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J D Moreira N, Dos Santos F, Li JB, Aletti F, Irigoyen MCC, Kistler EB. Enteral administration of the protease inhibitor gabexate mesilate preserves vascular function in experimental trauma/hemorrhagic shock. Sci Rep 2023; 13:10148. [PMID: 37349360 PMCID: PMC10287748 DOI: 10.1038/s41598-023-36021-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/27/2023] [Indexed: 06/24/2023] Open
Abstract
Preserving vascular function is crucial for preventing multiorgan failure and death in ischemic and low-pressure states such as trauma/hemorrhagic shock (T/HS). It has recently been reported that inhibiting circulating proteases released from the bowel to the circulation during T/HS may preserve vascular function and improve outcomes following T/HS. This study aimed to evaluate the role of the serine protease inhibitor gabexate mesilate (GM) in preserving vascular function during T/HS when given enterally. We studied the vascular reactivity of mesenteric arteries from male Wistar rats treated with enteral GM (10 mg/kg) (GM-treated, n = 6) or control (Shock-control, n = 6) following (T/HS) using pressure myography. Concentration-response curves of endothelial-dependent and endothelial-independent agonists (e.g., acetylcholine, sodium nitroprusside) ranging from 10-10 to 10-5 M were performed. In a second set of experiments, ex-vivo arteries from healthy rats were perfused with plasma from shocked animals from both groups and vascular performance was similarly measured. Arteries from the GM-treated group demonstrated a preserved concentration-response curve to the α1 adrenergic agonist phenylephrine compared to arteries from Shock-control animals (- logEC50: - 5.73 ± 0.25 vs. - 6.48 ± 0.2, Shock-control vs. GM-treated, p = 0.04). When perfused with plasma from GM-treated rats, healthy arteries exhibited an even greater constriction and sensitivity to phenylephrine (- logEC50: - 6.62 ± 0.21 vs. - 7.13 ± 0.21, Shock-control vs. GM-treated, p = 0.02). Enteral GM also preserved the endothelium-dependent vascular response to agonists following T/HS and limited syndecan-1 shedding as a marker of glycocalyx compromise (41.84 ± 9 vs. 17.63 ± 3.97 ng/mL, Shock-control vs. GM-treated, p = 0.02). Syndecan-1 cleavage was correlated with plasma trypsin-like activity (r2 = 0.9611). Enteral gabexate mesilate was able to maintain vascular function in experimental T/HS, which was reflected by improved hemodynamics (mean arterial pressure 50.39 ± 7.91 vs. 64.95 ± 3.43 mmHg, Shock-control vs. GM treated, p = 0.0001). Enteral serine protease inhibition may be a potential therapeutic intervention in the treatment of T/HS.
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Affiliation(s)
- Nathalia J D Moreira
- Instituto do Coração, Hospital das ClínicasFaculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
| | - Fernando Dos Santos
- Department of Anesthesiology and Critical Care, University of California, San Diego, La Jolla, CA, USA
| | - Joyce B Li
- Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA
| | - Federico Aletti
- Universidade Federal de São Paulo, São José dos Campos, Brazil
| | - Maria Claudia C Irigoyen
- Instituto do Coração, Hospital das ClínicasFaculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Erik B Kistler
- Department of Anesthesiology and Critical Care, University of California, San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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2
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Park JB, Avolio A. Arteriosclerosis and Atherosclerosis Assessment in Clinical Practice: Methods and Significance. Pulse (Basel) 2023; 11:1-8. [PMID: 37404379 PMCID: PMC10315159 DOI: 10.1159/000530616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/24/2023] [Indexed: 07/06/2023] Open
Abstract
Alongside cancer, cardiovascular disease (CVD) exhibits the highest rates of morbidity and mortality globally, in western society as well as in Asian countries. Aging is a serious problem for the Asian population as progression toward a super-aged society is moving at a remarkably high rate. This increased rate of aging leads to increased CVD risk and, consequently, high CVD incidence. However, aging is not the only deleterious factor of vascular problems; hypertension, hypercholesterolemia, diabetes mellitus, and kidney disease may induce atherosclerosis and arteriosclerosis (i.e., arterial stiffening), and the progression of these diseases ultimately leads to cardiovascular, cerebrovascular, chronic kidney, or peripheral artery disease. Despite the existence of several guidelines on the treatment of risk factors such as hypertension and CVD, there is still an ongoing debate regarding the clinical need for assessment of arteriosclerosis and atherosclerosis, which act as a bridge between cardiovascular risk factors and CVD. In other words, although arteriosclerosis and atherosclerosis are essential to our understanding of vascular diseases, the need for additional tests beyond the conventional diagnosis method remains disputed. This is presumably due to insufficient discussion on how to apply such tests in clinical practice. This study aimed to fill this gap.
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Affiliation(s)
- Jeong Bae Park
- JB Lab and Clinic and Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
| | - Alberto Avolio
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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3
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Rizzoni D, Agabiti-Rosei C, De Ciuceis C. State of the Art Review: Vascular Remodeling in Hypertension. Am J Hypertens 2023; 36:1-13. [PMID: 35961002 DOI: 10.1093/ajh/hpac093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023] Open
Abstract
Although the gold-standard method for the assessment of structural alteration in small resistance arteries is the evaluation of the MLR by micromyography in bioptic tissues, new, noninvasive techniques are presently under development, focusing mainly on the evaluation of WLR in retinal arterioles. These approaches represent a promising and interesting future perspective. Appropriate antihypertensive treatment is able to prevent the development of microvascular alterations or to induce their regression. Also, conductance arteries may be affected by a remodeling process in hypertension, and a cross-talk may exist between structural changes in the small and large arteries. In conclusion, the evaluation of microvascular structure is ready for clinical prime time, and it could, in the future, represent an evaluation to be performed in the majority of hypertensive patients, to better stratify cardiovascular risk and better evaluate the effects of antihypertensive therapy. However, for this purpose, we need a clear demonstration of the prognostic relevance of noninvasive measures of microvascular structure, in basal conditions and during treatment. Vascular remodeling may be frequently observed in hypertension, as well as in obesity and diabetes mellitus. An increased media to lumen ratio (MLR) or wall to lumen ratio (WLR) in microvessels is the hallmark of hypertension, and may impair organ flow reserve, being relevant in the maintenance and, probably, also in the progressive worsening of hypertensive disease, as well as in the development of hypertension-mediated organ damage/cardiovascular events. The molecular mechanisms underlying the development of vascular remodeling are only partly understood.
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Affiliation(s)
- Damiano Rizzoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Division of Medicine, Spedali Civili di Brescia, Montichiari (Brescia), Italy
| | - Claudia Agabiti-Rosei
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Second Division of Medicine, Spedali Civili di Brescia, Brescia, Italy
| | - Carolina De Ciuceis
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Second Division of Medicine, Spedali Civili di Brescia, Brescia, Italy
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4
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Brown PA. Differential and targeted vesiculation: pathologic cellular responses to elevated arterial pressure. Mol Cell Biochem 2022; 477:1023-1040. [PMID: 34989921 DOI: 10.1007/s11010-021-04351-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
Extracellular vesicles are small membrane-enclosed particles released during cell activation or injury. They have been investigated for several decades and found to be secreted in various diseases. Their pathogenic role is further supported by the presence of several important molecules among their cargo, including proteins, lipids, and nucleic acids. Many studies have reported enhanced and targeted extracellular vesicle biogenesis in diseases that involve chronic or transient elevation of arterial pressure resulting in endothelial dysfunction, within either the general circulatory system or specific local vascular beds. In addition, several associated pathologic processes have been studied and reported. However, the role of elevated pressure as a common pathogenic trigger across vascular domains and disease chronicity has not been previously described. This review will therefore summarize our current knowledge of the differential and targeted biogenesis of extracellular vesicles in major diseases that are characterized by elevated arterial pressure leading to endothelial dysfunction and propose a unified theory of pressure-induced extracellular vesicle-mediated pathogenesis.
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Affiliation(s)
- Paul A Brown
- Department of Basic Medical Sciences, Faculty of Medical Sciences Teaching and Research Complex, The University of the West Indies, Mona, Kingston 7, Jamaica.
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5
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Favre J, Vessieres E, Guihot AL, Proux C, Grimaud L, Rivron J, Garcia MC, Réthoré L, Zahreddine R, Davezac M, Fébrissy C, Adlanmerini M, Loufrani L, Procaccio V, Foidart JM, Flouriot G, Lenfant F, Fontaine C, Arnal JF, Henrion D. Membrane estrogen receptor alpha (ERα) participates in flow-mediated dilation in a ligand-independent manner. eLife 2021; 10:68695. [PMID: 34842136 PMCID: PMC8676342 DOI: 10.7554/elife.68695] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
Estrogen receptor alpha (ERα) activation by estrogens prevents atheroma through its nuclear action, whereas plasma membrane-located ERα accelerates endothelial healing. The genetic deficiency of ERα was associated with a reduction in flow-mediated dilation (FMD) in one man. Here, we evaluated ex vivo the role of ERα on FMD of resistance arteries. FMD, but not agonist (acetylcholine, insulin)-mediated dilation, was reduced in male and female mice lacking ERα (Esr1-/- mice) compared to wild-type mice and was not dependent on the presence of estrogens. In C451A-ERα mice lacking membrane ERα, not in mice lacking AF2-dependent nuclear ERα actions, FMD was reduced, and restored by antioxidant treatments. Compared to wild-type mice, isolated perfused kidneys of C451A-ERα mice revealed a decreased flow-mediated nitrate production and an increased H2O2 production. Thus, endothelial membrane ERα promotes NO bioavailability through inhibition of oxidative stress and thereby participates in FMD in a ligand-independent manner.
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Affiliation(s)
- Julie Favre
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France
| | - Emilie Vessieres
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France
| | - Anne-Laure Guihot
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France
| | - Coralyne Proux
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France
| | - Linda Grimaud
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France
| | - Jordan Rivron
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France
| | - Manuela Cl Garcia
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France
| | - Léa Réthoré
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France
| | - Rana Zahreddine
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Morgane Davezac
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Chanaelle Fébrissy
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Marine Adlanmerini
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Laurent Loufrani
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,University Hospital (CHU) of Angers, Angers, France
| | - Vincent Procaccio
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,University Hospital (CHU) of Angers, Angers, France
| | - Jean-Michel Foidart
- Groupe Interdisciplinaire de Génoprotéomique Appliquée, Université de Liège, Liège, Belgium
| | - Gilles Flouriot
- INSERM U1085, IRSET (Institut de Recherche en Santé, Environnement et Travail), University of Rennes, Rennes, France
| | - Françoise Lenfant
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Coralie Fontaine
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Jean-François Arnal
- INSERM U1297, Paul Sabatier University (Toulouse III) , University Hospital (UHC) of Toulouse, Toulouse, France
| | - Daniel Henrion
- Angers University, MITOVASC, CNRS UMR 6015, INSERM U1083, Angers, France.,CARFI facility, Angers University, Angers, France.,University Hospital (CHU) of Angers, Angers, France
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6
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Aziz A, Thompson J, Gyamfi-Bannerman C, D’Alton M, Wapner R, Bello NA. The Evidence of Aspirin Use in Prevention of Adverse Pregnancy Outcomes (APOs): Should It Be Continued Long Term After an APO? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-021-00936-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Baranowska-Kuczko M, Kozłowska H, Kloza M, Harasim-Symbor E, Biernacki M, Kasacka I, Malinowska B. Beneficial Changes in Rat Vascular Endocannabinoid System in Primary Hypertension and under Treatment with Chronic Inhibition of Fatty Acid Amide Hydrolase by URB597. Int J Mol Sci 2021; 22:4833. [PMID: 34063297 PMCID: PMC8125657 DOI: 10.3390/ijms22094833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022] Open
Abstract
Our study aimed to examine the effects of hypertension and the chronic administration of the fatty acid amide hydrolase (FAAH) inhibitor URB597 on vascular function and the endocannabinoid system in spontaneously hypertensive rats (SHR). Functional studies were performed on small mesenteric G3 arteries (sMA) and aortas isolated from SHR and normotensive Wistar Kyoto rats (WKY) treated with URB597 (1 mg/kg; twice daily for 14 days). In the aortas and sMA of SHR, endocannabinoid levels and cannabinoid CB1 receptor (CB1R) expression were elevated. The CB1R antagonist AM251 diminished the methanandamide-evoked relaxation only in the sMA of SHR and enhanced the vasoconstriction induced by phenylephrine and the thromboxane analog U46619 in sMA in SHR and WKY. In the sMA of SHR, URB597 elevated anandamide levels, improved the endothelium-dependent vasorelaxation to acetylcholine, and in the presence of AM251 reduced the vasoconstriction to phenylephrine and enhanced the vasodilatation to methanandamide, and tended to reduce hypertrophy. In the aortas, URB597 elevated endocannabinoid levels improved the endothelium-dependent vasorelaxation to acetylcholine and decreased CB1R expression. Our study showed that hypertension and chronic administration of URB597 caused local, resistance artery-specific beneficial alterations in the vascular endocannabinoid system, which may bring further advantages for therapeutic application of pharmacological inhibition of FAAH.
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Affiliation(s)
- Marta Baranowska-Kuczko
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, ul. Mickiewicza 2A, 15-222 Białystok, Poland; (H.K.); (M.K.); (B.M.)
- Department of Clinical Pharmacy, Medical University of Białystok, ul. Mickiewicza 2A, 15-222 Białystok, Poland
| | - Hanna Kozłowska
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, ul. Mickiewicza 2A, 15-222 Białystok, Poland; (H.K.); (M.K.); (B.M.)
| | - Monika Kloza
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, ul. Mickiewicza 2A, 15-222 Białystok, Poland; (H.K.); (M.K.); (B.M.)
| | - Ewa Harasim-Symbor
- Department of Physiology, Medical University of Białystok, ul. Mickiewicza 2C, 15-222 Białystok, Poland;
| | - Michał Biernacki
- Department of Analytical Chemistry, Medical University of Białystok, ul. Mickiewicza 2D, 15-222 Białystok, Poland;
| | - Irena Kasacka
- Department of Histology and Cytophysiology, Medical University of Białystok, ul. Mickiewicza 2C, 15-222 Białystok, Poland;
| | - Barbara Malinowska
- Department of Experimental Physiology and Pathophysiology, Medical University of Białystok, ul. Mickiewicza 2A, 15-222 Białystok, Poland; (H.K.); (M.K.); (B.M.)
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8
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Mazloomi S, Khodadadi I, Alizadeh N, Shafiee G. Association of glutamate cystein ligase (GCL) activity Peroxiredoxin 4 (prxR4) and apelin levels in women with preeclampsia. Pregnancy Hypertens 2020; 23:163-168. [PMID: 33421846 DOI: 10.1016/j.preghy.2020.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/08/2020] [Accepted: 12/18/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Preeclampsia is a common disease of pregnancy that is characterized by symptoms such as high blood pressure and proteinuria. Peroxiredoxin 4 (Prx4), is a protein with antioxidant properties which is produced in placenta and protects it from antioxidant stress and recurrent miscarriage. For regeneration of Peroxiredoxin 4 need to glutathione (GSH) and Glutamate-cysteine ligase (GCL) enzyme controls the pathway of glutathione regeneration. Apelin is a paired internal ligand with a G protein coupled receptor and is associated with angiotensin receptor (AT1) as a blood pressure regulator. This study was designed to evaluate GCL enzyme activity and Peroxiredoxin 4, glutathione and apelin levels in serum of women with preeclampsia. MATERIAL AND METHODS Thirty pregnant women with preeclampsia and 30 healthy pregnant women were enrolled in this study. All participants were diagnosed by clinical examination and confirmation by Obstetrician-Gynecologist. The GCL enzyme activity and concentration of Prx4 and apelin in serum samples were measured using ready-to-use non-competitive ELISA methods while glutathione level was determined using Ellman's reagent. RESULTS The GCL enzyme activity and Prx4 level were significantly lower in preeclampsia compared with control group (p < 0.05). In addition, marked reductions were observed in the concentrations of glutathione and apelin in preeclampsia compared to the healthy pregnant women (p < 0.05). CONCLUSION This study identified the role of the GCL and Prx4 system in preeclampsia disorder and may be one of the ways to prevent and reduce the risks of preeclampsia in high-risk women using diet control and stress reduction.
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Affiliation(s)
- Sahar Mazloomi
- Ph.D Candidate, Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Iraj Khodadadi
- Professor of Biochemistry, Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Narges Alizadeh
- Obstetricians and Gynecologist, Bijar Imam Hossain Hospital, Kurdistan University of Medical Sciences, Kurdistan, Iran
| | - Gholamreza Shafiee
- Assistant Professor of Clinical Biochemistry, Department of Clinical Biochemistry, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran; Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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9
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Brown IAM, Diederich L, Good ME, DeLalio LJ, Murphy SA, Cortese-Krott MM, Hall JL, Le TH, Isakson BE. Vascular Smooth Muscle Remodeling in Conductive and Resistance Arteries in Hypertension. Arterioscler Thromb Vasc Biol 2019; 38:1969-1985. [PMID: 30354262 DOI: 10.1161/atvbaha.118.311229] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease is a leading cause of death worldwide and accounts for >17.3 million deaths per year, with an estimated increase in incidence to 23.6 million by 2030. 1 Cardiovascular death represents 31% of all global deaths 2 -with stroke, heart attack, and ruptured aneurysms predominantly contributing to these high mortality rates. A key risk factor for cardiovascular disease is hypertension. Although treatment or reduction in hypertension can prevent the onset of cardiovascular events, existing therapies are only partially effective. A key pathological hallmark of hypertension is increased peripheral vascular resistance because of structural and functional changes in large (conductive) and small (resistance) arteries. In this review, we discuss the clinical implications of vascular remodeling, compare the differences between vascular smooth muscle cell remodeling in conductive and resistance arteries, discuss the genetic factors associated with vascular smooth muscle cell function in hypertensive patients, and provide a prospective assessment of current and future research and pharmacological targets for the treatment of hypertension.
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Affiliation(s)
- Isola A M Brown
- From the Robert M. Berne Cardiovascular Research Center (I.A.M.B., M.E.G., L.J.D., S.A.M., B.E.I.)
| | - Lukas Diederich
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology and Angiology, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany (L.D., M.M.C.-K.)
| | - Miranda E Good
- From the Robert M. Berne Cardiovascular Research Center (I.A.M.B., M.E.G., L.J.D., S.A.M., B.E.I.)
| | - Leon J DeLalio
- From the Robert M. Berne Cardiovascular Research Center (I.A.M.B., M.E.G., L.J.D., S.A.M., B.E.I.).,Department of Pharmacology (L.J.D.)
| | - Sara A Murphy
- From the Robert M. Berne Cardiovascular Research Center (I.A.M.B., M.E.G., L.J.D., S.A.M., B.E.I.)
| | - Miriam M Cortese-Krott
- Cardiovascular Research Laboratory, Division of Cardiology, Pneumology and Angiology, Medical Faculty, Heinrich Heine University, Dusseldorf, Germany (L.D., M.M.C.-K.)
| | - Jennifer L Hall
- Lillehei Heart Institute (J.L.H.).,Division of Cardiology, Department of Medicine (J.L.H.), University of Minnesota, Minneapolis.,American Heart Association, Dallas, TX (J.L.H.)
| | - Thu H Le
- Division of Nephrology, Department of Medicine (T.H.L.)
| | - Brant E Isakson
- From the Robert M. Berne Cardiovascular Research Center (I.A.M.B., M.E.G., L.J.D., S.A.M., B.E.I.).,Department of Molecular Physiology and Biophysics (B.E.I.), University of Virginia School of Medicine, Charlottesville
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10
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Pereira CA, Carneiro FS, Matsumoto T, Tostes RC. Bonus Effects of Antidiabetic Drugs: Possible Beneficial Effects on Endothelial Dysfunction, Vascular Inflammation and Atherosclerosis. Basic Clin Pharmacol Toxicol 2018; 123:523-538. [DOI: 10.1111/bcpt.13054] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 06/04/2018] [Indexed: 01/17/2023]
Affiliation(s)
- Camila A. Pereira
- Department of Pharmacology; Ribeirao Preto Medical School; University of Sao Paulo; Ribeirao Preto Brazil
| | - Fernando S. Carneiro
- Department of Pharmacology; Ribeirao Preto Medical School; University of Sao Paulo; Ribeirao Preto Brazil
| | - Takayuki Matsumoto
- Department of Physiology and Morphology; Institute of Medicinal Chemistry; Hoshi University; Shinagawa-ku Tokyo Japan
| | - Rita C. Tostes
- Department of Pharmacology; Ribeirao Preto Medical School; University of Sao Paulo; Ribeirao Preto Brazil
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11
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Tzanis G, Dimopoulos S, Manetos C, Koroboki E, Manios E, Vasileiadis I, Zakopoulos N, Nanas S. Muscle microcirculation alterations and relation to dipping status in newly diagnosed untreated patients with arterial hypertension-A pilot study. Microcirculation 2017; 24. [PMID: 28585358 DOI: 10.1111/micc.12384] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/30/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The importance of abnormalities observed in the microcirculation of patients with arterial hypertension (AH) is being increasingly recognized. The authors aimed to evaluate skeletal muscle microcirculation in untreated, newly diagnosed hypertensive patients with NIRS, a noninvasive method that evaluates microcirculation. METHODS We evaluated 34 subjects, 17 patients with AH (13 males, 49±13 years, BMI: 26±2 kg/m2 ) and 17 healthy controls (12 males, 49±15 years, BMI: 25±3 kg/m2 ). The thenar muscle StO2 (%) was measured by NIRS before, during and after 3-minutes vascular occlusion to calculate OCR (%/min), EF (%/min), and RHT (minute). The dipping status of hypertensive patients was assessed. RESULTS The RHT differed between AH patients and healthy subjects (2.6±0.3 vs 2.1±0.3 minutes, P<.001). Dippers had higher EF than nondippers (939±280 vs 710±164%/min, P=.05). CONCLUSIONS The study suggests an impaired muscle microcirculation in newly diagnosed, untreated AH patients.
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Affiliation(s)
- Georgios Tzanis
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Stavros Dimopoulos
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Chris Manetos
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Eleni Koroboki
- Clinical Therapeutics, Hypertensive Center, Alexandra Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Manios
- Clinical Therapeutics, Hypertensive Center, Alexandra Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Vasileiadis
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, National & Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Zakopoulos
- Clinical Therapeutics, Hypertensive Center, Alexandra Hospital, National & Kapodistrian University of Athens, Athens, Greece
| | - Serafim Nanas
- 1st Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, National & Kapodistrian University of Athens, Athens, Greece
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12
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Abstract
Although the endothelium has a number of important functions, the term endothelial dysfunction is commonly used to describe impairment in its vasodilatory capacity. It is increasingly recognized that this is related to hypertension, although whether it predates essential hypertension or is a consequence of it is still unknown. In this review, we explore the mechanisms of endothelial dysfunction in essential hypertension, its prognostic significance and methods of pharmacological reversal.
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Haq S, Mathur M, Singh J, Kaur N, Sibia RS, Badhan R. Colour Doppler Evaluation of Extracranial Carotid Artery in Patients Presenting with Acute Ischemic Stroke and Correlation with Various Risk Factors. J Clin Diagn Res 2017; 11:TC01-TC05. [PMID: 28511475 PMCID: PMC5427401 DOI: 10.7860/jcdr/2017/25493.9541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/18/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Stroke is defined as an abrupt onset of neurologic deficit due to vascular cause. It is one of the leading causes of mortality and morbidity all over the world making early diagnosis and treatment inevitable. Lesions of extra cranial carotid arteries are implicated in majority of cases of acute ischemic stroke. Carotid Doppler is a non-invasive imaging technique, with sensitivity approaching that of angiography. Computed Tomography (CT) plays a major role to assess the site and nature of the lesion in patients with acute ischemic stroke. AIM To evaluate the role of carotid Doppler sonography in patients presenting with acute ischemic stroke and find association between carotid artery stenosis and risk factors such as diabetes mellitus, hypertension, hyperlipidemia, smoking and age. MATERIALS AND METHODS The present study was conducted on 50 patients. CT scan was done to diagnose acute ischemic stroke in patients who presented to emergency medicine with symptoms of acute ischemic stroke. Retrospectively CIMT and plaque characterization were done by gray scale ultrasound. Site and severity of stenosis were assessed on colour Doppler. All these findings were correlated with clinical presentation and risk factors. The collected data was statistically analyzed and multivariant logistic regression (R-value) test of significance was applied by using SPSS 16.0 version software. RESULTS On carotid Doppler, ICA/CCA PSV ratio was good predictor of stenosis and ratio above three indicates significant stenosis (>60%). Carotid bulb was most common location of plaque formation. Hypertension and diabetes were the most prevalent risk factors for cerebral ischemic stroke. Out of total 50 patients, 32 had hypertension (64%) and 22 had diabetes (44%). Hypertension and hyperlipidemia showed maximum mean R-values (0.275 and 0.048 respectively) and positive correlation with stenosis and increased CIMT in acute ischemic stroke patients. CONCLUSION The present study highlights the importance of Doppler sonography in acute ischemic stroke patients through surveillance of atherosclerosis.
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Affiliation(s)
- Samrin Haq
- Junior Resident, Department of Radiology, GMC, Patiala, Punjab, India
| | - Manoj Mathur
- Associate Professor, Department of Radiology, GMC, Patiala, Punjab, India
| | - Jasvir Singh
- Junior Resident, Department of Radiology, GMC, Patiala, Punjab, India
| | - Navkiran Kaur
- Associate Professor, Department of Medicine, GMC, Patiala, Punjab, India
| | | | - Rajesh Badhan
- Senior Resident, Department of Radiology, GMC, Patiala, Punjab, India
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Abstract
PURPOSE OF REVIEW Pre-eclampsia remains a leading worldwide cause of maternal death and of perinatal morbidity. There remains no definitive treatment except delivery of the fetus. RECENT FINDINGS Recent insights into the cardiovascular changes that are evident prior to, during, and persist after pre-eclampsia have improved understanding of the underlying pathophysiology-disruption of normal endothelial function and decreased nitric oxide bioavailability. S-nitrosoglutathione (GSNO) is an endogenous S-nitrosothiol that acts as a NO pool and, by replenishing or preventing the breakdown of GSNO, endothelial dysfunction can be ameliorated. GSNO reductase inhibitors are a novel class of drug that can increase NO bioavailability. GSNO reductase inhibitors have demonstrated improvement of endothelial dysfunction in animal models, and in vivo human studies have shown them to be well tolerated. GSNOR inhibitors offer a potentially promising option for the management of pre-eclampsia.
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Affiliation(s)
- Thomas R Everett
- Department of Fetal Medicine, Leeds Teaching Hospitals Trust, Leeds, UK.
- University of Leeds, Leeds, UK.
| | - Ian B Wilkinson
- Experimental Medicine and Immunotherapeutics, Addenbrooke's Hospital, Box 98, Cambridge, UK
| | - Christoph C Lees
- Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Abstract
Nitric oxide (NO) generated by endothelial cells to relax vascular smooth muscle is one of the most intensely studied molecules in the past 25 years. Much of what is known about NO regulation of NO is based on blockade of its generation and analysis of changes in vascular regulation. This approach has been useful to demonstrate the importance of NO in large scale forms of regulation but provides less information on the nuances of NO regulation. However, there is a growing body of studies on multiple types of in vivo measurement of NO in normal and pathological conditions. This discussion will focus on in vivo studies and how they are reshaping the understanding of NO's role in vascular resistance regulation and the pathologies of hypertension and diabetes mellitus. The role of microelectrode measurements in the measurement of [NO] will be considered because much of the controversy about what NO does and at what concentration depends upon the measurement methodology. For those studies where the technology has been tested and found to be well founded, the concept evolving is that the stresses imposed on the vasculature in the form of flow-mediated stimulation, chemicals within the tissue, and oxygen tension can cause rapid and large changes in the NO concentration to affect vascular regulation. All these functions are compromised in both animal and human forms of hypertension and diabetes mellitus due to altered regulation of endothelial cells and formation of oxidants that both damage endothelial cells and change the regulation of endothelial nitric oxide synthase.
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Affiliation(s)
- Harold Glenn Bohlen
- Department of Cellular and Integrative Physiology, Indiana University Medical School, Indianapolis, Indiana, Indiana, USA
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Varadharaj S, Porter K, Pleister A, Wannemacher J, Sow A, Jarjoura D, Zweier JL, Khayat RN. Endothelial nitric oxide synthase uncoupling: a novel pathway in OSA induced vascular endothelial dysfunction. Respir Physiol Neurobiol 2015; 207:40-7. [PMID: 25534145 PMCID: PMC4297730 DOI: 10.1016/j.resp.2014.12.012] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/04/2014] [Accepted: 12/15/2014] [Indexed: 01/22/2023]
Abstract
The mechanism of vascular endothelial dysfunction (VED) and cardiovascular disease in obstructive sleep apnea (OSA) is unknown. We performed a comprehensive evaluation of endothelial nitric oxide synthase (eNOS) function directly in the microcirculatory endothelial tissue of OSA patients who have very low cardiovascular risk status. Nineteen OSA patients underwent gluteal biopsies before, and after effective treatment of OSA. We measured superoxide (O2(•-)) and nitric oxide (NO) in the microcirculatory endothelium using confocal microscopy. We evaluated the effect of the NOS inhibitor l-Nitroarginine-Methyl-Ester (l-NAME) and the NOS cofactor tetrahydrobiopterin (BH4) on endothelial O2(•-) and NO in patient endothelial tissue before and after treatment. We found that eNOS is dysfunctional in OSA patients pre-treatment, and is a source of endothelial O2(•-) overproduction. eNOS dysfunction was reversible with the addition of BH4. These findings provide a new mechanism of endothelial dysfunction in OSA patients and a potentially targetable pathway for treatment of cardiovascular risk in OSA.
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Affiliation(s)
- Saradhadevi Varadharaj
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States; Division of Pulmonary Critical Care and Sleep, The Davis Heart and Lung Research Institute and Division of Cardiovascular Medicine, the Ohio State University, Columbus, OH, United States
| | - Kyle Porter
- The Center for Biostatistics, the Ohio State University, Columbus, OH, United States
| | - Adam Pleister
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States
| | - Jacob Wannemacher
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States
| | - Angela Sow
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States
| | - David Jarjoura
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States
| | - Jay L Zweier
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States; Division of Pulmonary Critical Care and Sleep, The Davis Heart and Lung Research Institute and Division of Cardiovascular Medicine, the Ohio State University, Columbus, OH, United States
| | - Rami N Khayat
- The Sleep Heart Program, the Ohio State University, Columbus, OH, United States; Division of Pulmonary Critical Care and Sleep, The Davis Heart and Lung Research Institute and Division of Cardiovascular Medicine, the Ohio State University, Columbus, OH, United States.
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17
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Miyagi T, Kohagura K, Ishiki T, Kochi M, Kinjyo T, Kinjyo K, Maehara Y, Sakima A, Iseki K, Ohya Y. Interrelationship between brachial artery function and renal small artery sclerosis in chronic kidney disease. Hypertens Res 2014; 37:863-9. [PMID: 24646648 DOI: 10.1038/hr.2014.60] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 01/06/2014] [Accepted: 01/25/2014] [Indexed: 02/01/2023]
Abstract
Chronic kidney disease (CKD), characterized by senile inflammation, is a risk factor for cardiovascular disease. Conduit artery function and small artery structure relate to cardiovascular disease. We examined the correlations, determinants and interrelationships of arterial indices in association with CKD in a cross-sectional study of 139 patients (60% male; mean age 44 years) with CKD (stages 3-5, 39%) who underwent a renal biopsy. Conduit artery function and small artery sclerosis were assessed by brachial artery flow-mediated dilatation (FMD) and semiquantitative evaluation of small artery intimal thickening (SA-IT), respectively. The estimated glomerular filtration rate correlated with FMD (r=0.31, P=0.0002) and inversely correlated with SA-IT (r=-0.54, P<0.0001). Multiple regression analysis showed that FMD was inversely correlated with SA-IT and vice versa. In addition, high-sensitivity C-reactive protein (hs-CRP) was significantly correlated with SA-IT, but not FMD. Multiple logistic analysis revealed that higher hs-CRP concomitant with decreased FMD was further associated with the risk of severe SA-IT compared with their individual effects. These findings suggest that both conduit artery and small artery disease develop with mutual interaction in parallel with decreased kidney function. Coexistence of inflammation and conduit artery dysfunction may be closely related to renal small artery sclerosis in patients with CKD.
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Affiliation(s)
- Tsuyoshi Miyagi
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kentaro Kohagura
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Tetsuya Ishiki
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Masako Kochi
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Takanori Kinjyo
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kojiro Kinjyo
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Yuichi Maehara
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Atsushi Sakima
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
| | - Kunitoshi Iseki
- Dialysis Unit, University Hospital of the Ryukyus, Nishihara-cho, Japan
| | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Nishihara-cho, Japan
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Cao Y, Zheng L, Liu S, Peng Z, Zhang S. Total flavonoids from Plumula Nelumbinis suppress angiotensin II-induced fractalkine production by inhibiting the ROS/NF-κB pathway in human umbilical vein endothelial cells. Exp Ther Med 2014; 7:1187-1192. [PMID: 24940409 PMCID: PMC3991487 DOI: 10.3892/etm.2014.1554] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 01/28/2014] [Indexed: 11/29/2022] Open
Abstract
Angiotensin II (Ang II) is a neuroendocrine factor that promotes hypertension and has been implicated in vascular inflammation through the induction of reactive oxygen species (ROS) and proinflammatory genes in endothelial cells. However, relatively little attention has been paid to the effect of Ang II on fractalkine (FKN), an important chemokine involved in endothelial dysfunction. In the study, we aimed to investigate the protective role of total flavonoids from Plumula Nelumbinis (TFPN), the main component extracted from Semen Nelumbinis, in Ang II-induced oxidative stress injury in human umbilical vein endothelial cells (HUVECs). Furthermore, we studied whether TFPN could attenuate the Ang II-induced generation of ROS and the activation of nuclear factor-κB (NF-κB); whether these Ang II-induced effects were inhibited by apocynin (a nicotinamide adenine dinucleotide phosphate oxidase inhibitor) and pyrrolidine dithiocarbamate (an NF-κB inhibitor). In the present study, it was observed that total flavonoids from Plumula Nelumbinis (TFPN), the main component extracted from Semen Nelumbinis, concentration-dependently inhibited the FKN production induced by Ang II in human umbilical vein endothelial cells (HUVECs). Furthermore, TFPN attenuated the Ang II-induced generation of ROS and the activation of nuclear factor-κB (NF-κB); these Ang II-induced effects were also inhibited by apocynin (a nicotinamide adenine dinucleotide phosphate oxidase inhibitor) and pyrrolidine dithiocarbamate (an NF-κB inhibitor). In conclusion, the findings of the present study indicate that TFPN attenuate Ang II-induced upregulation of FKN by inhibiting the ROS/NF-κB pathway in HUVECs and thus have a suppressive effect on vascular inflammation.
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Affiliation(s)
- Yongwen Cao
- Department of Cardiology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Lulu Zheng
- Department of Cardiology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Shao Liu
- Department of Pharmacology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
| | - Zhenyu Peng
- Department of Emergency, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China
| | - Saidan Zhang
- Department of Cardiology, Xiangya Hospital of Central South University, Changsha, Hunan 410008, P.R. China
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Kakar P, Lip GYH. Hypertension: endothelial dysfunction, the prothrombotic state and antithrombotic therapy. Expert Rev Cardiovasc Ther 2014; 5:441-50. [PMID: 17489669 DOI: 10.1586/14779072.5.3.441] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The pathophysiology of essential hypertension and its complications has been a focus of much research and clinical interest. More recent attention has been directed towards inflammation and endothelial dysfunction, especially since inflammation can promote endothelial dysfunction and the latter has been intimately related to thrombogenesis and atherogenesis. Hypertension is also associated with a prothrombotic or hypercoagulable state, and this may contribute to the observation that despite the blood vessels being exposed to high pressures in hypertension the common complications of the latter are paradoxically thrombotic rather than hemorrhagic--the so-called 'thrombotic paradox of hypertension' (or 'Birmingham paradox'). Despite these thrombotic complications, the role of antithrombotic therapy for primary prevention in hypertension is less defined, unless the patient is at significant risk of cardiovascular events or has renal impairment. Antithrombotic therapy for secondary prevention in hypertension is recommended, but unanswered questions regarding the interactions between aspirin and angiotensin-converting enzyme inhibitors remain.
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Affiliation(s)
- Puneet Kakar
- Hemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK
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20
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Rajendran P, Rengarajan T, Thangavel J, Nishigaki Y, Sakthisekaran D, Sethi G, Nishigaki I. The vascular endothelium and human diseases. Int J Biol Sci 2013; 9:1057-69. [PMID: 24250251 PMCID: PMC3831119 DOI: 10.7150/ijbs.7502] [Citation(s) in RCA: 908] [Impact Index Per Article: 82.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 10/07/2013] [Indexed: 02/07/2023] Open
Abstract
Alterations of endothelial cells and the vasculature play a central role in the pathogenesis of a broad spectrum of the most dreadful of human diseases, as endothelial cells have the key function of participating in the maintenance of patent and functional capillaries. The endothelium is directly involved in peripheral vascular disease, stroke, heart disease, diabetes, insulin resistance, chronic kidney failure, tumor growth, metastasis, venous thrombosis, and severe viral infectious diseases. Dysfunction of the vascular endothelium is thus a hallmark of human diseases. In this review the main endothelial abnormalities found in various human diseases such as cancer, diabetes mellitus, atherosclerosis, and viral infections are addressed.
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Affiliation(s)
- Peramaiyan Rajendran
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
| | | | - Jayakumar Thangavel
- 2. Department of Pharmacology and Center of Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, Illinois, United States of America
| | - Yutaka Nishigaki
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
| | - Dhanapal Sakthisekaran
- 3. Department of Medical Biochemistry, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai, India 600 113
| | - Gautam Sethi
- 4. Department of Pharmacology,Yong Loo Lin School of Medicine,National University Health System, 10 Medical Drive, MD11, #05-09, Clinical Research Centre, Singapore 117597
| | - Ikuo Nishigaki
- 1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan
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Roustit M, Cracowski JL. Assessment of endothelial and neurovascular function in human skin microcirculation. Trends Pharmacol Sci 2013; 34:373-84. [DOI: 10.1016/j.tips.2013.05.007] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/03/2013] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
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High wall shear stress and spatial gradients in vascular pathology: a review. Ann Biomed Eng 2012; 41:1411-27. [PMID: 23229281 DOI: 10.1007/s10439-012-0695-0] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 11/06/2012] [Indexed: 12/18/2022]
Abstract
Cardiovascular pathologies such as intracranial aneurysms (IAs) and atherosclerosis preferentially localize to bifurcations and curvatures where hemodynamics are complex. While extensive knowledge about low wall shear stress (WSS) has been generated in the past, due to its strong relevance to atherogenesis, high WSS (typically >3 Pa) has emerged as a key regulator of vascular biology and pathology as well, receiving renewed interests. As reviewed here, chronic high WSS not only stimulates adaptive outward remodeling, but also contributes to saccular IA formation (at bifurcation apices or outer curves) and atherosclerotic plaque destabilization (in stenosed vessels). Recent advances in understanding IA pathogenesis have shed new light on the role of high WSS in pathological vascular remodeling. In complex geometries, high WSS can couple with significant spatial WSS gradient (WSSG). A combination of high WSS and positive WSSG has been shown to trigger aneurysm initiation. Since endothelial cells (ECs) are sensors of WSS, we have begun to elucidate EC responses to high WSS alone and in combination with WSSG. Understanding such responses will provide insight into not only aneurysm formation, but also plaque destabilization and other vascular pathologies and potentially lead to improved strategies for disease management and novel targets for pharmacological intervention.
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Sahin T, Celikyurt U, Geyik B, Oner G, Kilic T, Bildirici U, Kozdag G, Ural D. Relationship between endothelial functions and acetylsalicylic acid resistance in newly diagnosed hypertensive patients. Clin Cardiol 2012; 35:755-63. [PMID: 22847393 DOI: 10.1002/clc.22042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 06/23/2012] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We aimed to investigate the effects and dose dependency of aspirin on endothelial functions and prevalence of aspirin resistance in newly diagnosed hypertensive patients without previous drug therapy and development of cardiac complications. HYPOTHESIS Acetylsalicyclic acid improves endothelial function. METHODS Fifty-eight hypertensive patients and 61 healthy subjects in the control group were included in the study. Endothelial functions of the patient and control groups were evaluated with brachial artery examination. Patient and control groups were divided into 2 groups. A total of 100 mg and 300 mg of aspirin were given to the separate groups for 1 week. After 1 week, endothelial functions were reevaluated and aspirin resistance examined with a platelet function analyzer (PFA-100; Dade Behring, Marbourg, Germany). RESULTS Baseline flow-mediated dilatation (FMD) change percent in hypertensive patients was 9.8%, and it was significantly lower than in the control group (12%) (P < 0.001). Frequency of acetylsalicylic acid (ASA) resistance was 20% and 26% in control and hypertensive patient groups, respectively (P = not significant). ASA resistance was 28% and 24% in 100 mg and 300 mg in hypertensive patients, respectively (P = not significant). FMD change percent increased both in the control and hypertensive groups after ASA treatment from 12.4% to 13.3% and 9.8 % to 11.9 %, respectively. FMD percentage change was significantly increased in hypertensive patients irrespective of ASA resistance (P = 0.02, for ASA resistance [+]; P < 0.012, for ASA resistance [-]). CONCLUSIONS Endothelial functions were impaired more in hypertensive patients compared to the control group. Endothelial functions were improved with all ASA doses in hypertensive patients irrespective of ASA resistance.
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Affiliation(s)
- Tayfun Sahin
- Department of Cardiology, Medical Faculty of Kocaeli University, Kocaeli, Turkey.
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Pinter A, Horvath T, Sarkozi A, Kollai M. Relationship between heart rate variability and endothelial function in healthy subjects. Auton Neurosci 2012; 169:107-12. [PMID: 22749462 DOI: 10.1016/j.autneu.2012.05.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 05/24/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
In various diseased states reduced cardiac vagal activity is accompanied by impaired endothelial function. Evidence from animal studies indicates interaction between the two systems, but such data from human studies is limited. The aim of this study was to test the hypothesis that cardiac vagal activity and endothelial function are related in healthy individuals. 46 young males were studied. From 10 minute long ECG recordings mean RR-interval and time and frequency domain vagal heart rate variability indices (RMSSD; pNN50 and HF, respectively) were determined. Heart rate variability indices were used to define cardiac vagal activity. Endothelial function was assessed by measuring brachial artery flow mediated dilation. Hyperemic, diastolic shear rate was used to normalize flow mediated dilation. All three vagal heart rate variability indices correlated significantly and positively with flow mediated dilation across subjects, with r values within the range of 0.43-0.52, p<0.01 for all relations. After adjusting for potential confounders, vagal heart rate variability indices remained significantly associated with normalized flow mediated dilation. RR-interval was related to most heart rate variability indices, but was not related to flow mediated dilation. Our data demonstrate that vagal heart rate variability indices are related to flow mediated dilation across healthy male subjects. The results cannot serve as evidence of a causal relationship, but are of interest and render for further investigation into underlying mechanisms.
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Affiliation(s)
- Alexandra Pinter
- Institute of Human Physiology and Clinical Experimental Research, Semmelweis University, Budapest, Hungary.
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Dharmashankar K, Welsh A, Wang J, Kizhakekuttu TJ, Ying R, Gutterman DD, Widlansky ME. Nitric oxide synthase-dependent vasodilation of human subcutaneous arterioles correlates with noninvasive measurements of endothelial function. Am J Hypertens 2012; 25:528-34. [PMID: 22337207 DOI: 10.1038/ajh.2012.8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Noninvasive measurements of endothelial function predict future adverse cardiovascular events, but offer limited opportunities for mechanistic insights into phenotypic observations. Subcutaneous adipose arterioles, accessible through minimally invasive methods, provide an opportunity for complimentary mechanistic studies. Limited data relating subcutaneous arteriolar endothelial function, cardiovascular risk factors, and noninvasive measurements of endothelial function currently exist. METHODS Forty-four subjects underwent noninvasive studies of endothelial function (brachial reactivity (flow-mediated dilation (FMD) and digital pulse arterial tonometry (PAT)) and measurements of endothelial-dependent vasodilation of gluteal subcutaneous arterioles to acetylcholine. Arteriolar endothelial function was measured (i) percent vasodilation to maximal acetylcholine dose (10(-5) mol/l) and (ii) total area under the curve (AUC) for the entire acetylcholine dose-response curve (total AUC-acetylcholine (Ach), doses 10(-10)-10(-5) mol/l). RESULTS Acetylcholine responses were almost completely nitric oxide (NO) dependent. Total AUC-Ach predicted FMD and PAT, but maximal acetylcholine vasodilation was not associated with these measures. A history of hypertension, diabetes, smoking, and low-density lipoprotein cholesterol levels were independent predictors of total AUC-Ach. In regression models, total AUC-Ach independently predicted FMD. CONCLUSIONS Acetylcholine vasodilator responses in human gluteal subcutaneous arterioles are NO synthase dependent and correlate with cardiac risk factors and in vivo measures of endothelial function. These data suggest subcutaneous arterioles offer an opportunity for translational studies of mechanisms of modulating NO bioavailability relevant to in vivo endothelial function measures.
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Kassan M, Galán M, Partyka M, Saifudeen Z, Henrion D, Trebak M, Matrougui K. Endoplasmic reticulum stress is involved in cardiac damage and vascular endothelial dysfunction in hypertensive mice. Arterioscler Thromb Vasc Biol 2012; 32:1652-61. [PMID: 22539597 DOI: 10.1161/atvbaha.112.249318] [Citation(s) in RCA: 171] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Cardiac damage and vascular dysfunction are major causes of morbidity and mortality in hypertension. In the present study, we explored the beneficial therapeutic effect of endoplasmic reticulum (ER) stress inhibition on cardiac damage and vascular dysfunction in hypertension. METHODS AND RESULTS Mice were infused with angiotensin II (400 ng/kg per minute) with or without ER stress inhibitors (taurine-conjugated ursodeoxycholic acid and 4-phenylbutyric acid) for 2 weeks. Mice infused with angiotensin II displayed an increase in blood pressure, cardiac hypertrophy and fibrosis associated with enhanced collagen I content, transforming growth factor-β1 (TGF-β1) activity, and ER stress markers, which were blunted after ER stress inhibition. Hypertension induced ER stress in aorta and mesenteric resistance arteries (MRA), enhanced TGF-β1 activity in aorta but not in MRA, and reduced endothelial NO synthase phosphorylation and endothelium-dependent relaxation (EDR) in aorta and MRA. The inhibition of ER stress significantly reduced TGF-β1 activity, enhanced endothelial NO synthase phosphorylation, and improved EDR. The inhibition of TGF-β1 pathway improved EDR in aorta but not in MRA, whereas the reduction in reactive oxygen species levels ameliorated EDR in MRA only. Infusion of tunicamycin in control mice induced ER stress in aorta and MRA, and reduced EDR by a TGF-β1-dependent mechanism in aorta and reactive oxygen species-dependent mechanism in MRA. CONCLUSIONS ER stress inhibition reduces cardiac damage and improves vascular function in hypertension. Therefore, ER stress could be a potential target for cardiovascular diseases.
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Affiliation(s)
- Modar Kassan
- Department of Physiology, Hypertension and Renal Center of Excellence, Tulane University, New Orleans, LA 70112, USA
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Swift DL, Earnest CP, Blair SN, Church TS. The effect of different doses of aerobic exercise training on endothelial function in postmenopausal women with elevated blood pressure: results from the DREW study. Br J Sports Med 2011; 46:753-8. [PMID: 21947813 DOI: 10.1136/bjsports-2011-090025] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to examine the effect of three different doses of aerobic exercise training (corresponding to approximately 50%, 100% and 150% of the National Institutes of Health consensus guidelines) on endothelial function in sedentary obese postmenopausal women with elevated blood pressure. Aerobic exercise training improves endothelial function in individuals with cardiovascular risk; however, it is unknown whether these adaptations occur in a dose-dependent manner. METHODS Obese postmenopausal women (n=155) with elevated blood pressure (systolic blood pressure between 120 and 159.0 mm Hg) were randomly assigned to one of four groups: 4, 8 or 12 kilocalories per kilogram of energy expenditure per week (kcal/kg/week) or a non-exercise control group for 6 months. Endothelial function was assessed via flow-mediated dilation (FMD) at baseline and post-intervention. RESULTS After exercise training, there was a similar improvement (1.02-1.5%) in FMD in all three exercise groups (p<0.05) compared with control (-0.5%). Change in FMD after exercise training was significantly correlated with FMD at baseline (r= -0.35, p<0.001). Post hoc analyses found a significant improvement in FMD in exercisers (all exercise groups combined) with endothelial dysfunction (FMD < 5.5%) at baseline (1.8%, 95% CI: 1.17 to 2.38; p<0.001) compared with exercisers with normal endothelial function (FMD ≥ 5.5%) (-1.2%; 95% CI: -1.17 to 0.69; p=0.60). CONCLUSIONS Aerobic exercise training was associated with improved FMD in postmenopausal women with elevated blood pressure. In addition, exercise training may be more efficacious in improving endothelial function in postmenopausal women with endothelial dysfunction than individuals with normal endothelial function at baseline.
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Affiliation(s)
- Damon L Swift
- Department of Preventive Medicine, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA.
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Dyson KS, Argarwal N, Williams-Bell M, Bhatti A, Denniss SG, Hughson RL. Sustained hyperaemia stimulus is necessary to induce flow-mediated dilation of the human brachial artery. Clin Physiol Funct Imaging 2011; 31:415-21. [DOI: 10.1111/j.1475-097x.2011.01036.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patt BT, Jarjoura D, Haddad DN, Sen CK, Roy S, Flavahan NA, Khayat RN. Endothelial dysfunction in the microcirculation of patients with obstructive sleep apnea. Am J Respir Crit Care Med 2010; 182:1540-5. [PMID: 20656942 DOI: 10.1164/rccm.201002-0162oc] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
RATIONALE Obstructive sleep apnea (OSA) is a risk factor for cardiovascular disease. We hypothesized that patients with OSA and no cardiovascular disease have oxidant-related microcirculatory endothelial dysfunction. OBJECTIVES To evaluate the microcirculation in OSA. METHODS This study included seven patients with OSA and seven age- and weight-matched control subjects (mean age, 38 yr; mean body mass index, 32.5 kg/m²). All participants were free of cardiovascular risk factors. Participants received measurement of brachial artery flow-mediated dilation and forearm subcutaneous biopsy. Patients underwent repeated tests 12 weeks after treatment. Microcirculatory endothelial cells were isolated, and immunohistochemistry staining for peroxynitrite in the microcirculation was performed. MEASUREMENTS AND MAIN RESULTS Flow-mediated dilation was lower in patients than in control subjects at baseline (mean ± SEM: 5.7 ± 0.5 vs. 9.5 ± 0.6; P = 0.02) and increased after treatment (5.7-7.3; change, 1.7 ± 0.6; P = 0.04). Microcirculatory peroxynitrite deposit was higher in patients compared with control subjects (44.0 ± 1.6 vs. 21.8 ± 1.9 stain density units; P < 0.001) and decreased after treatment from 44.0 to 30.5 stain density units (change, -13.5 ± 2.9; P = 0.009). In patients, transcription of endothelial nitric oxide synthase decreased from 5.2 to -1.3 after treatment (change, 6.5 ± 2.5; P = 0.05), and transcription of superoxide dismutase1 decreased from -4.0 to -12.3 after treatment (change, -8.3 ± 2.1; P = 0.01). These changes persisted after adjustment for weight and underlying severity of OSA. CONCLUSIONS This is the first direct evaluation of the microcirculation in OSA. Patients with OSA with low cardiovascular risk status had increased oxidant production in the microcirculation and endothelial dysfunction, both of which improved with treatment. Endothelial nitric oxide synthase transcription decreased with treatment.
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Skoloudík D, Fadrná T, Roubec M, Bar M, Zapletal O, Blatný J, Langová K, Bardon P, Sanák D, Kanovský P, Herzig R. Changes in hemocoagulation in acute stroke patients after one-hour sono-thrombolysis using a diagnostic probe. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:1052-1059. [PMID: 20620692 DOI: 10.1016/j.ultrasmedbio.2010.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/26/2010] [Accepted: 04/16/2010] [Indexed: 05/29/2023]
Abstract
The aim was to monitor the changes in hemocoagulation parameters in acute ischemic stroke (AIS) patients after sono-thrombolysis of the occluded middle cerebral artery using a duplex transcranial probe with 2.0-MHz frequency in Doppler mode. Sixteen AIS patients indicated for intravenous thrombolysis (IVT) (8 males; mean age 68.3 +/- 7.1 y) and 16 AIS patients contraindicated for IVT (11 males; mean age 67.9 +/- 7.9 y) were randomized for sono-thrombolysis (8 + 8 patients) or standard treatment (control group) (8 + 8 patients). The significant decrease of plasminogen activator inhibitor-1, plasminogen and alpha-2-antiplasmin activity by a mean of 60, 32 and 24%, respectively, and the increase of tissue plasminogen activator by a mean of 56% was found after sono-thrombolysis when compared with control group (p < 0.0125); these changes were more evident in patients treated with a combination of sono-thrombolysis and IVT (79, 38, 50 and 82%, respectively) than in patients treated by sono-thrombolysis alone (34, 13, 17 and 30%, respectively).
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Affiliation(s)
- David Skoloudík
- Department of Neurology, University Hospital, Ostrava, Czech Republic.
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Debbabi H, Bonnin P, Ducluzeau PH, Leftheriotis G, Levy BI. Noninvasive assessment of endothelial function in the skin microcirculation. Am J Hypertens 2010; 23:541-6. [PMID: 20168305 DOI: 10.1038/ajh.2010.10] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The structure and function of blood vessels varies along the vascular tree. Endothelial dysfunction is a hallmark of increased cardiovascular (CV) risk that can be assessed by several methods, some of which are invasive and of restricted application. The aim of this study was to determine whether the laser Doppler response of skin microcirculation to acetylcholine, reflects that of conduit artery assessed by brachial artery flow-mediated dilation (FMD). METHODS Noninvasive measurement of endothelium-dependent vasodilation in the skin microcirculation by laser Doppler flowmetry (LDF) in response to a local transdermal iontophoretic application of acetylcholine (Ach-SkBF) is an operator-independent method. Ach-SkBF and FMD were measured in the nondominant upper limb of 55 unselected consecutive patients admitted in our department for evaluation of CV risk factors. RESULTS Ach-SkBF was (mean +/- s.d. (min-max)) 490 +/- 414%, (10-1667%) and FMD was 3.77 +/- 3.01% (0.91-10.91). A strong linear relationship was found between Ach-SkBF and FMD: Ach-SkBF = 122.7 FMD + 25.8 (r = 0.92, P < 0.0001). CONCLUSIONS Endothelial dilatory response to increased blood flow and to acetylcholine are similar in large arteries and in the skin microvasculature. Thus, measurement of blood flow changes in the skin microcirculation using LDF coupled with acetylcholine iontophoresis represents a technically challenging and reliable noninvasive method for the assessment of endothelial function within a large range of normal and altered endothelium responses.
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Human endothelial dysfunction: EDCFs. Pflugers Arch 2010; 459:1015-23. [PMID: 20107832 DOI: 10.1007/s00424-009-0783-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 12/25/2009] [Accepted: 12/28/2009] [Indexed: 02/07/2023]
Abstract
Human studies, conducted in the presence of clinical conditions characterized by endothelial dysfunction, evidenced that endothelial cells, in response to different agonists and physical stimuli, become a source of endothelium-derived contracting factors (EDCFs), mainly cyclooxygenase (COX)-derived prostanoids. Their production has been documented in several human diseases, mostly in essential hypertension and aging. The EDCF production was at first identified as responsible for impaired endothelium-dependent vasodilation in the forearm microcirculation of patients with essential hypertension. Subsequent studies demonstrated that COX-dependent EDCF products are also a characteristic of the aging process, and essential hypertension seems to only anticipate the phenomenon. Of note, in aging and hypertension, both indomethacin, a COX inhibitor, and vitamin C, an antioxidant, totally reverse the blunted vasodilation to acetylcholine by restoring NO availability, thus suggesting that EDCFs could be one of the major sources of oxygen free radicals. The presence of EDCFs was documented also in other clinical setting, such as coronary artery disease and estrogen deprivation. In conclusion, many human pathological conditions characterized by a decline in endothelial function are associated with a progressive decrease in NO bioavailability and increase in the production of EDCFs. The mechanisms that regulate the balance between NO and EDCFs and the processes transforming the endothelium from a protective organ to a source of vasoconstrictor, proaggregatory and promitogenic mediators, remain to be determined.
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Abstract
Impaired endothelial vasodilatation may contribute to the exaggerated blood pressure (BP) responses to exercise in individuals who are overweight/obese. The present study investigated whether consumption of cocoa flavanols, which improve endothelium-dependent flow-mediated dilatation (FMD), can modify BP responsiveness to exercise. Twenty-one volunteers (eight females and thirteen males, 54·9 (se2·2) years, BMI 31·6 (se0·8) kg/m2, systolic BP 134 (se2) mmHg, diastolic BP (DBP) 87 (se2) mmHg) were randomised to consume single servings of either a high-flavanol (HF, 701 mg) or a low-flavanol (LF, 22 mg) cocoa beverage in a double-blind, cross-over design with 3–7-d washout between treatments. Two hours after cocoa consumption, FMD was measured, followed by continuous beat-to-beat assessment (Finapres™) of BP before and during 10 min of cycling at 75 % of age-predicted maximum heart rate. Averaged data from two assessments on each type of beverage were compared by analysis of covariance using pre-exercise BP as the covariate. Pre-exercise BP was similar after taking LF and HF (153 (se3)/88 (se3)v. 153 (se4)/87 (se2) mmHg, respectively,P>0·05). However, the BP response to exercise (area under BP curve) was attenuated by HF compared with LF. BP increases were 68 % lower for DBP (P = 0·03) and 14 % lower for mean BP (P = 0·05). FMD measurements were higher after taking HF than after taking LF (6·1 (se0·6) %v. 3·4 (se0·5) %,P < 0·001). By facilitating vasodilation and attenuating exercise-induced increases in BP, cocoa flavanols may decrease cardiovascular risk and enhance the cardiovascular benefits of moderate intensity exercise in at-risk individuals.
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Vittorio TJ, Lanier G, Zolty R, Sarswat N, Tseng CH, Colombo PC, Jorde UP. Association between endothelial function and chronotropic incompetence in subjects with chronic heart failure receiving optimal medical therapy. Echocardiography 2010; 27:294-9. [PMID: 20070352 DOI: 10.1111/j.1540-8175.2009.01011.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Impairment of flow-mediated, endothelium-dependent vasodilatation (FMD) of the brachial artery identifies peripheral endothelial dysfunction in subjects with chronic congestive heart failure (CHF) and is associated with increased morbidity and mortality. To further elucidate the interaction of peripheral and central mechanisms in the syndrome of CHF, we examined the association between endothelial function and chronotropic incompetence, an emerging prognostic marker in CHF. METHODS Thirty subjects with stable New York Heart Association (NYHA) functional class II-III CHF were studied. A vascular ultrasound study was performed to measure brachial artery FMD. The percentage of age-adjusted maximal predicted heart rate (MPHR) reached during cardiopulmonary exercise tolerance testing (CPETT) was used to assess the degree of chronotropic competence. All patients received ACE inhibitors and beta-adrenoceptor blockers. RESULTS Brachial artery FMD averaged 1.3 +/- 2.4% and age-adjusted % MPHR 74.1 +/- 11.7%. FMD correlated with % MPHR among all patients (r = 0.60, P = 0.01). FMD and resting heart rate (RHR) did not significantly correlate (r = 0.13, P = 0.55). CONCLUSIONS FMD, a measure of peripheral endothelial dysfunction, and % MPHR, a central determinant of cardiac output, are moderately correlated in heart failure patients receiving optimal medical therapy. Whether a cause-effect relationship underlies this association remains to be investigated.
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Affiliation(s)
- Timothy J Vittorio
- Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY 10029-6574, USA
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Groeneweg G, Huygen FJPM, Coderre TJ, Zijlstra FJ. Regulation of peripheral blood flow in complex regional pain syndrome: clinical implication for symptomatic relief and pain management. BMC Musculoskelet Disord 2009; 10:116. [PMID: 19775468 PMCID: PMC2758836 DOI: 10.1186/1471-2474-10-116] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Accepted: 09/23/2009] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND During the chronic stage of Complex Regional Pain Syndrome (CRPS), impaired microcirculation is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Several mechanisms may be responsible for the ischemia and pain in chronic cold CPRS. DISCUSSION The diminished blood flow may be caused by either sympathetic dysfunction, hypersensitivity to circulating catecholamines, or endothelial dysfunction. The pain may be of neuropathic, inflammatory, nociceptive, or functional nature, or of mixed origin. SUMMARY The origin of the pain should be the basis of the symptomatic therapy. Since the difference in temperature between both hands fluctuates over time in cold CRPS, when in doubt, the clinician should prioritize the patient's report of a persistent cold extremity over clinical tests that show no difference. Future research should focus on developing easily applied methods for clinical use to differentiate between central and peripheral blood flow regulation disorders in individual patients.
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Affiliation(s)
- George Groeneweg
- Department of Anesthesiology, Subdivision Pain Treatment Centre, Erasmus MC, Rotterdam, the Netherlands.
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Vittorio TJ, Zolty R, Garg PK, Sarswat N, Tseng CH, Jorde UP, Colombo PC. Interdependence of Cardiac and Endothelial Function in Patients with Symptomatic Chronic Heart Failure of Nonischemic Etiology. Echocardiography 2009; 26:916-21. [DOI: 10.1111/j.1540-8175.2009.00907.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Versari D, Daghini E, Virdis A, Ghiadoni L, Taddei S. Endothelium-dependent contractions and endothelial dysfunction in human hypertension. Br J Pharmacol 2009; 157:527-36. [PMID: 19630832 PMCID: PMC2707964 DOI: 10.1111/j.1476-5381.2009.00240.x] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 01/20/2009] [Accepted: 02/05/2009] [Indexed: 12/14/2022] Open
Abstract
The endothelium is a crucial regulator of vascular physiology, producing in healthy conditions several substances with a potent antiatherosclerotic properties. Accordingly, the presence of endothelial dysfunction is associated with subclinical atherosclerosis and with an increased future risk of cardiovascular events. A large body of evidence supports the fundamental role of nitric oxide (NO) as the main endothelium-derived relaxing factor. However, in the presence of pathological conditions, such as hypertension, endothelial cells, in response to a number of agents and physical stimuli, become also a source of endothelium-derived contracting factors (EDCFs), including endothelins and angiotensin II and particularly cyclooxygenase-derived prostanoids and superoxide anions. These latter were at first identified as responsible for impaired endothelium-dependent vasodilation in patients with essential hypertension. However, cyclooxygenase-dependent EDCFs production is characteristic of the aging process, and essential hypertension seems to only anticipate the phenomenon. It is worth noting that both in aging and hypertension EDCF production is associated with a parallel decrease in NO availability, suggesting that this substance could be oxygen free radicals themselves. Accordingly, in hypertension both indomethacin, a cyclooxygenase inhibitor, and vitamin C, an antioxidant, increase the vasodilation to acetylcholine by restoring NO availability. In conclusion, hypertension is characterized by a decline in endothelial function, associated with a progressive decrease in NO bioavailability and increase in the production of EDCF. The mechanisms that regulate the balance between NO and EDCF, and the processes transforming the endothelium from a protective organ to a source of vasoconstrictor, proaggregatory and promitogenic mediators remain to be determined.
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Affiliation(s)
- Daniele Versari
- Department of Internal Medicine, University of Pisa, Pisa, Italy
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Espinola-Zavaleta N, Soto-López ME, Carreón-Torres E, Gamboa R, Mejía AM, Márquez-Velasco R, Bojalil R, Huesca-Gomez C, Reyes PA, Pérez-Méndez O. Altered Flow-Mediated Vasodilatation, Low Paraoxonase-1 Activity, and Abnormal High-Density Lipoprotein Subclass Distribution in Takayasu's Arteritis. Circ J 2009; 73:760-6. [DOI: 10.1253/circj.cj-08-0582] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | - Ricardo Gamboa
- Department of Physiology, Instituto Nacional de Cardiología "Ignacio Chávez"
| | - Ana M. Mejía
- Department of Hematology, Instituto Nacional de Cardiología "Ignacio Chávez"
| | | | - Rafael Bojalil
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez"
| | | | - Pedro A. Reyes
- Department of Immunology, Instituto Nacional de Cardiología "Ignacio Chávez"
| | - Oscar Pérez-Méndez
- Department of Molecular Biology, Instituto Nacional de Cardiología "Ignacio Chávez"
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Prognostic role of flow-mediated dilatation of the brachial artery in hypertensive patients. J Hypertens 2008; 26:1612-8. [PMID: 18622240 DOI: 10.1097/hjh.0b013e328304b083] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The prognostic role of endothelial dysfunction, as evaluated by flow-mediated vasodilatation of the brachial artery, has been demonstrated in patients at very high risk. We aimed to investigate whether flow-mediated vasodilatation predicts cardiovascular events in uncomplicated hypertensive patients. METHODS AND RESULTS A total of 172 prospectively identified uncomplicated hypertensive patients (age 56 +/- 8 years, 41% women, 48 with diabetes mellitus type 2) were studied. At baseline all patients were untreated and underwent baseline standard laboratory examination. A standard echocardiogram was performed for the evaluation of left ventricular anatomy and function and patients with systolic dysfunction or left ventricular wall motion abnormalities were excluded. Endothelial function was measured as flow-mediated vasodilatation of the brachial artery using high-resolution ultrasound. Patients were followed for 95 +/- 37 months (range 2-136 months). A first nonfatal or fatal cardiovascular event occurred in 32 patients. The incidence of cardiovascular events was 1.4 and 3.1 per 100 patient-years in patients with a flow-mediated vasodilatation below and above the median value (4.7%), respectively (P < 0.005 by the log-rank test). In Cox analysis, controlling for age, sex, glycemia, cholesterol, smoking, BMI, systolic and diastolic blood pressure at baseline and left ventricular mass index, a low flow-mediated vasodilatation conferred an increased risk of cardiovascular events (odds ratio 2.67, 95% confidence interval 1.17 to 6.1, P = 0.02). CONCLUSION The presence of endothelial dysfunction, as evaluated by flow-mediated vasodilatation of the brachial artery, identifies hypertensive patients at increased risk of nonfatal and fatal cardiovascular events.
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Cottone S, Mulè G, Guarneri M, Palermo A, Lorito MC, Riccobene R, Arsena R, Vaccaro F, Vadalà A, Nardi E, Cusimano P, Cerasola G. Endothelin-1 and F2-isoprostane relate to and predict renal dysfunction in hypertensive patients. Nephrol Dial Transplant 2008; 24:497-503. [PMID: 18772174 DOI: 10.1093/ndt/gfn489] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Hypertension and additional non-traditional risk factors can damage the kidney directly and by promoting atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate a large part of the effects of risk factors on the kidney. We hypothesized that in hypertensive patients (HT), oxidative stress, measured as 8-ISO-prostaglandin F2alpha (8-ISO-PGF2alpha), should raise paralleling decreasing renal function and should correlate with estimated glomerular filtration rate (eGFR). METHODS In 626 HT with renal function ranging from stages 1 to 5 and 100 healthy controls, plasma levels of 8-ISO-PGF2alpha, high-sensitivity C-reactive protein (CRP), transforming growth factor-beta (TGF-beta) and endothelin-1 (ET-1) were measured. GFR was estimated by the Modification of Diet in Renal Disease study equation. RESULTS When HT were stratified according to renal function stages, 8-ISO-PGF2alpha, CRP, TGF-beta and ET-1 increased progressively and significantly with decreasing eGFR. The multiple regression analysis, considering eGFR as a dependent variable, showed that 8-ISO-PGF2alpha (beta = -0.361, P < 0.000001), ET-1 (beta = -0.197, P < 0.0001) and TGF-beta (beta = -0.170, P < 0.0004) correlated independently with eGFR. All biomarkers were good predictors of eGFR <60 ml/min/1.73 m(2) [receiver-operator-curve (ROC) areas]. ET-1 was shown to be the best predictor with a ROC area = 0.938; with a threshold of 4 pg/ml, 91% sensitivity and 85% specificity were observed, whereas 8-ISO had a ROC area = 0.931, and for a threshold of 329 pg/ml, sensitivity and specificity were 89%, respectively. In contrast, CRP showed the lower predictive value with a ROC area = 0.917; with a threshold of 2.52 mg/l, an 87% sensitivity and an 83% specificity were obtained. CONCLUSIONS Our findings are a clear-cut demonstration of a strong and negative correlation of both oxidative stress and ET-1 with renal function stages in HT. ET-1 and 8-isoprostane are predictive of eGFR.
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Affiliation(s)
- Santina Cottone
- Cattedra di Nefrologia e U.O. di Malattie Renali ed Ipertensione Arteriosa, Italy.
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SARTORI MT, BILORA F, ZANON E, VARVARIKIS C, SAGGIORATO G, CAMPAGNOLO E, PAGNAN A, CELLA G. Endothelial dysfunction in haemophilia patients. Haemophilia 2008; 14:1055-62. [DOI: 10.1111/j.1365-2516.2008.01808.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pries AR, Habazettl H, Ambrosio G, Hansen PR, Kaski JC, Schächinger V, Tillmanns H, Vassalli G, Tritto I, Weis M, de Wit C, Bugiardini R. A review of methods for assessment of coronary microvascular disease in both clinical and experimental settings. Cardiovasc Res 2008; 80:165-74. [PMID: 18511433 DOI: 10.1093/cvr/cvn136] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Obstructive disease of the large coronary arteries is the prominent cause for angina pectoris. However, angina may also occur in the absence of significant coronary atherosclerosis or coronary artery spasm, especially in women. Myocardial ischaemia in these patients is often associated with abnormalities of the coronary microcirculation and may thus represent a manifestation of coronary microvascular disease (CMD). Elucidation of the role of the microvasculature in the genesis of myocardial ischaemia and cardiac damage-in the presence or absence of obstructive coronary atherosclerosis-will certainly result in more rational diagnostic and therapeutic interventions for patients with ischaemic heart disease. Specifically targeted research based on improved assessment modalities is needed to improve the diagnosis of CMD and to translate current molecular, cellular, and physiological knowledge into new therapeutic options.
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Affiliation(s)
- Axel R Pries
- Department of Physiology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Arnimallee 22, D-14195 Berlin, Germany
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Phosphodiesterase type 5 inhibition reverses impaired forearm exercise-induced vasodilatation in hypertensive patients. J Hypertens 2008; 26:501-7. [PMID: 18300861 DOI: 10.1097/hjh.0b013e3282f382ff] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Established hypertension is characterized by increased peripheral vascular resistance and endothelial dysfunction, features that may underlie the reduced exercise-induced vasodilatation seen in hypertensive patients. Sildenafil citrate is a phosphodiesterase type 5 (PDE5) inhibitor used clinically for the treatment of male erectile dysfunction. Its vasodilating properties are due to the inhibition of cyclic guanosine monophosphate (cGMP) breakdown and prolongation of the signalling actions of the nitric oxide (NO)-cGMP pathway in vascular smooth muscle cells. Sildenafil has beneficial effects on endothelial function and exercise tolerance in congestive heart failure and pulmonary hypertension, and we hypothesized that it would improve exercise-induced vasodilatation in hypertensive patients. METHODS AND RESULTS Ten hypertensive patients and ten matched normotensive subjects were studied in a three-way, randomized, single-blind and placebo-controlled study. On each study day, forearm blood flow (FBF) responses to handgrip exercise were assessed before and after intra-arterial (brachial) infusion of sildenafil, verapamil (a control, cGMP-independent vasodilator), and saline (placebo). Preinfusion exercise-induced vasodilatation was significantly reduced in hypertensive patients compared to normotensive controls. Sildenafil and verapamil infusions both caused a similar increase in baseline FBF. However, while verapamil did not affect the vasodilator response to handgrip exercise in either group, sildenafil substantially enhanced this response in hypertensive patients, but not in normotensive subjects. CONCLUSIONS Our data suggest that sildenafil, through an increase in cGMP levels in the vasculature, substantially and selectively improves the vasodilator response to handgrip exercise in hypertensive patients. These findings represent an essential first step in support of further studies exploring the potentially beneficial effects of PDE5 inhibition on impaired exercise capacity in hypertension.
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Khazaei M, Moien-Afshari F, Laher I. Vascular endothelial function in health and diseases. ACTA ACUST UNITED AC 2008; 15:49-67. [PMID: 18434105 DOI: 10.1016/j.pathophys.2008.02.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2007] [Revised: 02/07/2008] [Accepted: 02/08/2008] [Indexed: 11/30/2022]
Abstract
The vascular endothelium constitutes approximately 1% of body mass (1kg) and has a surface area of approximately 5000m(2). The endothelium is a multifunctional endocrine organ strategically placed between the vessel wall and the circulating blood, and has a key role in vascular homeostasis. The endothelium is both a target for and mediator of cardiovascular disease. The endothelium releases several relaxing and constricting factors, which can affect vascular homeostasis. Endothelial dysfunction, whether caused by physical injury or cellular damage, leads to compensatory responses that alter the normal homeostatic properties of the endothelium. In this review, we summarized some physiological aspects of endothelial function and then we discussed endothelial dysfunction during some pathological conditions.
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Affiliation(s)
- M Khazaei
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
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47
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Gemignani V, Bianchini E, Faita F, Giannarelli C, Plantinga Y, Ghiadoni L, Demi M. Ultrasound measurement of the brachial artery flow-mediated dilation without ECG gating. ULTRASOUND IN MEDICINE & BIOLOGY 2008; 34:385-391. [PMID: 17964069 DOI: 10.1016/j.ultrasmedbio.2007.08.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 07/27/2007] [Accepted: 08/11/2007] [Indexed: 05/25/2023]
Abstract
The methods commonly used for noninvasive ultrasound assessment of endothelium-dependent flow-mediated dilation (FMD) require an electrocardiogram (ECG) signal to synchronize the measurements with the cardiac cycle. In this article, we present a method for assessing FMD that does not require ECG gating. The approach is based on temporal filtering of the diameter-time curve, which is obtained by means of a B-mode image processing system. The method was tested on 22 healthy volunteers without cardiovascular risk factors. The measurements obtained with the proposed approach were compared with those obtained with ECG gating and with both systolic and end-diastolic measurements. Results showed good agreement between the methods and a higher precision of the new method due to the fact that it is based on a larger number of measurements. Further advantages were also found both in terms of reliability of the measure and simplification of the instrumentation. (E-mail: gemi@ifc.cnr.it).
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Affiliation(s)
- Vincenzo Gemignani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy.
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Eschen O, Christensen JH, Dethlefsen C, Schmidt EB. Cellular Adhesion Molecules in Healthy Subjects: Short Term Variations and Relations to Flow Mediated Dilation. Biomark Insights 2008. [DOI: 10.1177/117727190800300002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective was primarily to describe short term intra-individual variation in serum levels of soluble adhesion molecules (sCAMs: E-selectin, P-selectin, intercellular adhesion molecule-1(sICAM-1) and vascular cellular adhesion molecule-1(sVCAM-1)) in healthy subjects. Secondly, sCAMs were correlated to brachial artery flow mediated vasodilation (FMD). Forty healthy subjects aged 24–66 years had sCAMs measured twice with 4 week intervals and short-term intra-individual variation was estimated as variation in the paired measurements after correcting for the analytical precision of the used method. At baseline, brachial FMD was measured. No difference was observed in mean sCAMs in the whole study group. Estimated intra-subject variations in sCAMs were 7.6–11.3%. In a regression analysis, significant negative association was found between sE-selectin and FMD after controlling for possible confounders (p < 0.04) while no significant correlation could be demonstrated between the other sCAMs and FMD. In conclusion, short term intra-individual variations in sCAMs were 7.6–11.3% in healthy subjects. We also found a significant negative association between sE-selectin and FMD, indicating an possible association between inflammation and dysfunction of the vascular endothelium; however further studies are required to confirm this preliminary finding.
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Affiliation(s)
- Ole Eschen
- Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
- Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
| | | | - Claus Dethlefsen
- Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
| | - Erik Berg Schmidt
- Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
- Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
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Carey RM. Pathophysiology of Primary Hypertension. Microcirculation 2008. [DOI: 10.1016/b978-0-12-374530-9.00020-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Imatoh T, Miyazaki M, Une H. Does elevated high-sensitivity serum C-reactive protein associate with hypertension in non-obese Japanese males? Clin Exp Hypertens 2007; 29:395-401. [PMID: 17729056 DOI: 10.1080/10641960701578394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The object of this study is to assess whether elevated hsCRP levels are independently related to hypertension in non-obese Japanese males. This cross-sectional study comprised 86 hypertensive and 109 normotensive subjects. We defined hypertension as a systolic blood pressure >/=140 mmHg and/or a diastolic blood pressure >/=90 mmHg and/or taking antihypertensive therapy. Log-hsCRP levels were significantly higher in hypertensive than normotensive subjects. In logistic regression analysis, subjects in the highest tertile had a two-fold higher risk than those in the lowest tertile. The association between hypertension and hsCRP levels was marginally significant. In addition, there was a significant tendency for hypertension to increase with an increase in CRP level (p < .05). These findings suggest that elevated hsCRP level is an independent risk factor for hypertension in non-obese Japanese males.
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Affiliation(s)
- Takuya Imatoh
- Department of Hygiene and Preventive Medicine, School of Medicine, Fukuoka University, Fukuoka, Japan.
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