Nitroglycerine-Induced Vasodilation for Assessment of Vascular Function A Comparison With Flow-Mediated Vasodilation

作者：Maruhashi Tatsuya; Soga Junko; Fujimura Noritaka; Idei Naomi; Mikami Shinsuke; Iwamoto Yumiko; Kajikawa Masato; Matsumoto Takeshi; Hidaka Takayuki; Kihara Yasuki; Chayama Kazuaki; Noma Kensuke; Nakashima Ayumu; Goto Chikara; Higashi Yukihito^*

来源：Arteriosclerosis, Thrombosis, and Vascular Biology, 2013, 33(6): 1401-+.

DOI：10.1161/ATVBAHA.112.300934

• atherosclerosis
• cardiovascular risk factors
• flow-mediated vasodilation
• nitroglycerine-induced vasodilation

Objective-Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors. %26lt;br%26gt;Approach and Results-We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 +/- 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r= 0.42; P%26lt; 0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P%26lt; 0.001), systolic blood pressure (r=-0.32; P%26lt; 0.001), diastolic blood pressure (r=-0.24; P%26lt; 0.001), heart rate (r=-0.21; P%26lt; 0.001), glucose (r=-0.23; P%26lt; 0.001), and smoking pack-year (r=-0.12; P= 0.01), as well as Framingham risk score (r=-0.30; P%26lt; 0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 +/- 5.6% versus 13.7 +/- 5.4% and 15.3 +/- 4.3%; P%26lt; 0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation. %26lt;br%26gt;Conclusions-These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.

• 出版日期2013-6