A comparison of flow-mediated dilatation and von Willebrand factor as markers of endothelial cell function in health and in hypertension: relationship to cardiovascular risk and effects of treatment - A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial
A comparison of flow-mediated dilatation and von Willebrand factor as markers of endothelial cell function in health and in hypertension: relationship to cardiovascular risk and effects of treatment - A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial
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DOI：
10.1097/00001721-200307000-00001
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发表时间：
2003-07-01
影响因子：
1.1
通讯作者：
Lip, GYH
中科院分区：
文献类型：
--
作者：
Felmeden, DC;Blann, AD;Lip, GYH
“适当内皮细胞功能的丧失（与各种心血管综合征如高血压有关）最广泛地通过评估血流介导的扩张（FMD）或测量血浆标志物如血管性血友病因子（vWF）来量化。然而，这两种方法之间的关系尚不清楚，因为它们与10年心血管风险（由Fracket方程定义）的关系以及它们对强化心血管风险因素管理的反应。我们通过测量132名受试者的vWF和FMD两者来检验vWF和FMD之间存在负相关关系的假设，其中89名为高血压患者（平均血压，167/91 mmHg），43名为健康血压正常者（平均血压，133/80 mmHg）。高分辨率超声评估闭塞后反应性充血后内皮依赖性肱动脉FMD。采用酶联免疫吸附试验测定血浆vWF。在接受心血管危险因素强化管理6个月后，这些测量结果在患者中重复，vWF和FMD显著相关（r =-0.517，P < 0.001），并且使用Fragrance方程，两者均与10年心血管危险相关（vWF，r = 0.48，P < 0.001; FMD，r =-0.624，P < 0.001）。经过6个月的心血管危险因素强化管理后，血浆vWF显著降低，而FMD显著增加（均P < 0.002）。我们的结论是，两种根本不同的方法来评估内皮功能相互关联，以及与10年的心血管风险。6个月的强化风险因素管理对内皮有益，如vWF和FMD改善所定义。因此，这些方法可能是有用的指标，以确定患者在未来的心血管事件的风险，也可能有助于了解高血压血管风险的发病机制的早期发展。(C)2003年利平科特威廉姆斯威尔金斯。
`Loss of adequate endothelial cell function (associated with various cardiovascular syndromes such as hypertension) is most widely quantified by assessing flow-mediated dilatation (FMD) or measuring plasma markers such as von Willebrand factor (vWF). However, the relationship between these two methods is unclear, as is their relationship to 10-year cardiovascular risk (defined by the Framingham equation) and their response to intensive cardiovascular risk factor management. We tested the hypothesis that there is an inverse relationship between vWF and FMD by measuring both in 132 subjects, of whom 89 were hypertensive (mean blood pressure, 167/91 mmHg) and 43 were healthy normotensive (mean blood pressure, 133/80 mmHg). High-resolution ultrasound assessed endothelium-dependent brachial artery FMD following reactive hyperaemia after occlusion. Plasma vWF was defined by enzyme-linked immunosorbent assay. These measurements were repeated in the patients after 6 months of intensive cardiovascular risk factor management vWF and FMD correlated significantly (r = -0.517, P < 0.001), and both correlated with 10-year cardiovascular risk using the Framingham equation (vWF, r = 0.48, P < 0.001; FMD, r = -0.624, P < 0.001). Following 6 months intensive cardiovascular risk factor management, plasma vWF was significantly reduced whereas FMD significantly increased (both P < 0.002). We conclude that two fundamentally different methods for assessing endothelial function correlate well with each other, as well as with 10-year cardiovascular risk. Six months of intensive risk factor management is beneficial to the endothelium, as defined by improved vWF and FMD. These methods might therefore be useful indices to identify patients at risk of future cardiovascular events, and may also assist in the understanding of early developments in the pathogenesis of vascular risk in hypertension. (C) 2003 Lippincott Williams Wilkins.