Relationship between endothelial function in the coronary and brachial arteries

Abstract-Vascular reactivity is reflected by blood biomarkers and noninvasive vascular function measurement. The relation of biomarkers to flow-mediated dilation and peripheral arterial tonometry in the general population is little understood. In 5000 individuals (mean age, 56Ϯ11 years; age range, 35-74 years; 49% women) of the population-based Gutenberg Health Study we simultaneously assessed 6 biomarkers of cardiovascular function (midregional proadrenomedullin [MR-proADM], midregional pro atrial natriuretic peptide [MR-proANP], N-terminal pro B-type natriuretic peptide, copeptin, C-terminal proendothelin 1, and neopterin) in relation to flow-mediated dilation and peripheral arterial tonometry. Strongest partial correlations (adjusted for age and sex) were observed for baseline pulse amplitude with MR-proADM (rϭ0.13) and MR-proANP (rϭϪ0.13); hyperemic response variables showed the highest correlation for MR-proADM and peripheral arterial tonometry ratio (rϭϪ0.14). In multivariable linear regression models, strongest associations with baseline vascular function were observed for MR-proANP with baseline pulse amplitude 1 Early detection of vascular impairment before clinically manifest disease has been the goal of preventive efforts.2,3 Methods applied for screening of vascular dysfunction at the population level need to be noninvasive or minimally invasive. Most popular screening methods used recently are composed of the determination of flow-mediated dilation (FMD) of the brachial artery and peripheral arterial tonometry (PAT).4-6 FMD reflects conduit artery reactivity, 7 and PAT represents microvascular status. 8 Both measures are modestly correlated with coronary endothelial function, 9,10 and prospective data have remained controversial. 2,3Another approach to assess vascular status is the measurement of circulating biomarkers that may directly mirror vascular activation. Established and novel vasoactive peptides or their more stable precursors are composed of midregional proadrenomedullin (MR-proADM), midregional Received January 23, 2012; first decision February 8, 2012; revision accepted May 8, 2012. From the Department of General and Interventional Cardiology (R.B.S., C.R.S., S.W., T.Z., E.L., S.B.), University Heart Center, Hamburg-Eppendorf, Germany; Department of Medicine 2 (P.S.W., A.S., A.W., T.G., T.M.), Center of Thrombosis and Hemostasis (P.S.W.), and Institute of Clinical Chemistry and Laboratory Medicine (K.J.L.), University Medical Center Mainz, Johannes Gutenberg-University, Mainz, Germany; B · R · A · H · M · S GmbH (J.K.), Thermo Fisher Scientific, Hennigsdorf, Germany.S.B. and T.M. contributed equally to the article. The antidiuretic hypothalamic hormone vasopressin regulates osmotic homeostasis through water retention in the kidneys and acts directly on vascular smooth muscle cells.18 Endothelin 1 is a potent paracrine vasoconstrictor produced predominantly by endothelial cells. 19 The pteridine derivative neopterin is a marker of monocyte activation and mirrors elevated inflammatory sta...

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“…8 Both measures are modestly correlated with coronary endothelial function, 9,10 and prospective data have remained controversial.…”

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confidence: 99%

Multiple Endothelial Biomarkers and Noninvasive Vascular Function in the General Population

et al. 2012

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“…According to previous studies, we found that vascular endothelial functions were impaired in patients with CSF 7,8,13 . Endothelial dysfunction appears to be a generalized process and can be detected in coronary and peripheral arteries before the development of atherosclerosis 14 .…”

Section: Discussionmentioning

confidence: 67%

“…This stimulus makes the endothelium release nitric oxide (NO) with subsequent vasodilatation that can be imaged and quantitated as an index of vasomotor function 6 . Brachial endothelial function has also been found to be associated with CSF 7,8 . Nebivolol is a third-generation highly cardioselective β1-adrenoceptor antagonist and it also affects the L-arginine/ NO pathway, causing vasodilatation by increasing endothelial NO release 9 .…”

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confidence: 99%

Função endotelial vascular em pacientes com fluxo coronário lento e os efeitos do nebivolol

Güneş¹,

Gümrükçüoğlu

Akdağ

et al. 2011

Arq. Bras. Cardiol.

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“…Relationships between coronary and brachial artery endothelial function have been demonstrated using ACh and FMD techniques, respectively in individuals with (Anderson et al 1995) and without CAD (Teragawa et al 2005). While there is merit in demonstrating the magnitude of endothelial responses is comparable between arteries, ACh and flow-mediated stimuli activate the endothelium via differing mechanisms.…”

Section: Technical Aspects Of the Fmd Techniquementioning

confidence: 99%

Effects of acute and chronic low-volume high-intensity interval exercise on cardiovascular health in patients with coronary artery disease

Currie

2013

Appl. Physiol. Nutr. Metab.

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The merits of low-volume high-intensity interval exercise (HIT) have been established in healthy populations; however, no studies have examined this exercise prescription in patients with coronary artery disease (CAD). The present thesis examined the acute and chronic effects of HIT in patients with CAD. The first study demonstrated transient improvements in brachial artery endothelial-dependent function, which was assessed using flow-mediated dilation (FMD) 60 min following a single bout of either HIT or moderate-intensity endurance exercise (END) in habitually active patients. The second study demonstrated no effects of training status on the acute endothelial responses to exercise; following 12-weeks of either HIT or END training. However, there was a significant reduction in endothelial-independent function immediately postexercise, at both pre- and post-training, which requires further examination. The third study demonstrated comparable increases in fitness and resting FMD following 12-weeks of END and HIT, lending support to the notion that favourable adaptations are obtainable with a smaller volume of exercise. Finally, the fourth study demonstrated no change in heart rate recovery following 12-weeks of END and HIT. However, pre-training heart rate recovery values reported by our sample were in a low risk range, which suggests training induced improvements may only be achievable in populations with attenuated pre-training values. The results of this thesis provide preliminary evidence that supports the use of HIT in patients with CAD. The findings of favourable transient and chronic improvements following HIT are notable, especially given that the HIT protocol involves less time and work than END, which was modelled after the current exercise prescription in cardiac rehabilitation. Further investigations are necessary, including the assessment of additional physiological indices; the feasibility and adherence to HIT; the inclusion of CAD populations with comorbidities, including heart failure and diabetes; as well as other forms of HIT training, including HIT combined with resistance training.

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Relationship between endothelial function in the coronary and brachial arteries

Cited by 77 publications

References 34 publications

Multiple Endothelial Biomarkers and Noninvasive Vascular Function in the General Population

Multiple Endothelial Biomarkers and Noninvasive Vascular Function in the General Population

Função endotelial vascular em pacientes com fluxo coronário lento e os efeitos do nebivolol

Effects of acute and chronic low-volume high-intensity interval exercise on cardiovascular health in patients with coronary artery disease

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