Evaluation of Endothelial Dysfunction in Patients with Isolated Coronary Artery Ectasia by Ultrasonographic Brachial Artery Flow Mediated Dilation

2021 ◽  
Vol 8 (05) ◽  
pp. 246-250
Author(s):  
Syed Imamuddin ◽  
Chamarti Venkata Arunavalli ◽  
Parvathareddy Krishna Malakonda Reddy ◽  
Ponnapati Venkata Anil Kumar Reddy
Keyword(s):  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Brachial Artery ◽  
Molecular Mechanisms ◽  
Tertiary Care ◽  
Surrogate Marker ◽  
Disease Process ◽  
Seldinger Technique ◽  
Flow Mediated Dilation ◽  
Coronary Artery Ectasia

BACKGROUND Evaluation of endothelial function in isolated coronary artery ectasia (ICAE) with flow-mediated dilation (FMD) is limited and use of flow mediated vasodilation as a surrogate marker for the extent of coronary atherosclerosis remains unknown. Thus, the following study was done to evaluate for endothelial dysfunction (ED) in subjects with ICAE by assessing the FMD in the brachial artery. METHODS This was an observational study, conducted at a referral hospital providing tertiary care in India between June 2017 and November 2018. Fifty patients with ICAE and fifty control patients with normal coronary arteries (NCA) on coronary angiogram, done by using a standard Seldinger technique via femoral route, were the subjects of the study. Brachial artery FMD was determined by using a highresolution ultrasound system (Samsung RS80A) using a linear transducer of a frequency of 7.5 Mega Hertz. RESULTS The groups had same baseline characteristics in terms of age, sex etc. (all P values > 0.05). However, values of serum uric acid and low-density lipoproteins were statistically significantly higher in ICAE subjects (P < 0.0001). Whereas, dilatation of brachial artery in response to shear stress was significantly lower in patients with ICAE subjects than in patients with normal coronaries. (8.85 ± 0.49 vs. 12.83 ± 0.45, P < 0.0001). Marki’s classification, type 1, type 2, type 3 and type 4 coronary artery ectasia (CAE) was present in 8 (16 %), 4 (8 %), 13 (26 %), and 25 (50 %), respectively. CONCLUSIONS Atherosclerosis may play a pivotal role in the genesis of ICAE. Hyperlipidaemia may have a specific role in the disease process. Further research is required to evaluate the exact molecular mechanisms involved in CAE. KEYWORDS Coronary Artery Disease, Ectasia, Endothelial Dysfunction, Hyperlipidaemia

scholarly journals Predictive value of brachial artery flow-mediated dilation on coronary artery abnormality in acute stage of Kawasaki disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yizhou Wen ◽  
Xianmin Wang ◽  
Yonghong Guo ◽  
Mei Jin ◽  
Jimei Xi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Kawasaki Disease ◽  
Brachial Artery ◽  
Characteristic Curve ◽  
Coronary Aneurysm ◽  
Acute Stage ◽  
Flow Mediated Dilation ◽  
Strong Negative Correlation ◽  
Coronary Artery Abnormality ◽  
Artery Flow

AbstractCoronary artery abnormalities (CAAs) are a severe complication of Kawasaki disease (KD) that may lead to cardiovascular events. Given the evidence that brachial artery flow-mediated dilation (FMD) decreases in children after the onset of KD, we hypothesized that it could be an early marker of CAA development in the acute stage and investigated its relationship with variation in the coronary artery diameter. A total of 326 sex- and age-matched children were enrolled, including 120 with KD, 109 febrile children and 97 healthy controls. In this study, FMD was significantly decreased in the KD group compared with the febrile and healthy groups. FMD was lower in the CAA group than in the no coronary artery abnormality group. The comparison of FMD showed an obvious difference among the CAA subgroups. The FMD in the coronary aneurysm (CA) group showed a strong negative correlation with the pretreatment maximum coronary artery Z-score (preZmax). While preZmax was 2.5, the receiver operating characteristic curve indicated an optimal cutoff point of 3.44% for FMD. FMD ≤ 3.44% could be considered as a signal of coronary lesions in acute stage of KD.

Abstract 2450: A Randomized Controlled Trial of Low Dose Hormone Therapy on Myocardial Ischemia in Postmenopausal Women with No Obstructive Coronary Artery Disease:Results from the NHLBI-sponsored WISE

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
C. Bairey Merz ◽  
Marian Olson ◽  
Candace McClure ◽  
James Symons ◽  
George Sopko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chest Pain ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Myocardial Ischemia ◽  
Hormone Therapy ◽  
Postmenopausal Women ◽  
Brachial Artery ◽  
Low Dose

Background: Compared with men, women have more evidence of myocardial ischemia in the setting of no obstructive coronary artery disease (CAD). While low endogenous estrogen levels are associated with endothelial dysfunction, the role of low dose hormone therapy has not been fully evaluated in women suffering from myocardial ischemia and no obstructive CAD. Objective: This WISE ancillary trial evaluated the effect of low dose hormone therapy in postmenopausal women with myocardial ischemia and no obstructive CAD on: endothelial dysfunction, assessed by brachial artery reactivity, physical functional disability assessed by exercise testing, and quality of life assessed by cardiac symptoms and psychological questionnaires. Methods: Using a multicenter, randomized, placebo-controlled design, seventy-four participants with normal/minimally diseased epicardial coronary arteries (<50% luminal diameter stenosis) who fulfilled the inclusion criteria were planned to be randomized to receive either 1 mg norethindrone/10 mcg ethinyl estradiol (1/10 NA/EE) or placebo for twelve weeks. Baseline and exit brachial artery reactivity (BART), exercise stress testing, WISE psychosocial questionnaires, SF-36, blood lipids and hormone levels were evaluated. Results: Recruitment was closed prematurely due to failure to recruit in the year following publication of the Women’s Health Initiative hormone trial results. Of the 37 women randomized, 35 completed the study. While there was no difference in the frequency of chest pain between groups at the baseline visit, at study exit there was less frequent chest pain in the 1/10 NA/EE group compared to the placebo group (p=0.02). Women taking 1/10 NA/EE also showed a trend to improved BART and exercise tolerance, and had significantly fewer hot flashes/night sweats (p=0.003), less avoidance of intimacy (p=0.05), and borderline differences in sexual desire and vaginal dryness (p=0.06). Conclusion: Among postmenopausal women with myocardial ischemia and no obstructive CAD, hormone therapy with 1/10 NA/EE is associated with reduced chest pain symptoms, menopausal symptoms and improved quality of life with trends for improved endothelial function and exercise performance.

Decreased nitrate-mediated dilatation in patients with coronary artery ectasia: an ultrasonographic evaluation of brachial artery

2006 ◽  
Vol 17 (4) ◽  
pp. 365-369 ◽  
Author(s):  
Yuksel Aksoy ◽  
Nusret Acikgoz ◽  
Nasir Sivri ◽  
Emrah Bariskaner ◽  
Erdal Akturk ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Brachial Artery ◽  
Coronary Artery Ectasia

scholarly journals Morphological spectrum of atherosclerotic lesions in a tertiary care Institute in Punjab

2018 ◽  
Vol 10 (1) ◽  
pp. 19-24
Author(s):  
Rajiv Kumar Gupta ◽  
Ruchita Tyagi ◽  
Vikrampal Singh ◽  
Samir Kapoor ◽  
Gurmeet Singh ◽  
...  
Keyword(s):  
Coronary Artery ◽  
South Asians ◽  
Tertiary Care ◽  
Disease Process ◽  
Heart Association ◽  
Lifestyle Changes ◽  
Female Ratio ◽  
Fibrous Cap ◽  
Atherosclerotic Lesions ◽  
Morphological Studies

Background: The incidence of coronary artery disease (CAD) has risen considerably in developing world due to industrialization, urbanisation and lifestyle changes, especially among Indians and South Asians. The onset of CAD has been seen to occur at an early age and the severity of the disease and mortality associated with CAD has also increased. The pathology of atherosclerosis needs to be re-evaluated to develop targeted therapy which can contain the disease process at the earliest stage. Aims and Objectives: Most of the morphological studies on atherosclerosis have been done on autopsy cases. In this study, we have analysed the morphological spectrum of atherosclerotic lesions in live patients. Materials and Methods:  We retrospectively analysed the histopathology slides of 85 cases whose endarterectomy plaques were received in the Department of Pathology over a period of three and half years (January 2014 to June 2017) and classified the lesions according to Modified American Heart Association classification of atherosclerosis. Results: The average age of patients was 60 years and male to female ratio of 4.3:1. Left anterior descending artery was the commonest vessel involved (52.4%). Majority of the cases had fibrocalcific plaques,followed by fibrous cap atheroma and calcified nodules. Conclusion: Coronary artery plaques were found even in patients less than 40 years old.  Aggressive lipid defense therapy needs to be the cornerstone of management of CAD.

scholarly journals Serum amyloid A induces endothelial dysfunction in porcine coronary arteries and human coronary artery endothelial cells

2008 ◽  
Vol 295 (6) ◽  
pp. H2399-H2408 ◽  
Author(s):  
Xinwen Wang ◽  
Hong Chai ◽  
Zehao Wang ◽  
Peter H. Lin ◽  
Qizhi Yao ◽  
...  
Keyword(s):  
Endothelial Cells ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Coronary Arteries ◽  
Molecular Mechanisms ◽  
Serum Amyloid A ◽  
Serum Amyloid ◽  
Dependent Manner ◽  
Amyloid A ◽  
Enos Mrna

The objective of this study was to determine the effects and mechanisms of serum amyloid A (SAA) on coronary endothelial function. Porcine coronary arteries and human coronary arterial endothelial cells (HCAECs) were treated with SAA (0, 1, 10, or 25 μg/ml). Vasomotor reactivity was studied using a myograph tension system. SAA significantly reduced endothelium-dependent vasorelaxation of porcine coronary arteries in response to bradykinin in a concentration-dependent manner. SAA significantly decreased endothelial nitric oxide (NO) synthase (eNOS) mRNA and protein levels as well as NO bioavailability, whereas it increased ROS in both artery rings and HCAECs. In addition, the activities of internal antioxidant enzymes catalase and SOD were decreased in SAA-treated HCAECs. Bio-plex immunoassay analysis showed the activation of JNK, ERK2, and IκB-α after SAA treatment. Consequently, the antioxidants seleno-l-methionine and Mn(III) tetrakis-(4-benzoic acid)porphyrin and specific inhibitors for JNK and ERK1/2 effectively blocked the SAA-induced eNOS mRNA decrease and SAA-induced decrease in endothelium-dependent vasorelaxation in porcine coronary arteries. Thus, SAA at clinically relevant concentrations causes endothelial dysfunction in both porcine coronary arteries and HCAECs through molecular mechanisms involving eNOS downregulation, oxidative stress, and activation of JNK and ERK1/2 as well as NF-κB. These findings suggest that SAA may contribute to the progress of coronary artery disease.

scholarly journals Correlation between masked hypertension and endothelial dysfunction measured by flow-mediated dilation: a protocol of systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e047564
Author(s):  
Xiaohua Zhang ◽  
Yong Li ◽  
Ling Gao ◽  
Qian Yu ◽  
Congliang Zhou ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Endothelial Dysfunction ◽  
Meta Analysis ◽  
Surrogate Marker ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Control Group ◽  
Pool Data ◽  
Masked Hypertension ◽  
Flow Mediated Dilation

IntroductionA surrogate marker to evaluate artery endothelial response when stimulated by reactive hyperaemia, known as brachial flow-mediated dilation (FMD), has prognostic value in predicting hypertensive organ damage and cardiovascular disease events. However, the degree of correlation between brachial FMD and masked hypertension (MH) outcomes is still unclear. Therefore, the purpose of this study is to pool data regarding FMD with respect to MH.Methods and analysisElectronic databases MEDLINE, EMBASE, China National Knowledge Infrastructure and Cochrane Library will be searched for the following keywords: endothelial dysfunction, flow-mediated dilation, and masked hypertension, masked uncontrolled hypertension (MUCH) and prehypertension. The following are the eligibility criteria: population—adults (18 years old or older) without hypertension at baseline, with suspected endothelial dysfunction, or from MH/MUCH populations (office blood pressure <140/90 mm Hg and home blood pressure ≥135 mm Hg and/or 85 mm Hg) and from controlled clinical trials, cohort studies, or randomised and controlled trials; exposures—any metrics for FMD; comparisons—participants without MH or MUCH; and outcome—change in FMD between the case group and the control group. Two authors will be engaged in screening and collecting data independently; disagreements will be resolved through discussion. Data extraction will include primary data designated as HR, OR, correlations and regression coefficients. Comprehensive Meta-Analysis V.2.0 will be used to conduct related subgroup and sensitivity analyses and publication bias.Ethics and disseminationThis study does not require ethics approval. It will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42020208362.

New endothelial markers: implications for coronary artery disease and chronic periodontitis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TE Lipatova ◽  
AV Eremin ◽  
AV Lepilin
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Progenitor Cells ◽  
Brachial Artery ◽  
Chronic Periodontitis ◽  
Healthy Person ◽  
Endothelial Markers ◽  
Cd34 Cells ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is an association between chronic periodontitis (CP) and coronary artery disease (CAD). Endothelial function is increasingly used as an important outcome measure in cardiovascular diseases. But the data on early markers endothelial dysfunction in patients with CP is limited. Aim. To determine whether there are differences in parameters of tissue endothelial markers in gingiva between patients with CP, CAD or CAD and concomitant CP. Methods We examined 30 patients with CAD, 75 patients with CP and 35 patients with CAD and concomitant CP and 25 healthy control. There were no differences between the groups of patients with CP, CAD and co-morbidity in age, gender, smoking and obesity. In marginal gingiva NO-synthase-like cells (NOs-cells) and marker of endothelial progenitor cells (CD34+ cells) by immunohistochemical and morphometric analyses were assessed. Endothelium-dependent vasodilation (EDV) of the brachial artery was evaluated. Results Immunoreactivity to NOs and the CD34+ cells was found mainly in the vascular. In patients with average and severe CP significant decrease of expression of NOs–cells (6.2 ± 2.4% vs 7.9 ± 1.9%, p &lt; 0.05) and of CD34+ -cells (6.3%±1.8 vs 8.9 ± 2.6%, p &lt; 0.05) in gingiva was detected. There were no differences of endothelial immunohistochemical markers between the groups of patients with mild CP and healthy person. In patients with CAD also significant decrease of expression of NOs–cells (5.0 ± 2.1%) and of CD34+ -cells (4.9%±2.0%) in gingiva was found. The most significance changes of gingival expression of NOs–cells (4.3 ± 1.4%) and of CD34+ -cells (3.8%±1.7%) in patients with CAD and concomitant CP were observed. In the control group EDV 15.4 ± 6.5%, in patients with mild CP 13.9 ± 6.5, in patients with average and severe CP 10,9 ± 5,1% (p = 0.02 between healthy person). There were associations between the decrease of EDV of the brachial artery with gingival expression of NOs–cells and of CD34+ -cells (Spearman"s R = 0.575 and R = 0.578). Conclusion Average and severe periodontitis is associated with vascular effects outside the oral cavity. Periodontitis also as CAD are associated with changes in the cell expression of NOs and endothelial progenitor cells in the periodontal tissue. Immunohistochemical assessment of endothelial markers in periodontium is a promising method of early assessment of endothelial dysfunction in cardiovascular disease.

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