Smooth muscle dysfunction occurs independently of impaired endothelium-dependent dilation in adults at risk of atherosclerosis
Smooth muscle dysfunction occurs independently of impaired endothelium-dependent dilation in adults at risk of atherosclerosis
复制标题
DOI：
10.1016/s0735-1097(98)00206-x
复制
发表时间：
1998-07-01
影响因子：
24
通讯作者：
Celermajer, DS
中科院分区：
文献类型：
--
作者：
Adams, MR;Robinson, J;Celermajer, DS
目标。我们试图评估有动脉粥样硬化风险的成年人的平滑肌功能。背景。先前对有动脉粥样硬化风险的受试者的研究表明，动脉内皮功能障碍，在内皮一氧化氮（NO）的药理或生理刺激后，血管舒张反应降低。大多数人还表现出对外源性 NO（例如硝酸甘油 (NTG)）的反应会导致血管舒张受到轻微但不显着的损害。我们假设，在大量连续研究的有动脉粥样硬化风险的成年人中，NTG 反应可能会降低，与任何受损的内皮依赖性反应无关，与伴随的平滑肌功能障碍一致。方法。使用高分辨率超声，测量了 800 名无症状受试者的肱动脉扩张器对 400 μg 舌下 NTG 的反应。科目也。评估血管危险因素、血压、血清总胆固醇和血流介导的内皮依赖性扩张（EDD）的病史。结果。我们研究了 317 名男性和 483 名女性，年龄 38 +/- 17 岁（平均值 +/- SD，范围 15 至 76）。平均胆固醇水平为 5.2 +/- 1.3 mmol/L，有 136 名吸烟者和戒烟者（平均吸烟年数为 16 +/- 9 年）和 105 名糖尿病受试者。在单变量分析中，NTG 血管扩张剂反应的降低与高胆固醇、吸烟、糖尿病、年龄增长、男性、血管尺寸增大和 EDD 减少相关（全部 p < 0.01）。在多变量分析中，糖尿病、较大的血管尺寸和 EDD 减少均与 NTG 相关血管舒张受损独立相关（p 均小于或等于 0.001）。在 574 名从未吸烟的非糖尿病受试者中，仍然观察到 EDD 和 NTG 反应之间的独立关系（r = 0.24，p = 0.01）。结论。 EDD 减少的无症状受试者对外源性 NO 的血管舒张反应受损，这与有动脉粥样硬化风险的成人的平滑肌功能障碍一致。 (C) 1998 年由美国心脏病学会发布。
Objectives. We sought to assess.smooth muscle function in adults at risk for atherosclerosis.Background. Previous studies in subjects at risk for atherosclerosis have demonstrated arterial endothelial dysfunction, with reduced vasodilator responses after pharmacologic or physiologic stimulation of endothelial nitric oxide (NO). Most have also shown a slight but nonsignificant impairment of vasodilation in response to exogenous sources of NO, such as nitroglycerin (NTG). We hypothesized that NTG responses might be reduced in a large number of consecutively studied adults at risk for atherosclerosis, independent of any impaired endothelium-dependent responses, consistent with concomitant smooth muscle dysfunction.Methods. Using high resolution ultrasound, the dilator response of the brachial artery to 400 mu g of sublingual NTG was measured in 800 asymptomatic subjects. Subjects were also. assessed for a history of vascular risk factors, blood pressure, total serum cholesterol and flow-mediated endothelium-dependent dilation (EDD).Results. We studied 317 men and 483 women, 38 +/- 17 years old (mean +/- SD, range 15 to 76). The mean cholesterol level was 5.2 +/- 1.3 mmol/liter, and there were 136 smokers and ex-smokers (16 +/- 9 mean pack years) and 105 diabetic subjects. On univariate analysis, a reduced vasodilator response to NTG was associated with high cholesterol, cigarette smoking, diabetes mellitus, in creasing age, male gender, larger vessel size and reduced EDD (p < 0.01 for all). On multivariate analysis, diabetes, larger vessel size and reduced EDD were all independently associated with impaired NTG-related vasodilation (p less than or equal to 0.001 for all). In the 574 nondiabetic subjects who had never smoked cigarettes, the independent relation between EDD and NTG responses was still observed (r = 0.24, p = 0.01).Conclusions. The vasodilator response to exogenous NO is impaired in asymptomatic subjects with reduced EDD, consistent with smooth muscle dysfunction in adults at risk for atherosclerosis. (C) 1998 by the American College of Cardiology.