CLINICAL STUDIES
Impaired brachial artery endothelial function is not predicted by elevated triglycerides
Greg B. Schnell, MDa,
Annette Robertson, RNa,
Deborah Houstona,
Linda Malleya and
Todd J. Anderson, MDa
a Division of Cardiology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Manuscript received August 20, 1998;
revised manuscript received January 25, 1999,
accepted February 16, 1999.
Reprint requests and correspondence: Dr. Todd J. Anderson, Division of Cardiology, Foothill’s Hospital, 1403 29th St NW, Calgary, Alberta, Canada T2N 2T9
todd.anderson{at}crha-health.ab.ca
OBJECTIVES
The purpose of this study was to determine if patients with modest hyperlipidemia, and no other risk factors for coronary artery disease (CAD), have impaired endothelium-dependent (ED) vasoactivity.
BACKGROUND
Hypercholesterolemia impairs ED vasodilation, but the impact of elevated triglycerides on endothelial function is not as well established.
METHODS
High-resolution ultrasound was used to determine flow-mediated dilation (FMD) in the brachial artery (BA) after a 5-min arterial occlusion (endothelium-dependent stimulus) and nitroglycerin-induced dilation (endothelium-independent stimulus). We studied 40 healthy controls (Group 1), 38 patients with elevated low-density lipoprotein (LDL) cholesterol (Group 2) and 35 patients with elevated triglycerides (Group 3). Patients were excluded if they had known CAD or other risk factors for CAD, or if they were receiving lipid-lowering or vasoactive medications.
RESULTS
Control patients (Group 1) had normal LDL cholesterol (2.6 ± 0.8 mmol/liter) and triglyceride levels (1.0 ± 0.5 mmol/liter) compared with Group 2 (5.2 ± 1.2 mmol/liter, 1.8 ± 0.6 mmol/liter) and Group 3 (3.5 ± 0.9 mmol/liter, 4.2 ± 2.5 mmol/liter) subjects (p < 0.001). Baseline BA diameters were the same across the three groups. There was no significant attenuation of flow-mediated vasodilation (FMD) in either of the hyperlipidemic groups (Group 1: 10.9 ± 5.0% vs. Group 2: 8.6 ± 6.1% vs. Group 3: 9.4 ± 3.9%; p = 0.14). However, nitroglycerin-induced vasodilation was mildly reduced (Group 1: 21.0 ± 5.0% vs. 16.9 ± 7.6% vs. 17.3 ± 7.7%; p = 0.01). By multivariate analysis, after controlling for baseline diameters, only the ratio of LDL/high-density lipoprotein predicted a minor impairment in FMD.
CONCLUSIONS
In patients free from other cardiac risk factors, modest elevations of triglycerides or LDL cholesterol do not significantly attenuate BA endothelial-dependent vasodilation. Synergism with other cardiac risk factors may be required to significantly impair endothelial function in these patients.
|
Abbreviations and Acronyms
| | CAD | = coronary artery disease | | ECG | = electrocardiogram | | FMD | = flow-mediated vasodilation | | HDL | = high-density lipoprotein | | LDL | = low-density lipoprotein | | NO | = nitric oxide |
|
This article has been cited by other articles:
|
|
|
|
 
L. M Yunker, J. S Parboosingh, H. E Conradson, P. Faris, P. J Bridge, J. Buithieu, L. M Title, F. Charbonneau, S. Verma, E. M Lonn, et al.
The effect of iron status on vascular health
Vascular Medicine,
May 1, 2006;
11(2):
85 - 91.
[Abstract]
[PDF]
|
|
|
|
|
|
|
N. Nair, R. K Oka, L. D Waring, E. M Umoh, C B. Taylor, and J. P Cooke
Vascular compliance versus flow-mediated vasodilation: correlation with cardiovascular risk factors
Vascular Medicine,
November 1, 2005;
10(4):
275 - 283.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A. L. Moens, I. Goovaerts, M. J. Claeys, and C. J. Vrints
Flow-Mediated Vasodilation: A Diagnostic Instrument, or an Experimental Tool?
Chest,
June 1, 2005;
127(6):
2254 - 2263.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Bots, J. Westerink, T. J. Rabelink, and E. J.P. de Koning
Assessment of flow-mediated vasodilatation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response
Eur. Heart J.,
February 2, 2005;
26(4):
363 - 368.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Sanada, Y. Higashi, K. Nakagawa, M. Tsuda, I. Kodama, M. Kimura, K. Chayama, and K. Ohama
A Comparison of Low-Dose and Standard-Dose Oral Estrogen on Forearm Endothelial Function in Early Postmenopausal Women
J. Clin. Endocrinol. Metab.,
March 1, 2003;
88(3):
1303 - 1309.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. J. Anderson, J. Hubacek, D. G. Wyse, and M. L. Knudtson
Effect of chelation therapy on endothelial function in patients with coronary artery disease: PATCH substudy
J. Am. Coll. Cardiol.,
February 5, 2003;
41(3):
420 - 425.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. H. Capell, C. A. DeSouza, P. Poirier, M. L. Bell, B. L. Stauffer, K. M. Weil, T. L. Hernandez, and R. H. Eckel
Short-Term Triglyceride Lowering With Fenofibrate Improves Vasodilator Function in Subjects With Hypertriglyceridemia
Arterioscler. Thromb. Vasc. Biol.,
February 1, 2003;
23(2):
307 - 313.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I.J.A.M Jonkers, M.A van de Ree, A.H.M Smelt, F.H.A.F de Man, H Jansen, A.E Meinders, A van der Laarse, and G.J Blauw
Insulin resistance but not hypertriglyceridemia per se is associated with endothelial dysfunction in chronic hypertriglyceridemia
Cardiovasc Res,
February 1, 2002;
53(2):
496 - 501.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Kelm
Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects
Am J Physiol Heart Circ Physiol,
January 1, 2002;
282(1):
H1 - H5.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Zitzmann, M. Brune, B. Kornmann, J. Gromoll, S. von Eckardstein, A. von Eckardstein, and E. Nieschlag
The CAG Repeat Polymorphism in the AR Gene Affects High Density Lipoprotein Cholesterol and Arterial Vasoreactivity
J. Clin. Endocrinol. Metab.,
October 1, 2001;
86(10):
4867 - 4873.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Lundman, M. J. Eriksson, M. Stuhlinger, J. P. Cooke, A. Hamsten, and P. Tornvall
Mild-to-moderate hypertriglyceridemia in young men is associated with endothelial dysfunction and increased plasma concentrations of asymmetric dimethylarginine
J. Am. Coll. Cardiol.,
July 1, 2001;
38(1):
111 - 116.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. J. Nestel, H. Shige, S. Pomeroy, M. Cehun, and J. Chin-Dusting
Post-prandial remnant lipids impair arterial compliance
J. Am. Coll. Cardiol.,
June 1, 2001;
37(7):
1929 - 1935.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. W Wilmink, M. B Twickler, J. D. Banga, G. M Dallinga-Thie, H. Eeltink, D.W. Erkelens, T. J Rabelink, and E. S Stroes
Effect of statin versus fibrate on postprandial endothelial dysfunction: role of remnant-like particles
Cardiovasc Res,
June 1, 2001;
50(3):
577 - 582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. A. Vogel, M. C. Corretti, and G. D. Plotnick
The postprandial effect of components of the mediterranean diet on endothelial function
J. Am. Coll. Cardiol.,
November 1, 2000;
36(5):
1455 - 1460.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. N. Hodis
Myocardial Ischemia and Lipoprotein Lipase Activity
Circulation,
October 3, 2000;
102(14):
1600 - 1601.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Vakkilainen, S. Makimattila, A. Seppala-Lindroos, S. Vehkavaara, S. Lahdenpera, P.-H. Groop, M.-R. Taskinen, and H. Yki-Jarvinen
Endothelial Dysfunction in Men With Small LDL Particles
Circulation,
August 15, 2000;
102(7):
716 - 721.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. T. Raitakari, N. Lai, K. Griffiths, R. McCredie, D. Sullivan, and D. S. Celermajer
Enhanced peripheral vasodilation in humans after a fatty meal
J. Am. Coll. Cardiol.,
August 1, 2000;
36(2):
417 - 422.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
