Comparison of endothelium-dependent and -independent dilation between the upper and lower extremity arteries in elderly patients with peripheral artery disease
- VernacularTitle:老年周围动脉疾病患者上下肢动脉舒张功能对比
- Author:
Jian CAO
;
Xiaoying LI
;
Tao LIU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2008;12(28):5597-5600
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Dysfunction of vascular endothelium is the initial event of atherosclerosis. Although there are many approaches to evaluate the function of vascular endothelium, few are widely used in clinic. OBJECTIVE: To evaluate the brachial and superficial femoral endothelium-dependent dilation, i.e. flow-mediated dilation (FMD) and endothelium-independent dilation, i.e. nitroglycerin-mediated dilation (NMD), of elderly patients with peripheral artery disease (PAD), and to investigate the correlation and characteristics between brachial and superficial femoral FMD and NMD.DESIGN, TIME AND SETTING: Non-randomized concurrent control trial was performed at Department of Geriatric Cardiology, Chinese PLA General Hospital from October 2000 to May 2002.PARTICIPANTS: Thirty-three PAD patients were selected as PAD group, including 27 male and 6 female, aged (79±6)years, who had more than one focus of plaque and arterial stenosis more than 50% in artery of lower extremity by Doppler ultrasound. Accorded with the standard for Health of China Academy of Geriatrics in 1995, 40 healthy retired cadres undergoing health examination were selected as control, including 29 male and 11 female. In addition, 30 patients with coronary arteriosclerotic heart disease or cardiovascular risk factors (excluding age and sex) were selected as risk factor group.METHODS: Using non-invasive approach, high resolution color Doppler ultrasound diagnosis system was applied to detect the basic caliber of upper and lower extremtity arteries in all participants, then the blood flow of the tested artery was blocked and the vascular caliber was detected again after the blood flow was restored to evaluate the endothelium-dependent dilation. The tested subjects took 0.6 mg nitroglycerin to induce vasodilatation after detecting the basic caliber of upper and lower extremtity arteries, then the difference between the two detections was regarded as the endothelium-independent dilation.MAIN OUTCOME MEASURES: The endothelium-dependent dilation and endothelium-independent dilation of upper and lower extremtity arteries.RESULTS: Both FMD and NMD of the brachial artery and the superficial femoral artery in 33 PAD patients were significantly lower than those of healthy controls and non-PAD patients with cardiovascular risk factors (t=-11.82-10.91, P <0.05). In old PAD patients, the superficial femoral FMD and NMD were significantly lower than brachial FMD (t=3.535,3.315, P < 0.01); There was close relationship between the brachial and superficial femoral FMD (r=0.931 4, P < 0.01), so was the NMD (r=0.919 1, P < 0.01).CONCLUSION: The superficial femoral FMD and NMD may reflect the vasoreactivity of PAD patients more directly and sensitively than those of brachial artery. There is close relationship between brachial and superficial femoral arteries.
