Relationship between endothelial function and coronary risk factors in patients with stable coronary artery disease
Relationship between endothelial function and coronary risk factors in patients with stable coronary artery disease
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DOI：
10.1253/circj.71.698
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发表时间：
2007-05-01
影响因子：
3.3
通讯作者：
Sonmez, Kenan
中科院分区：
文献类型：
--
作者：
Kirma, Cevat;Akcakoyun, Mustafa;Sonmez, Kenan
研究背景实验和临床研究结果表明，冠状动脉疾病（CAD）本身及其传统危险因素导致内皮功能障碍。本研究的目的是确定哪些CAD危险因素维持其贡献内皮功能障碍，尽管存在已建立的CAD.Methods和结果-研究组包括150例CAD患者。使用高分辨率超声，测量静息和反应性充血期间（血流介导的扩张，FMD%：内皮依赖性刺激血管舒张）以及舌下含服硝酸甘油后（NTG%：内皮非依赖性血管舒张）的肱动脉直径。探讨冠心病危险因素[糖尿病（DM）、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯、年龄、早发动脉粥样硬化家族史、吸烟、高血压（HT）、体重指数（BMI）]与FMD%的关系。在单因素分析中，FMD%与年龄（r=-0.300，p < 0.001）和BMI（r=-0.230，p < 0.005）呈负相关，与非糖尿病患者相比，糖尿病患者的FMD%显著降低（p < 0.001）。在逐步多元回归分析中，FMD仍与DM和高龄相关，但与BMI无关（分别为β =0.065，p < 0.001，β =-0.001，p=0.002，β =-0.087，p < 0.284）。FMD%与高胆固醇血症、早发性动脉粥样硬化家族史、高血压和吸烟无关。
Background Results of experimental and clinical studies suggest that both coronary artery disease (CAD) itself and its traditional risk factors lead to endothelial dysfunction. The aim of the present study was to determine which CAD risk factors sustain their contribution to endothelial dysfunction despite the presence of established CAD.Methods and Results The study group comprised 150 patients with CAD. Using a high-resolution ultrasound, the diameter of the brachial artery at rest and during reactive hyperemia (flow-mediated dilatation, FMD%: endothel ial-dependent stimulus to vasodilatation), as well as after sublingual administration of nitroglycerin (NTG%: endothelium-independent vasodilatation), was measured. The relationship between FMD% and coronary risk factors [diabetes mellitus (DM), total cholesterol, high-density lipoprotein-chol e sterol, low-density lipoprotein-cholesterol, triglycerides, age, family history of premature atherosclerosis, smoking, hypertension (HT), body mass index (BMI)] was investigated. In univariate analysis there was an inverse relationship between FMD% and age (r=-0.300, p < 0.001), and BMI (r=-0.230, p < 0.005) and FMD% was significantly lower in diabetic patients when compared to non-diabetic patients (p < 0.001). In stepwise multivariate regression analysis; FMD still correlated with DM and advanced age, but not with BMI (beta=0.065, p < 0.001, beta=-0.001 p=0.002, beta=-0.087, p < 0.284, respectively). FMD% was found to be not associated with hypercholesterolemia, family history of premature atherosclerosis, HT and smoking.Conclusion Only aging and DM were independently associated with endothelial dysfunction in patients with established CAD.