Human cytomegalovirus seropositivity is associated with impaired vascular function
Human cytomegalovirus seropositivity is associated with impaired vascular function
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DOI：
10.1161/01.cir.0000084505.54603.c7
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发表时间：
2003-08-12
期刊：
影响因子：
37.8
通讯作者：
Vallance, P
中科院分区：
文献类型：
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作者：
Grahame-Clarke, C;Chan, NN;Vallance, P
背景-疱疹病毒感染是动脉粥样硬化形成的一个可能的危险因素，糖尿病患者可能尤其危险。内皮功能障碍是动脉粥样硬化的早期标志，本研究检验了以下假设：（1）既往巨细胞病毒（CMV）和单纯疱疹病毒（HSV）感染与内皮功能障碍相关，（2）糖尿病患者的内皮功能障碍可能更明显。方法和结果-检测了400例受试者的血清样本中CMV和HSV的抗IgG抗体（糖尿病患者和非糖尿病患者的平均年龄分别为37.8 ± 4.3和37.9 ± 3.7 [SD]）。我们还评估了幽门螺杆菌和肺炎衣原体血清学。通过电子束计算机断层扫描对冠状动脉粥样硬化进行定量。受试者（n = 157）接受了乙酰胆碱、缓激肽、硝酸甘油、去甲肾上腺素和L-N（G）-单甲基-L-精氨酸静脉闭塞体积描记术。CMV血清阳性个体对缓激肽（P = 0.005）和硝酸甘油（P = 0.006）的反应降低。在调整对硝酸甘油的反应后，对缓激肽的反应降低仍然显著（P = 0.045），并且与传统的风险因素无关。其他微生物的阳性血清学对反应性没有独立影响。CMV与冠状动脉钙化之间的相关性较弱（P = 0.09）。其他病原体的阳性血清学不影响反应性，但总病原体负荷和受损的血管反应性之间存在关系。糖尿病患者和nondiabetes. Conclusions之间没有显着差异，这项研究表明，CMV血清阳性个体有内皮功能障碍和受损的反应NO。这种关联是独立的传统的危险因素，并可能与动脉粥样硬化负担增加。
Background-Herpesvirus infection is a possible risk factor for atherogenesis, and diabetics may be at particular risk. Endothelial dysfunction is an early marker for atherosclerosis, and the present study tests the hypotheses that ( 1) prior infection with cytomegalovirus (CMV) and herpes simplex virus (HSV) is associated with endothelial dysfunction and ( 2) this may be more marked in diabetics.Methods and Results-Serum samples were tested for anti-IgG antibodies to CMV and HSV from 400 subjects ( mean age for diabetics and nondiabetics, 37.8 +/- 4.3 and 37.9 +/- 3.7 [SD]). We also assessed Helicobacter pylori and Chlamydia pneumoniae serology. Coronary atheroma was quantified by means of electron beam computed tomography. Subjects (n = 157) underwent venous occlusion plethysmography with acetylcholine, bradykinin, glyceryl trinitrate, norepinephrine, and L-N(G)-monomethyl-L-arginine. Individuals who were seropositive for CMV had reduced responses to bradykinin (P = 0.005) and glyceryl trinitrate (P = 0.006). The reduced response to bradykinin remained significant (P = 0.045) after adjusting for the response to glyceryl trinitrate and was independent of conventional risk factors. Positive serology for the other organisms did not have an independent effect on reactivity. There was a weaker association between CMV and coronary artery calcification (P = 0.09). Positive serology for each of the other pathogens did not affect reactivity, but there was a relation between total pathogen burden and impaired vascular reactivity. No significant differences were found between diabetics and nondiabetics.Conclusions-This study shows that CMV-seropositive individuals have endothelial dysfunction and impaired responses to NO. This association was independent of conventional risk factors and may be associated with increased atherosclerosis burden.