Abstract
The change in brachial artery (BA) diameter after release of an occluding cuff has
been used as a measure of endothelial function, to characterize atherosclerotic risk
factors, and as a surrogate marker for coronary artery disease (CAD). We compared
the change in BA diameter to isometric handgrip (IHG) with the occlusion release method
to determine if a physiologic stress could be used to distinguish patients at risk
and with CAD. BA diameter was measured by ultrasound during and after IHG, and after
occlusion release in 93 subjects. At 120 seconds after release of IHG, BA diameter
increased by 9.99 ± 8.3% (p <0.001) in 26 average-risk patients, increased 1.84 ±
5.7% in 37 high-risk patients, and decreased 3.9 ± 5.6% in 30 patients with CAD (p
= 0.0001 for trend and p <0.01 between groups). There was a good correlation between
change in BA diameter to IHG and occlusion release (r = 0.763 and p = 0.0001). The
capacity for IHG and BA occlusion to characterize subjects by group was comparable
with the exception of high-risk patients versus patients with CAD (80.5% for IHG vs
71.6% for occlusion and release, p = 0.086). BA response to IHG may be useful for
identifying risk factors, patients at risk and with preclinical CAD, and the assessment
of treatment strategies.
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References
- Large coronary arteries in humans are responsive to changing blood flow.J Am Coll Cardiol. 1990; 16: 349-356
- The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress.N Engl J Med. 1991; 325: 1551-1556
- Coronary vasomotion in response to sympathetic stimulation in humans.J Am Coll Cardiol. 1989; 14: 1181-1190
- Dilation of normal and constriction of atherosclerotic coronary arteries caused by the cold pressor test.Circulation. 1988; 77: 43-52
- Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.Lancet. 1992; 340: 1111-1115
- Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction.J Am Coll Cardiol. 1994; 24: 1468-1474
- The effects of age and gender on brachial artery endothelium-dependent vasoactivity are stimulus-dependent.Clin Cardiol. 1995; 18: 471-476
- Correlation of cold pressor and flow-mediated brachial artery diameter responses with the presence of coronary artery disease.Am J Cardiol. 1995; 75: 783-787
- Plasma noradrenaline concentrations during isometric exercise.Br Heart J. 1978; 40: 1216-1220
- Sympathoadrenal-circulatory regulation during sustained isometric exercise in young and older men.Am J Physiol. 1991; 261: R1061-R1069
- Leisure-time physical activity levels and risk of coronary heart disease and death. The Multiple Risk Factor Intervention Trial.JAMA. 1987; 258: 2388-2395
- Technical aspects of evaluating brachial artery vasodilatation using high-frequency ultrasound.Am J Physiol. 1995; 268: H1397-H1404
- Muscle sympathetic activity and venous plasma noradrenaline concentrations during static exercise in normotensive and hypertensive subjects.Acta Physiol Scand. 1987; 129: 489-497
- Non-invasive measurement of human endothelium dependent arterial responses.Br Heart J. 1995; 74: 247-253
- Plasma lipid, lipoprotein cholesterol, and apoprotein distributions in selected US communities. The Atherosclerosis Risk in Communities (ARIC) Study.Arterioscler Thromb. 1993; 13: 1139-1158
- The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial Investigators.N Engl J Med. 1996; 335: 1001-1009
- Impaired vasodilation of forearm resistance vessels in hypercholesterolemic humans.J Clin Invest. 1990; 86: 228-234
- Comparison of the effects of exercise and cold pressor test on the vasomotor response of normal and atherosclerotic coronary arteries and their relation to the flow-mediated mechanism.Am J Cardiol. 1995; 76: 467-473
- Bioassay of endothelium-derived relaxing factor(s).Am J Physiol. 1985; 249: H95-H101
- Differential control of heart rate and sympathetic nerve activity during dynamic exercise. Insight from intraneural recordings in humans.J Clin Invest. 1987; 79: 508-516
- Adrenaline facilitates neurogenic vasoconstriction in borderline hypertensive subjects.J Hypertens. 1990; 8: 443-448
- Influence of the endothelium on tone and the response of isolated pig coronary artery to norepinephrine.J Pharmacol Experiment Therapeut. 1988; 244: 550-555
- Endothelium inhibits norepinephrine release from adrenergic nerves of rabbit carotid artery.Am J Physiol. 1988; 254: H871-H878
- Metabolic vasodilation in the human forearm is preserved in hypercholesterolemia despite impairment of endothelium-dependent and independent vasodilation.Cardiovasc Res. 1999; 43: 721-730
- Role of nitric oxide in coronary vasomotion during handgrip exercise.Am Heart J. 1997; 134: 967-973
- Changes in flow-mediated brachial artery vasoactivity with lowering of desirable cholesterol levels in healthy middle-aged men.Am J Cardiol. 1996; 77: 37-40
- Gender does not influence sympathetic neural reactivity to stress in healthy humans.Am J Physiol. 1996; 270: H350-H357
Article info
Publication history
Published online: August 16, 2004
Accepted:
June 13,
2000
Received in revised form:
June 13,
2000
Received:
March 10,
2000
Footnotes
☆This study was supported in part by a donation from Harold and Kay Peplau, Ypsilanti, Michigan; and an unrestricted grant from Bristol-Myers Squibb, Stamford, Connecticut.
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
