Nitroglycerine-Induced Vasodilation for Assessment of Vascular Function A Comparison With Flow-Mediated Vasodilation
Nitroglycerine-Induced Vasodilation for Assessment of Vascular Function A Comparison With Flow-Mediated Vasodilation
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DOI：
10.1161/atvbaha.112.300934
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发表时间：
2013-06-01
影响因子：
8.7
通讯作者：
Higashi, Yukihito
中科院分区：
文献类型：
--
作者：
Maruhashi, Tatsuya;Soga, Junko;Higashi, Yukihito
目的：在评价人类内皮功能时，硝酸甘油诱导的血管扩张已被用作血流介导的血管扩张(FMD)的对照试验，以区分内皮依赖和非内皮依赖的反应。最近，硝酸甘油诱导的血管扩张也被报道在动脉粥样硬化患者中受到损害。方法和结果：我们测量了436名健康体检者(平均年龄53+/-19岁；年龄范围19-86岁)硝酸甘油引起的血管扩张和FMD。硝酸甘油的血管扩张作用与FMD呈显著正相关(r=0.42P<；0.001)。单因素回归分析显示，硝酸甘油引起的血管扩张与年龄(r=-0.34；P<；0.001)、收缩压(r=-0.32；P<；0.001)、舒张压(r=-0.24；P<；0.001)、心率(r=-0.21；P<；0.001)、血糖(r=-0.23；P<；0.001)、吸烟年限(r=-0.12；P=0.01)以及Framingham危险评分(r=-0.30；P<；0.001)。有心血管疾病的患者硝酸甘油诱导的血管扩张显著小于有和没有心血管危险因素的受试者(分别为10.5±5.6%比13.7±-5.4%和15.3±4.3%；P<；0.001)，而有和没有心血管危险因素的受试者之间硝酸甘油诱导的血管扩张没有显著差异。多因素分析显示，男性、体重指数、高血压、糖尿病、基础肱动脉内径和FMD是硝酸甘油诱导的血管扩张的独立预测因素。结论：硝酸甘油诱导的血管扩张可能是动脉粥样硬化程度的标志。在硝酸甘油诱导的血管扩张受损的受试者中，FMD应被解释为反映内皮依赖性和非内皮依赖性血管扩张的血管功能指标。
Objective-Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors.Approach and Results-We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 +/- 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r= 0.42; P< 0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P< 0.001), systolic blood pressure (r=-0.32; P< 0.001), diastolic blood pressure (r=-0.24; P< 0.001), heart rate (r=-0.21; P< 0.001), glucose (r=-0.23; P< 0.001), and smoking pack-year (r=-0.12; P= 0.01), as well as Framingham risk score (r=-0.30; P< 0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 +/- 5.6% versus 13.7 +/- 5.4% and 15.3 +/- 4.3%; P< 0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation.Conclusions-These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.