Hypoglycemia Induces Vascular Endothelial Dysfunction in Subjects With Normal Glucose Tolerance

Abstract This prospective study determined the effects of hypoglycemic stimulation on vascular endothelial function in non-diabetic patients using reactive hyperemia peripheral arterial tonometry (RH-PAT). The study included non-diabetic patients who were hospitalized for an insulin tolerance test (ITT) for the diagnosis of hypoadrenocorticism or hypopituitarism. Vascular endothelial function was assessed using the reactive hyperemia index (RHI) measured by the RH-PAT. We also measured the levels of anterior pituitary hormone, adrenaline, noradrenaline, and dopamine at the time of hypoglycemia. The primary endpoint was a change in the RHI at 120 minutes after insulin administration. The study included 27 patients. ITT was associated with significant increases in systolic blood pressure, pulse rate, and the blood levels of adrenocorticotropic hormone, cortisol, growth hormone, adrenaline, noradrenaline, and dopamine. RHI significantly decreased after ITT from 2.24±0.51 to 1.71±0.42. A significant inverse correlation was observed between the change in RHI and change in adrenaline (r=-0.670, p=0.012). We concluded that hypoglycemic stimulation altered vascular endothelial function, as measured by RH-PAT, even in patients free of glucose intolerance. The observed deterioration in vascular endothelial function correlated with increases in catecholamine levels during hypoglycemia.Trial registration: UMIN000033244

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Effects of switching from clopidogrel to prasugrel at the chronic phase after coronary stenting on antiplatelet action and vascular endothelial function: Switch-Pras study

Heart and Vessels ◽

10.1007/s00380-020-01714-w ◽

2020 ◽

Author(s):

Taiki Masuyama ◽

Masashi Sakuma ◽

Ryutaro Waku ◽

Suguru Hirose ◽

Keijiro Kitahara ◽

...

Keyword(s):

Endothelial Function ◽

Reactive Hyperemia ◽

Flow Cytometric Analysis ◽

Chronic Phase ◽

High Sensitivity ◽

Coronary Intervention ◽

Vascular Endothelial ◽

Cyp2c19 Genotype ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry

Abstract Compared to clopidogrel, prasugrel has a lower incidence of ischemic events following percutaneous coronary intervention (PCI) because of an early reduction during the acute phase in P2Y12 reaction units (PRU). The objective of this study was to compare the antiplatelet effect and vascular endothelial function of both drugs during the chronic phase after PCI. Patients who had undergone PCI and were confirmed to have no restenosis by follow-up coronary angiography under dual anti-platelet therapy with clopidogrel (75 mg/day) and aspirin (100 mg/day) were randomized to either continue clopidogrel or switch to prasugrel (3.75 mg/day). At baseline, prior to randomization we determined the CYP2C19 genotype. At the baseline and 24 weeks after randomization, the P2Y12 reactivity unit (PRU) was measured using the VerifyNow™ P2Y12 assay. Endothelial function was evaluated by flow-mediated vasodilation (FMD) and reactive hyperemia peripheral arterial tonometry (RH-PAT), while and circulating CD34+/CD133+/CD45low progenitor cells were measured by flow cytometric analysis. Serum high-sensitivity C-reactive protein (hsCRP) level was also measured. The PRU was reduced significantly in the prasugrel group (P = 0.0008), especially in patients who were intermediate or poor metabolizers based on the CYP2C19 genotype (P < 0.0001). This reduction was not observed in the clopidogrel group. The number of CD34+/CD133+/CD45low cells increased in the clopidogrel group (P = 0.008), but not in the prasugrel group. The hsCRP, FMD and reactive hyperemia index measured by RH-PAT did not change in either group. Prasugrel is potentially better than clopidogrel for preventing thrombotic events, although clopidogrel may have an advantage over prasugrel in terms of preventing atherosclerotic events. Proper use of thienopyridine drugs based on the CYP2C19 genotype has promising clinical potential.

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Improvement of Vascular Endothelial Function Reflects Nonrecurrence After Catheter Ablation for Atrial Fibrillation

Journal of the American Heart Association ◽

10.1161/jaha.121.021551 ◽

2021 ◽

Author(s):

Hisanori Kanazawa ◽

Koichi Kaikita ◽

Miwa Ito ◽

Yusei Kawahara ◽

Tadashi Hoshiyama ◽

...

Keyword(s):

Atrial Fibrillation ◽

Endothelial Function ◽

Sinus Rhythm ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Arterial Tonometry ◽

Peripheral Arterial ◽

Af Recurrence

Background The clinical implication of vascular endothelial dysfunction in patients with atrial fibrillation (AF) remains unclear. This study aimed to elucidate the correlation between changes in vascular endothelial function assessed by reactive hyperemia‐peripheral arterial tonometry and the effect of sinus rhythm restoration after catheter ablation (CA) for AF. Methods and Results Consecutive 214 patients who underwent CA for AF were included in this single center, retrospective study. The natural logarithmic transformed reactive hyperemia‐peripheral arterial tonometry index (LnRHI) of all patients was measured before CA as well as 3 and 6 months after CA. LnRHI in sinus rhythm was significantly higher than that in AF before CA. Multivariate logistic regression analysis revealed that the presence of AF was an independent risk factor for lowering of LnRHI (odds ratio, 4.092; P =0.002) before CA. The LnRHI was significantly improved 3 and 6 months after CA in patients without AF recurrence. Multivariate Cox hazard analysis revealed that changes in LnRHI from before to 3 months after CA independently correlated with recurrence of AF (hazard ratio, 0.106; P =0.001). Receiver operating characteristic analysis showed the decrease in LnRHI levels from before to 3 months after CA as a significant marker that suspects AF recurrence (area under the curve, 0.792; log‐rank test, P <0.001). Conclusions The presence of AF was independently correlated with the impaired vascular endothelial function assessed by the reactive hyperemia‐peripheral arterial tonometry. Long‐term sinus rhythm restoration after CA for AF might contribute to the improvement of vascular endothelial function, which may reflect the nonrecurrence of AF.

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Impact of Catheter Sheath Insertion into the Radial Artery on Vascular Endothelial Function Assessed by Reactive Hyperemia Peripheral Arterial Tonometry

International Heart Journal ◽

10.1536/ihj.15-094 ◽

2015 ◽

Vol 56 (5) ◽

pp. 489-494 ◽

Cited By ~ 7

Author(s):

Tomoo Nakata ◽

Satoshi Ikeda ◽

Seiji Koga ◽

Takeo Yoshida ◽

Yuji Koide ◽

...

Keyword(s):

Endothelial Function ◽

Radial Artery ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Arterial Tonometry ◽

Catheter Sheath ◽

Sheath Insertion ◽

Peripheral Arterial

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TCT-280 Impact of catheter sheath insertion into radial artery on vascular endothelial function as assessed by reactive hyperemia peripheral arterial tonometry

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.08.1016 ◽

2013 ◽

Vol 62 (18) ◽

pp. B91

Author(s):

Tomoo Nakata ◽

Satoshi Ikeda ◽

Seiji Koga ◽

Takeo Yoshida ◽

Miyuki Eto ◽

...

Keyword(s):

Endothelial Function ◽

Radial Artery ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Arterial Tonometry ◽

Catheter Sheath ◽

Sheath Insertion ◽

Peripheral Arterial

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Does Overnight Duty Affect Vascular Endothelial Function?

10.21203/rs.3.rs-624966/v1 ◽

2021 ◽

Author(s):

A Garu ◽

Eri Nitta ◽

Yuri Yoshida ◽

Erika Yata ◽

Akari Tsunematsu ◽

...

Keyword(s):

Regression Analysis ◽

Endothelial Function ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Vas Score ◽

Arterial Tonometry ◽

Lack Of Sleep ◽

Peripheral Arterial

Abstract Background The reactive hyperemia index (RHI), which is obtained from the measurement of peripheral arterial tonometry (PAT), is highly associated with the percentage change in the end-diastolic arterial diameter (%flow-mediated dilatation) at reactive hyperemia. Low RHI is reported to be a mortality risk in patients with a high risk of cardiovascular (CV) disease. CV events are thought to be induced by physical and mental stress, including long-term fatigue and lack of sleep. However, the relationship between fatigue, lack of sleep, and endothelial function has not yet been established. MethodsHealthy hospital workers (n=13, 6 men and 7 women) with an average age of 31.6 years were assigned to this study after they provided written informed consent. During the study period, we conducted 72 measurements of reactive hyperemia-peripheral arterial tonometry (RH-PAT) in the morning before or after their duty. At each measurement of the RH-PAT, we recorded the participants’ hours of sleep and evaluated their degree of fatigue using a visual analog scale (VAS).ResultsAlthough the VAS was significantly less (36±16% and 64±12%, p<0.001) and the hours of sleep were longer (6.0±1.1 h and 2.3±1.0 h, p<0.001) before duty compared to those after duty, the RHI was comparable between them (2.12±0.53 vs. 1.97±0.50, p=0.21). The VAS score was significantly higher in participants with low RHI (<1.67) than in those with normal RHI (≥2.07) (59±13% and 46±21%, respectively, p<0.05). However, binary logistic regression showed no significant association between low RHI and the VAS when adjusted for systemic blood pressure (SBP) and heart rate variability (HRV). In a simple regression analysis, the RHI was significantly correlated with the VAS score (r=-0.287, p<0.05), while no significant correlation was found between the RHI and sleep duration (r=0.045, p=0.71). A multiple linear regression analysis also showed no significant association between the RHI and VAS scores after adjustment for SBP and HRV.ConclusionsVascular endothelial function was not associated with overnight duty, hours of sleep, or degree of fatigue in healthy young adults. Since the RHI may be decreased in severe fatigue conditions through autonomic nerve activity, one should consider the physical and mental conditions of the examinee when evaluating the RH-PAT results.

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Investigation of Clinical Factors Related To Diabetic Vascular Endothelial Function Using Reactive Hyperemia Peripheral Arterial Tonometry

Journal of Endocrinology and Diabetes ◽

10.15226/2374-6890/5/4/001109 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1-7

Author(s):

Junnosuke Miura ◽

Shunsuke Kikuchi ◽

Kanako Shimura ◽

Tetsuya Babazono ◽

Yasuko Uchigata

Keyword(s):

Endothelial Function ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Clinical Factors ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Arterial Tonometry ◽

Peripheral Arterial

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Does overnight duty affect vascular endothelial function?

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02277-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

A. Garu ◽

Eri Nitta ◽

Yuri Yoshida ◽

Erika Yata ◽

Akari Tsunematsu ◽

...

Keyword(s):

Regression Analysis ◽

Endothelial Function ◽

Reactive Hyperemia ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Peripheral Arterial Tonometry ◽

Vas Score ◽

Arterial Tonometry ◽

Lack Of Sleep ◽

Peripheral Arterial

Abstract Background The reactive hyperemia index (RHI), which is obtained from the measurement of peripheral arterial tonometry (PAT), is highly associated with the percentage change in the end-diastolic arterial diameter (%flow-mediated dilatation) at reactive hyperemia. Low RHI is reported to be a mortality risk in patients with a high risk of cardiovascular (CV) disease. CV events are thought to be induced by physical and mental stress, including long-term fatigue and lack of sleep. However, the relationship between fatigue, lack of sleep, and endothelial function has not yet been established. Methods Healthy hospital workers (n = 13, 6 men and 7 women) with an average age of 31.6 years were assigned to this study after they provided written informed consent. During the study period, we conducted 72 measurements of reactive hyperemia-peripheral arterial tonometry (RH-PAT) in the morning before or after their duty. At each measurement of the RH-PAT, we recorded the participants’ hours of sleep and evaluated their degree of fatigue using a visual analog scale (VAS). Results Although the VAS was significantly less (36 ± 16% and 64 ± 12%, p < 0.001) and the hours of sleep were longer (6.0 ± 1.1 h and 2.3 ± 1.0 h, p < 0.001) before duty compared to those after duty, the RHI was comparable between them (2.12 ± 0.53 vs. 1.97 ± 0.50, p = 0.21). The VAS score was significantly higher in participants with low RHI (< 1.67) than in those with normal RHI (≥ 2.07) (59 ± 13% and 46 ± 21%, respectively, p < 0.05). However, binary logistic regression showed no significant association between low RHI and the VAS when adjusted for systemic blood pressure (SBP) and heart rate variability (HRV). In a simple regression analysis, the RHI was significantly correlated with the VAS score but not with sleep duration. A multiple linear regression analysis also showed no significant association between the RHI and VAS scores after adjustment for SBP and HRV. Conclusions Vascular endothelial function was not associated with overnight duty, hours of sleep, or degree of fatigue in healthy young adults. Since the RHI may be decreased in severe fatigue conditions through autonomic nerve activity, one should consider the physical and mental conditions of the examinee when evaluating the RH-PAT results.

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Meta-analysis of Exercise Training on Vascular Endothelial Function in Cancer Survivors

Integrative Cancer Therapies ◽

10.1177/1534735418756193 ◽

2018 ◽

Vol 17 (2) ◽

pp. 192-199 ◽

Cited By ~ 11

Author(s):

Rhys I. Beaudry ◽

Yuanyuan Liang ◽

Steven T. Boyton ◽

Wesley J. Tucker ◽

R. Matthew Brothers ◽

...

Keyword(s):

Exercise Training ◽

Endothelial Function ◽

Cancer Survivors ◽

Vascular Function ◽

Meta Analysis ◽

Reactive Hyperemia ◽

Controlled Trials ◽

Vascular Endothelial ◽

Vascular Endothelial Function ◽

Randomized Controlled

Cancer and cardiovascular disease (CVD) are leading causes of morbidity and mortality in the United States. Vascular endothelial dysfunction, an important contributor in the development of CVD, improves with exercise training in patients with CVD. However, the role of regular exercise to improve vascular function in cancer survivors remains equivocal. We performed a meta-analysis to determine the effect of exercise training on vascular endothelial function in cancer survivors. We searched PubMed (1975 to 2016), EMBASE CINAHL (1937 to 2016), OVID MEDLINE (1948 to 2016), and Cochrane Central Registry of Controlled Trials (1991 to 2016) using search terms: vascular function, endothelial function, flow-mediated dilation [FMD], reactive hyperemia, exercise, and cancer. Studies selected were randomized controlled trials of exercise training on vascular endothelial function in cancer survivors. We calculated pooled effect sizes and performed a meta-analysis. We identified 4 randomized controlled trials (breast cancer, n=2; prostate cancer, n=2) measuring vascular endothelial function by FMD (n=3) or reactive hyperemia index (n=1), including 163 cancer survivors (exercise training, n=82; control, n=81). Aerobic exercise training improved vascular function (n=4 studies; standardized mean difference [95% CI]=0.65 [0.33, 0.96], I2=0%; FMD, weighted mean difference [WMD]=1.28 [0.22, 2.34], I2=23.2%) and peak exercise oxygen uptake (3 trials; WMD [95% CI]=2.22 [0.83, 3.61] mL/kg/min; I2=0%). Our findings indicate that exercise training improves vascular endothelial function and exercise capacity in breast and prostate cancer survivors.

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