|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2002; 40:521-528 © 2002 by the American College of Cardiology Foundation |
,*
* St. Vincent’s Hospital, Sydney, Australia
National Heart and Lung Institute, Royal Brompton Hospital, London, United Kingdom
Manuscript received June 4, 2001; revised manuscript received April 10, 2002, accepted May 14, 2002.
* Reprint requests and correspondence: Dr. Christopher S. Hayward, Cardiology Department, St. Vincent’s Hospital, Victoria St. Darlinghurst 2010, New South Wales, Australia.
chayward{at}stvincents.com.au
OBJECTIVES: The study was done to determine whether radial artery applanation tonometry can be used as a noninvasive method of assessing global endothelial function.
BACKGROUND: It is known that beta2-receptor stimulation results in endothelial release of nitric oxide. Furthermore, for over a century glyceryl trinitrate (GTN) has been known to markedly affect the arterial pressure waveform, even in the absence of significant blood pressure (BP) changes. Therefore, it was hypothesized that the change in the peripheral pressure waveform, as measured using tonometry and quantified using the augmentation index (AIx) and in response to Salbutamol (Salb), would allow assessment of global endothelial function.
METHODS: The study contained three parts. In the first study, Salb (400 µg) was administered to 11 healthy subjects via inhalation after either intravenous N-
-nitro-monomethyl-L-arginine (L-NMMA) (3 mg/kg over 5 min) or control solution (normal saline) in the supine, rested, fasted condition. The BP, heart rate and waveform responses were recorded each 5 min following Salb for 20 min. Next, GTN was given and responses recorded 5 min later. In the second study, both the reproducibility of Salb and the GTN responses were assessed in 9 subjects studied twice on separate days. In the third study, the Salb and GTN responses of 12 subjects with angiographic coronary artery disease (CAD) were compared with 10 age-matched control subjects with no atherosclerotic risk factors.
RESULTS: After control infusion, AIx decreased following Salb, from 50.8 ± 4.3% to 44.8 ± 4.2%, a change of –11.8 ± 3.7%, p < 0.01. After L-NMMA, AIx did not significantly change following Salb (54.2 ± 5.1% vs. 52.9 ± 5.3%, –2.0 ± 3.1%). The GTN-induced decreases in AIx were similar after either infusion (35.1 ± 3.3% vs. 36.5 ± 3.3%). Reproducibility of Salb-induced changes in AIx between studies performed on separate days was good (r = 0.80, p < 0.01). Salb-induced changes in AIx in CAD patients were significantly less compared to control subjects (–2.4 ± 1.9% vs. –13.2 ± 2.4%, respectively, p < 0.002). The GTN-induced changes were not significantly different (–27.6 ± 4.2 vs. –38.9 ± 4.4%, p = 0.07).
CONCLUSIONS: The peripheral arterial pressure waveform is sensitive to beta2-stimulation. Changes are related to nitric oxide release, are reproducible and can distinguish between clinical subject groups. Arterial waveform changes following Salb may thus provide a noninvasive method of measuring "global" arterial endothelial function.
| ||||||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  S. Munir, A. Guilcher, T. Kamalesh, B. Clapp, S. Redwood, M. Marber, and P. Chowienczyk Peripheral Augmentation Index Defines the Relationship Between Central and Peripheral Pulse Pressure Hypertension, January 1, 2008; 51(1): 112 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Crilly, C. Coch, M. Bruce, H. Clark, and D. Williams Indices of cardiovascular function derived from peripheral pulse wave analysis using radial applanation tonometry: a measurement repeatability study Vascular Medicine, August 1, 2007; 12(3): 189 - 197. [Abstract] [PDF]
|
|
|
|
|
|
A. Barac, U. Campia, and J. A. Panza Methods for Evaluating Endothelial Function in Humans Hypertension, April 1, 2007; 49(4): 748 - 760. [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Deanfield, J. P. Halcox, and T. J. Rabelink Endothelial Function and Dysfunction: Testing and Clinical Relevance Circulation, March 13, 2007; 115(10): 1285 - 1295. [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Donald, M. Charakida, T. J. Cole, P. Friberg, P. J. Chowienczyk, S. C. Millasseau, J. E. Deanfield, and J. P. Halcox Non-Invasive Assessment of Endothelial Function: Which Technique? J. Am. Coll. Cardiol., November 7, 2006; 48(9): 1846 - 1850. [Abstract] [Full Text] [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]
|
|
|
|
 |
|
 L. Lind, N. Fors, J. Hall, K. Marttala, and A. Stenborg A Comparison of Three Different Methods to Evaluate Endothelium-Dependent Vasodilation in the Elderly: The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) Study Arterioscler. Thromb. Vasc. Biol., November 1, 2005; 25(11): 2368 - 2375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. G Brillante, M. T Johnstone, and L. G Howes Effects of Intravenous PD 123319 on Haemodynamic and Arterial Stiffness Indices in Healthy Volunteers Journal of Renin-Angiotensin-Aldosterone System, June 1, 2005; 6(2): 102 - 106. [Abstract] [PDF]
|
|
|
|
|
|
M. F. O'Rourke and W. W. Nichols Shear Stress and Flow-Mediated Dilation Hypertension, August 1, 2004; 44(2): 119 - 120. [Full Text] [PDF]
|
|
|
|
|
|
J. R. Greenfield, K. Samaras, L. V. Campbell, A. B. Jenkins, P. J. Kelly, T. D. Spector, and C. S. Hayward Physical activity reduces genetic susceptibility to increased central systolic pressure augmentation: a study of female twins J. Am. Coll. Cardiol., July 16, 2003; 42(2): 264 - 270. [Abstract] [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
