Several modifiable cardiovascular risk factors such as hypercholesterolemia, smoking,
diabetes, hypertension, and hyperhomocysteinemia are associated with impaired endothelium-dependent
vasodilation in the preclinical phase of vascular disease.
1
,
2
,
3
,
4
,
5
We have previously found that endothelial dysfunction is more pronounced in patients
with angiographically proved coronary artery disease (CAD) compared with patients
with a similar risk factor profile but who have smooth coronary arteries.
6
Thus, endothelial dysfunction not only reflects the risk factor burden but also the
presence, and perhaps, stages of coronary disease.
6
Brachial artery ultrasound, first described by Celermajer et al,
1
utilizes high resolution ultrasound to assess flow-mediated dilation (FMD), an endothelium-dependent
response,
7
,
8
,
9
which is largely mediated by nitric oxide
10
and closely related to coronary endothelial function.
11
Vessel size, age, gender, menstrual cycle, and therapeutic interventions also influence
FMD.
1
,
12
,
13
Thus, it is difficult to interpret impairment of FMD in patients and it is very questionable
whether FMD can be recommended as a screening test for the detection of significant
CAD. However, the evaluation of FMD is increasingly used to assess short-term effects
of therapeutic interventions on systemic endothelial function.
14
,
15
,
16
The present study attempted to assess whether FMD was correlated with prognosis in
patients with chest pain who underwent coronary angiography.To read this article in full you will need to make a payment
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References
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- Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults.Circulation. 1993; 88: 2149-2155
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- Simvastatin, an HMG-coenzyme. A reductase inhibitor, improves endothelial function within 1 month.Circulation. 1997; 95: 1126-1131
- Additional benefit of vitamin E supplementation to simvastatin therapy on vasoreactivity of the brachial artery of hypercholesterolemic men.J Am Coll Cardiol. 1998; 32: 711-716
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Article Info
Publication History
Published online: August 16, 2004
Accepted:
January 24,
2000
Received in revised form:
January 24,
2000
Received:
November 22,
1999
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
