Internal carotid and brachial artery shear-dependent vasodilator function in young healthy humans
Internal carotid and brachial artery shear-dependent vasodilator function in young healthy humans
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DOI：
10.1113/jp280369
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发表时间：
2020-09-25
影响因子：
5.5
通讯作者：
Ainslie, Philip N.
中科院分区：
文献类型：
--
作者：
Carr, Jay M. J. R.;Hoiland, Ryan L.;Ainslie, Philip N.
肱动脉（BA）剪切介导的扩张是一种广泛使用的血管功能评估，与冠状动脉健康和心血管风险有关。脑血管健康经常使用脑血管（大脑中动脉速度）对二氧化碳的反应性来询问。我们发现，内皮依赖性直径（扩张器）的反应之间没有显着相关的颈内动脉（伊卡）和BA，也不是内皮非依赖性的反应。此外，伊卡内皮依赖性反应与大脑中动脉速度或伊卡血流对二氧化碳的反应性无关。因此，应通过血管特异性方法，而不是通过外周内皮功能或脑血管对二氧化碳的反应性，对颅外大脑动脉血管健康进行量化评估。本研究比较了颈内动脉（伊卡）和肱动脉（BA）的内皮依赖性和非依赖性血管舒张。我们假设伊卡和BA的内皮依赖性和非依赖性血管舒张在幅度上既不相似，血管之间也不相关。在19名健康成年人（23 ± 6岁，24 ± 3 kg/m2，6名女性）中，使用动态潮气末压力（+9 mmHg;脑血流介导的扩张，cFMD），在潮气末二氧化碳分压升高引起的短暂剪切应力升高期间，通过双功超声测定伊卡的内皮依赖性扩张。通过标准血流介导的扩张（FMD）评估BA内皮依赖性扩张。舌下给予400 μ g三硝酸甘油（GTN）后，同时评估伊卡和BA的内皮非依赖性扩张10分钟。伊卡的内皮依赖性血管舒张（3.4 ± 2.4%）低于BA（7.9 ± 3.3%;r（2）= 0.00，P = 0.93）（P = 0.013），且与BA无关。包括基线直径和剪切率曲线下面积作为协变量，维持了cFMD和FMD之间的差异（3.3 ± 4.2%vs.7.8 ± 3.8%，P = 0.03），而包括基线直径和基线剪切率调整的曲线下面积作为协变量则消除了这一点（5.9 +/-3.7%vs.5.9.8 +/-3.5%，P = 0.99）。GTN介导的伊卡血管舒张（14.3 ± 2.9%）低于BA（25.5 ± 8.8%;r（2）= 0.12，P = 0.19）（P = 0.002），且与BA无相关性。校正基线直径消除了GTN诱导的血管舒张差异（伊卡：20.1 ± 5.8% vs. BA：20.4 ± 5.5%;P = 0.93）。内皮依赖性反应的差异以及动脉之间缺乏相关性表明，不能假设年轻健康人的脑血管和外周血管内皮依赖性功能相关。
Key pointsBrachial artery (BA) shear-mediated dilatation is a widely used assessment of vascular function with links to coronary artery health and cardiovascular risk. Cerebral vascular health is often interrogated using cerebrovascular (middle cerebral artery velocity) reactivity to carbon dioxide. We show that endothelium-dependent diameter (dilator) responses are not significantly related between the internal carotid artery (ICA) and BA; nor are endothelium-independent responses. Additionally, ICA endothelium-dependent responses are not related to middle cerebral artery velocity or ICA blood flow reactivity responses to carbon dioxide. Therefore, assessment of large extracranial cerebral artery vascular health should be quantified via methods specific to the vessel, not via peripheral endothelial function or cerebrovascular reactivity to carbon dioxide. This study compared internal carotid artery (ICA) and brachial artery (BA) endothelium-dependent and -independent vasodilation. We hypothesized that endothelium-dependent and -independent vasodilation of the ICA and BA would be neither similar in magnitude nor correlated between vessels. In 19 healthy adults (23 +/- 6 years, 24 +/- 3 kg/m(2), six female), endothelium-dependent dilatation in the ICA was determined via Duplex ultrasound during transiently elevated shear stress caused by increased partial pressure of end-tidal carbon dioxide using dynamic end-tidal forcing (+9 mmHg; cerebral flow-mediated dilatation, cFMD). BA endothelium-dependent dilatation was assessed via standard flow-mediated dilatation (FMD). Endothelium-independent dilatation in the ICA and BA was assessed concurrently for 10 min following administration of 400 mu g sublingual glyceryl trinitrate (GTN). Endothelium-dependent vasodilation of the ICA (3.4 +/- 2.4%) was lower than (P = 0.013) and not correlated to that of the BA (7.9 +/- 3.3%;r(2) = 0.00,P = 0.93). Including baseline diameter and shear-rate area under the curve as covariates maintained the difference between cFMD and FMD (3.3 +/- 4.2%vs. 7.8 +/- 3.8%,P = 0.03), while including baseline diameter and baseline shear rate-adjusted area under the curve as covariates abolished it (5.9 +/- 3.7%vs. 5.9.8 +/- 3.5%,P = 0.99). GTN-mediated vasodilation of the ICA (14.3 +/- 2.9%) was lower than (P = 0.002) and not correlated to that of the BA (25.5 +/- 8.8%;r(2) = 0.12,P = 0.19). Adjusting for baseline diameter eliminated the differences in GTN-induced vasodilation (ICA: 20.1 +/- 5.8%vs. BA: 20.4 +/- 5.5%;P = 0.93). Differences in endothelium-dependent responses, and the lack of correlations between arteries, indicates that endothelium-dependent function cannot be assumed to be related across cerebral and peripheral vasculatures in young, healthy humans.