scholarly journals Cerebral Endothelial Function Determined by Cerebrovascular Reactivity to L-Arginine

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Janja Pretnar-Oblak
Keyword(s):  
Endothelial Function ◽  
Morphological Changes ◽  
Transcranial Doppler Sonography ◽  
Intima Media Thickness ◽  
Cerebrovascular Reactivity ◽  
Cerebral Endothelium ◽  
Enhanced Production ◽  
Pathological Conditions ◽  
Flow Mediated Dilatation ◽  
Potential Improvement

Endothelium forms the inner cellular lining of blood vessels and plays an important role in many physiological functions including the control of vasomotor tone. Cerebral endothelium is probably one of the most specific types but until recently it was impossible to determine its function. In this review, the role of cerebrovascular reactivity to L-arginine (CVR-L-Arg) for assessment of cerebral endothelial function is discussed. L-Arginine induces vasodilatation through enhanced production of nitric oxide (NO) in the cerebral endothelium. Transcranial Doppler sonography is used for evaluation of cerebral blood flow changes. The method is noninvasive, inexpensive, and enables reproducible measurements. CVR-L-Arg has been compared to flow-mediated dilatation as a gold standard for systemic endothelial function and intima-media thickness as a marker for morphological changes. However, it seems to show specific cerebral endothelial function. So far CVR-L-Arg has been used to study cerebral endothelial function in many pathological conditions such as stroke, migraine, etc. In addition CVR-L-Arg has also proven its usefulness in order to show potential improvement after pharmacological interventions. In conclusion CVR-L-Arg is a promising noninvasive research method that could provide means for evaluation of cerebral endothelial function in physiological and pathological conditions.

P6219Can too much exercise “burn” your endothelium?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Terentes-Printzios ◽  
C Vlachopoulos ◽  
D Kardara ◽  
A Anastasakis ◽  
G Vogiatzi ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Marathon Running ◽  
Vigorous Exercise ◽  
Marathon Runners ◽  
Beneficial Effects ◽  
Reduced Body ◽  
Flow Mediated Dilatation

Abstract Background/Introduction Regular aerobic exercise has beneficial effects on the cardiovascular system. Marathon running is an aerobic and extremely vigorous exercise. Endothelial function and carotid subclinical atherosclerosis are independent predictors of cardiovascular risk. Purpose We investigated the chronic alterations of these indices in marathon runners. Methods We studied 30 marathon runners and 20 age- and sex-matched recreationally active control subjects. Endothelial function was evaluated with flow-mediated dilatation of the brachial artery (FMD) and early atherosclerosis with carotid intima-media thickness (cIMT). All subjects completed analytical questionnaires about their medical history and training. Results Marathon runners had significantly higher systolic and pulse pressure compared to controls. They also had reduced body-mass index, waist to hip ratio and heart rate compared to controls (p<0.05, for all). Common cIMT was significantly lower in athletes than controls (0.56±0.11 vs. 0.63±0.07, p=0.029), while there was no difference in carotid bulb IMT between groups. FMD was higher in marathon runners compared to controls and nitrate-mediated dilatation (NMD) was similar in the two groups (9.0±3.7 vs. 6.4±1.7 and 12.6±5.7 vs. 12.3±3.4; p=0.002 and p=0.821, respectively). We also observed a reverse U-shaped curve between endothelial function and amount of exercise. (Figure) Effect of amount of exercise on FMD Conclusions Our study shows, that marathon runners have higher FMD compared to controls, indicating better vascular endothelial function, and also have lower cIMT compared to controls. Increased amount of exercise training seems to abolish the beneficial effect of exercise on endothelial function. These findings provide further insights in the effects of marathon running on endothelial function and carotid atherosclerosis.

scholarly journals Vasoreactivity in CADASIL: Comparison to structural MRI and neuropsychology

2017 ◽  
Vol 38 (6) ◽  
pp. 1085-1095 ◽  
Author(s):  
Fiona C Moreton ◽  
Breda Cullen ◽  
Christian Delles ◽  
Celestine Santosh ◽  
Rosario L Gonzalez ◽  
...  
Keyword(s):  
Vascular Function ◽  
Vascular Dysfunction ◽  
Neuropsychological Testing ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Structural Mri ◽  
Cerebrovascular Reactivity ◽  
Neuropsychological Measures ◽  
Flow Mediated Dilatation ◽  
Cerebral Vasoreactivity

Impaired cerebrovascular reactivity precedes histological and clinical evidence of CADASIL in animal models. We aimed to more fully characterise peripheral and cerebral vascular function and reactivity in a cohort of adult CADASIL patients, and explore the associations of these with conventional clinical, imaging and neuropsychological measures. A total of 22 adults with CADASIL gave informed consent to participate in an exploratory study of vascular function in CADASIL. Clinical assessment, comprehensive vascular assessment, MRI and neuropsychological testing were conducted. We measured cerebral vasoreactivity with transcranial Doppler and arterial spin labelling MRI with hypercapnia challenge. Number and volume of lacunes, subcortical hyperintensity volume, microbleeds and normalised brain volume were assessed on MRI. Analysis was exploratory and examined the associations between different markers. Cerebrovascular reactivity measured by ASL correlated with peripheral vasoreactivity measured by flow mediated dilatation. Subjects with ≥5 lacunes were older, with higher carotid intima-media thickness and had impaired cerebral and peripheral vasoreactivity. Subjects with depressive symptoms, disability or delayed processing speed also showed a trend to impaired vasoreactivity. Impaired vasoreactivity and vascular dysfunction may play a significant role in the pathophysiology of CADASIL, and vascular assessments may be useful biomarkers of severity in both longitudinal and clinical trials.

Deletion polymorphism in the α2B-adrenergic receptor gene is associated with flow-mediated dilatation of the brachial artery

2002 ◽  
Vol 103 (5) ◽  
pp. 517-524 ◽  
Author(s):  
Paula HEINONEN ◽  
Laura JARTTI ◽  
Mikko J. JÄRVISALO ◽  
Ullamari PESONEN ◽  
Jaakko A. KAPRIO ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Adrenergic Receptor ◽  
Intima Media Thickness ◽  
Deletion Variant ◽  
Media Thickness ◽  
Increased Risk ◽  
Flow Mediated Dilatation ◽  
Carotid Artery Compliance

A deletion variant of the α2B-adrenergic receptor (α2B-AR) has been associated with an increased risk of acute cardiac events in middle-aged men. Our aim was to determine the possible associations between the α2B-AR gene deletion variant and indicators of subclinical atherosclerosis in the brachial and carotid arteries. A total of 148 middle-aged men participating in an epidemiological twin study on risk factors for subclinical coronary heart disease were genotyped using PCR. Flow-mediated dilatation (FMD) of the brachial artery, carotid artery compliance and carotid intima-media thickness were measured using high-resolution ultrasound. FMD was 6.2±5.0% in subjects with the I/I (insertion/insertion) genotype, 5.5±4.1% in the I/D (insertion/deletion) group and 4.1±3.8% in the D/D (deletion/deletion) group (P = 0.03 for trend). In multivariate regression analysis controlling for age, presence of hypertension, smoking, use of angiotensin-converting enzyme inhibitors and plasma levels of low-density lipoprotein cholesterol and lipoprotein (a), the association between the α2B-AR genotype and FMD remained significant (P = 0.04 for trend). The α2B-AR genotype was not associated with intima-media thickness or carotid artery compliance. These findings indicate that subjects homozygous for the deletion allele of α2B-AR appear to have an increased risk of impaired endothelial function, which may provide an explanation for the previously observed increased risk of myocardial infarction in male subjects with this genotype. It is not known whether the association of the α2B-AR polymorphism with endothelial function is direct, or is mediated via altered sympathetic activation.

Endothelium-dependent vasodilatation in migraine patients

Cephalalgia ◽  
2011 ◽  
Vol 31 (6) ◽  
pp. 654-660 ◽  
Author(s):  
Denis Perko ◽  
Janja Pretnar-Oblak ◽  
Miso Sabovic ◽  
Bojana Zvan ◽  
Marjan Zaletel
Keyword(s):  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Healthy Subjects ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Inclusion Criteria ◽  
Standard Procedures ◽  
Flow Mediated Dilatation ◽  
Migraine Pathophysiology

Background: Endothelial dysfunction could be involved in the pathophysiology of migraine. The results obtained from a few studies on endothelial dysfunction in migraine are controversial. We investigated brachial flow-mediated dilatation (FMD), which reflects systemic endothelial dysfunction, in migraine patients without comorbidities. By employing strict inclusion criteria we avoided the possible changes to FMD from confounding factors. Methods. Forty migraine patients without comorbidities (20 with and 20 without aura) and 20 healthy subjects were included. FMD of brachial arteries and carotid intima-media thickness were measured by using standard procedures. Results. We did not find any difference in FMD between migraine patients and healthy subjects ( p = .96). Also, no differences were found among healthy subjects, migraine patients with aura and without aura ( p = .99). Conclusion. Our study showed that systemic endothelial function is not impaired in migraine patients without comorbidities, neither in those with or without aura. Considering these findings, the investigation of cerebral endothelial function would be useful in a further investigation of the role of endothelial (dys)function in migraine pathophysiology.

scholarly journals Transient Reduction of FMD-Response and L-Arginine Accompanied by Increased Levels of E-Selectin, VCAM, and ICAM after Prolonged Strenuous Exercise

Sports ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 86
Author(s):  
Christoffer Nyborg ◽  
Helene Støle Melsom ◽  
Martin Bonnevie-Svendsen ◽  
Jørgen Melau ◽  
Ingebjørg Seljeflot ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Strenuous Exercise ◽  
Finish Line ◽  
Endothelial Inflammation ◽  
Flow Mediated Dilatation ◽  
Line P ◽  
Ironman Distance

We assessed endothelial function by flow-mediated dilatation (FMD), levels of the NO-precursor L-arginine, and markers of endothelial inflammation before, at the finish line, and one week after the Norseman Xtreme triathlon. The race is an Ironman distance triathlon with a total elevation of 5200 m. Nine male participants were included. They completed the race in 14.5 (13.4–15.3) h. FMD was significantly reduced to 3.1 (2.1–5.0)% dilatation compared to 8.7 (8.2–9.3)% dilatation before the race (p < 0.05) and was normalized one week after the race. L-arginine showed significantly reduced levels at the finish line (p < 0.05) but was normalized one week after the race. Markers of endothelial inflammation E-Selectin, VCAM-1, and ICAM-1 all showed a pattern with increased values at the finish line compared to before the race (all p < 0.05), with normalization one week after the race. In conclusion, we found acutely reduced FMD with reduced L-arginine levels and increased E-Selectin, VCAM-1, and ICAM-1 immediately after the Norseman Xtreme triathlon. Our findings indicate a transient reduced endothelial function, measured by the FMD-response, after prolonged strenuous exercise that could be explained by reduced NO-precursor L-arginine levels and increased endothelial inflammation.

Decreased Flow-Mediated Dilatation in Children With Type 1 Diabetes: A Systematic Review and Meta-Analysis

Angiology ◽  
2021 ◽  
pp. 000331972110100
Author(s):  
Lei Cao ◽  
Miao Hou ◽  
Wanping Zhou ◽  
Ling Sun ◽  
Jie Shen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Endothelial Function ◽  
Meta Analysis ◽  
Quality Data ◽  
Cochrane Library ◽  
Healthy Children ◽  
Healthy Controls ◽  
Flow Mediated Dilatation

Type 1 diabetes (T1DM) is a strong risk factor for the development of cardiovascular disease. Flow-mediated dilatation (FMD) is an early noninvasive marker of endothelial function and it predicts future cardiovascular disease. However, the changes in FMD among T1DM children are still controversial. The present meta-analysis aimed to investigate whether FMD is impaired in children with T1DM. PubMed, EMBASE, Cochrane library, and Web of Science were searched for studies comparing FMD in children with T1DM and healthy controls. The Newcastle-Ottawa quality assessment scale for case–control studies was used to assess study quality. Data were pooled using a random effects models to obtain the weighted mean differences (WMD) in FMD and 95% CIs. Overall, 19 studies with 1245 patients and 872 healthy controls were included in this meta-analysis. Children with T1DM had significantly lower FMDs compared with healthy controls (WMD: −2.58; 95% CI: −3.36 to −1.81; P < .001). Meta-regression analysis revealed that low-density lipoprotein cholesterol levels impacted the observed difference in FMD between T1DM and healthy children. This meta-analysis showed that T1DM children have impaired endothelial function, which indicates they are at higher risk of developing cardiovascular disease in later life.

Flow-mediated dilatation following wrist and upper arm occlusion in humans: the contribution of nitric oxide

2001 ◽  
Vol 101 (6) ◽  
pp. 629-635 ◽  
Author(s):  
Sagar N. DOSHI ◽  
Katerina K. NAKA ◽  
Nicola PAYNE ◽  
Christopher J.H. JONES ◽  
Moira ASHTON ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Peak Flow ◽  
Ultrasound Probe ◽  
Upper Arm ◽  
Flow Mediated Dilatation ◽  
Synthase Inhibitor ◽  
Increased Blood Flow ◽  
Similar Peak

Flow-mediated dilatation (FMD) of the brachial artery assessed by high-resolution ultrasound is widely used to measure endothelial function. However, the technique is not standardized, with different groups using occlusion of either the wrist or the upper arm to induce increased blood flow. The validity of the test as a marker of endothelial function rests on the assumption that the dilatation observed is endothelium-dependent and mediated by nitric oxide (NO). We sought to compare the NO component of brachial artery dilatation observed following wrist or upper arm occlusion. Dilatation was assessed before and during intra-arterial infusion of the NO synthase inhibitor NG-monomethyl-l-arginine (l-NMMA) following occlusion of (i) the wrist (distal to ultrasound probe) and (ii) the upper arm (proximal to ultrasound probe) for 5min in ten healthy males. Dilatation was significantly greater after upper arm occlusion (upper arm, 11.62±3.17%; wrist, 7.25±2.49%; P = 0.003). During l-NMMA infusion, dilatation after wrist occlusion was abolished (from 7.25±2.49% to 0.16±2.24%; P < 0.001), whereas dilatation after upper arm occlusion was only partially attenuated (from 11.62±3.17% to 7.51±2.34%; P = 0.006). The peak flow stimulus was similar after wrist and upper arm occlusion. We conclude that dilatation following upper arm occlusion is greater than that observed after wrist occlusion, despite a similar peak flow stimulus. l-NMMA infusion revealed that FMD following wrist occlusion is mediated exclusively by NO, while dilatation following upper arm occlusion comprises a substantial component not mediated by NO, most probably related to tissue ischaemia around the brachial artery. FMD following wrist occlusion may be a more valid marker of endothelial function than dilatation following upper arm occlusion.

scholarly journals Transcranial Doppler Evaluation of the Cerebral Vasculature in Women Patients who Have Migraine with Aura

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3012-3017
Author(s):  
Igor Petrušić ◽  
Ana Podgorac ◽  
Aleksandra Radojičić ◽  
Jasna Zidverc-Trajković
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Migraine With Aura ◽  
Transcranial Doppler ◽  
Cerebral Blood Flow Velocity ◽  
Cerebral Arteries ◽  
Transcranial Doppler Sonography ◽  
Cerebrovascular Reactivity ◽  
Breath Holding ◽  
Left And Right

Abstract Background Previous studies suggest that increased cerebrovascular reactivity might be a feature of patients who have migraine with aura (MwA). The correlation between the clinical presentation of migraine with aura and transcranial Doppler parameters remains unclear. Objective The main aim of this study was to explore cerebral blood flow, vascular resistance, and cerebrovascular reactivity in women MwA. Also, the relationships between hemodynamic conditions and aura characteristics are examined. Design Cross-sectional study. Setting Headache Center, Neurology Clinic, Clinical Center of Serbia. Subjects Fifty-four women MwA and 49 healthy controls (HCs). Methods Transcranial Doppler sonography examination was used to determine blood flow mean velocity (MV) and pulsatility index (PI), as well as breath-holding index (BHI), in 15 arterial segments comprising the circle of Willis. Results A total of 54 women MwA and 49 HCs were studied. The PIs of all segments of the left and right middle cerebral arteries and the left and right anterior cerebral arteries were significantly higher in MwA with regards to HCs. Also, both the left and right BHIs were significantly higher in MwA than HCs. In addition, MVs of the right vertebral artery and the first segment of the basilar artery were significantly lower in MwA than HCs. Longer duration of migraine aura showed a weak negative correlation with the PI of the left posterior cerebral artery. Conclusions Our findings suggest increased vessel pulsatility, abnormal cerebrovascular reactivity, and decreased cerebral blood flow velocity in several arterial segments of the Willis circle in women MwA.

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