are abnormal in patients with RA.Methods. Twenty-five RA patients and 25 matched healthy controls were studied. All were free of traditional cardiovascular risk factors. FMD was measured in all subjects. PWA was performed in 18 RA patients and 18 controls, with results expressed as large and small artery compliance (C1 and C2). Modified Sharp scores were calculated in 13 RA patients.Results. Results (mean ؎ SD) in RA patients and controls, respectively, were as follows: FMD 107.6 ؎ 4.6% versus 108.5 ؎ 4.1% (P ‫؍‬ 0.49), C1 14.8 ؎ 2.8 ml/mm Hg ؋ 10 versus 17.9 ؎ 3.1 ml/mm Hg ؋ 10 (P ‫؍‬ 0.0033), C2 4.5 ؎ 2.3 ml/mm Hg ؋ 100 versus 7.7 ؎ 3.7 ml/mm Hg ؋ 100 (P ‫؍‬ 0.0039). There was an inverse correlation between C2 and modified Sharp scores in the RA patients (Spearman's rho -0.69, P ‫؍‬ 0.0085).Conclusion. FMD was normal in these RA patients, whereas arterial compliance was markedly reduced. PWA appears to be a more sensitive measure of vascular dysfunction than FMD in RA and may be the preferred surrogate marker of vascular dysfunction in longitudinal studies of RA patients. The inverse correlation between C2 and the modified Sharp score, a measure that reflects disease activity over time, supports the notion that chronic inflammation plays a role in RA-associated atherosclerosis.

show abstract

Section: Methodsmentioning

confidence: 99%

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Doornum¹,

McColl²,

Jenkins³

et al. 2003

Arthritis & Rheumatism

127

View full text Add to dashboard Cite

show abstract

“…1,2 These findings suggested that endothelial dysfunction contributes significantly to CAD progression and cardiovascular event rates. 14,15 Numerous studies have confirmed the independent prognostic relevance of hsCRP for the risk of cardiovascular events in patients with stable or unstable CAD and also in apparently healthy subjects. 6,7,16 Fichtlscherer et al indicated that elevated serum CRP levels indicative of a systemic inflammatory response reflected a blunted systemic endothelial function, and normalization of CRP levels over time was associated with a significant improvement in endothelium-mediated blood flow responses.…”

Section: Endothelial Function Inflammatory Marker Of Hscrp and Athementioning

confidence: 96%

Combined use of endothelial function assessed by brachial ultrasound and high‐sensitive C‐reactive protein in predicting cardiovascular events

Huang

Chen

et al. 2007

Clinical Cardiology

View full text Add to dashboard Cite

SummaryBackground: Endothelial function plays a key role in determining the clinical manifestations of atherosclerotic lesions. Elevated high-sensitive C-reactive protein (hsCRP) relates to long-term prognosis of cardiovascular disease.Hypothesis: We test the hypothesis that combined use of endothelial function and hsCRP could increase predictive value of future cardiovascular events.Methods and Results: 205 patients were followed up for a median period of 24 months. Endothelial function was assessed using brachial ultrasound to measure endothelium-dependent flow-mediated vasodilation (FMD). Cox regression analyses were conducted for the 205 subjects, with cardiovascular events being defined as myocardial infarction, hospitalization due to congestive heart failure, percutaneous coronary intervention, coronary artery bypass grafting, and ischemic stroke. Twenty nine (14%) developed cardiovascular events. Both FMD and hsCRP were significantly predictive of cardiovascular events (relative risk for patients with FMD < 3% as compared to those with FMD

show abstract

“…In addition, oxygen free radicals impair endothelial function through direct inactivation of NO (84). While all traditional risk factors have been associated with peripheral endothelial dysfunction, a close quantitative relationship does not exist (85)(86)(87)(88). This suggests that endothelial function measurements may add unique information not captured by Framingham risk scores.…”

Section: Relationship Of Endothelial Function To Risk Factors and Thementioning

confidence: 99%

Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk

Anderson

2006

Canadian Journal of Cardiology

154

113

View full text Add to dashboard Cite

T he understanding of the pathophysiology of atherosclerosis and its vascular complications has increased dramatically over the past decade. Numerous measurable biomarkers play a role in the atherosclerosis process, and are associated with clinically important vascular events. Not only has their evaluation advanced our knowledge of the atherosclerotic process but it has also accelerated a search for new diagnostic tools to aid in risk stratification. Putative factors include soluble biomarkers and imaging assessments of vascular structure and function. The endothelium plays a key role in vascular homeostasis through the release of a variety of paracrine factors that interact with platelets, inflammatory cells and the vessel wall. The endothelium's central location allows it to sense and respond to a variety of perturbations. Endothelial dysfunction is an early marker of disease. Risk factors can also affect mechanical properties such as arterial stiffness, which is now recognized as a major contributor to systolic hypertension in elderly people. Methods of assessing endothelial function and arterial stiffness are available for clinical research and recent evidence suggests that these measures may provide important prognostic information. ATTRIBUTES OF A SURROGATE BIOMARKEREpidemiological studies, such as Framingham, have allowed longitudinal assessment of cardiovascular events and the development of simple scoring tables for risk calculation (1,2). These factors involved include blood pressure, lipid profile, smoking status and age. More recently, many factors thought to be associated with the atherosclerotic process have been studied. Some of these have been shown to correlate with clinical outcomes and have been deemed biomarkers (3,4). However, association does not necessarily imply causation and, due to a variety of limitations, most of these markers will not be useful for the clinical evaluation of risk or drug therapy (5). To become clinically important, a biomarker must fulfill the criteria for a surrogate marker. A surrogate substitutes for clinically important end points with respect to how an individual feels, functions or survives. Classic examples include blood pressure and low density lipoprotein cholesterol. These are targets of treatment. A surrogate should meet the following criteria:• Adds independent information above currently used criteria;• Is reliably and reproducibly measured;• Accounts for a significant proportion of disease risk;• Provides good predictive value;• Is reasonably associated with the underlying pathophysiology;• If it is to be used in risk prevention, is present before the clinical appearance of the outcome; and• Is available and practical for widespread application (5-8). ADVANCES IN VASCULAR BIOLOGY

show abstract

Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction

Abstract: Loss of endothelium-dependent dilation in the systemic arteries occurs in the preclinical phase of vascular disease and is associated with interaction of the same risk factors known to predispose to atherosclerosis and its complications in later life.

Cited by 1,132 publications

References 28 publications

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Screening for atherosclerosis in patients with rheumatoid arthritis: Comparison of two in vivo tests of vascular function

Combined use of endothelial function assessed by brachial ultrasound and high‐sensitive C‐reactive protein in predicting cardiovascular events

Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk

Contact Info

Product

Resources

About