Cardiac Rehabilitation and Endothelial Function

Endothelial dysfunction is an early abnormality in the process of atherosclerosis and cardiovascular disease and has been associated with worse clinical outcome. Cardiac rehabilitation (CR) has been reported to be helpful to reduce cardiovascular events in various types of cardiac disease, but the mechanisms of its beneficial effects remain only partially known. In this article, we review the studies that assessed the effect of CR on endothelial function in patients with various cardiac conditions. Available data show that CR significantly improves impaired endothelial function in these patients, which may contribute to the beneficial effects of CR on clinical outcome.

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Comparison of biomarkers of endothelial dysfunction and microvascular endothelial function in patients with primary aldosteronism and essential hypertension

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320321999491 ◽

2021 ◽

Vol 22 (1) ◽

pp. 147032032199949

Author(s):

Miaomiao Sang ◽

Yu Fu ◽

Chenmin Wei ◽

Jing Yang ◽

Xueting Qiu ◽

...

Keyword(s):

Essential Hypertension ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Primary Aldosteronism ◽

Cardiovascular Events ◽

Statistical Significance ◽

Enzyme Linked Immunosorbent Assay ◽

Microvascular Endothelial ◽

Pai 1 ◽

Microvascular Endothelial Function

Introduction: Studies have shown that primary aldosteronism (PA) has a higher risk of cardiovascular events than essential hypertension (EH). Endothelial dysfunction is an independent predictor of cardiovascular events. Whether PA and EH differ in the endothelial dysfunction is uncertain. Our study was designed to investigate the levels of biomarkers of endothelial dysfunction (Asymmetric dimethylarginine, ADMA; E-selectin, and Plasminogen activator inhibitor-1, PAI-1) and assess the microvascular endothelial function in patients with PA and EH, respectively. Methods: The biomarkers of endothelial dysfunction were measured by enzyme-linked immunosorbent assay (ELISA). Microvascular endothelial function was evaluated by Pulse amplitude tonometry (PAT). Results: Thirty-one subjects with EH and 36 subjects with PA including 22 with aldosterone-producing adenoma (APA) and 14 with idiopathic hyperaldosteronism (IHA) were enrolled in our study. The ADMA levels among the three groups were different (APA 47.83 (27.50, 87.74) ng/ml vs EH 25.08 (22.44, 39.79) ng/ml vs IHA 26.00 (22.23, 33.75) ng/ml; p = 0.04), however, when the APA group was compared with EH and IHA group, there was no statistical significance (47.83 (27.50, 87.74) ng/ml vs 25.08 (22.44, 39.79) ng/ml for EH, p = 0.11; 47.83 (27.50, 87.74) ng/ml vs IHA 26.00 (33.75) ng/ml, p = 0.07). The results of ADMA levels are presented as Median (p25, p75). Whereas, levels of PAI-1 and E-selectin, microvascular endothelial function were not significantly different between PA and EH subjects. Conclusions: Our study shows no significant differences between PA and EH in terms of biomarkers of endothelial dysfunction and microvascular endothelial function. The microvascular endothelial function of PA and EH patients is comparable.

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Sleep deprivation and endothelial function: reconciling seminal evidence with recent perspectives

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00607.2020 ◽

2021 ◽

Vol 320 (1) ◽

pp. H29-H35

Author(s):

Joshua M. Cherubini ◽

Jem L. Cheng ◽

Jennifer S. Williams ◽

Maureen J. MacDonald

Keyword(s):

Cardiovascular Disease ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Sleep Deprivation ◽

Vascular Function ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Health Concern ◽

Short Sleep ◽

Inadequate Sleep

Sleep is critical for the maintenance of physiological homeostasis and, as such, inadequate sleep beckons a myriad of pathologies. Sleep deprivation is a growing health concern in contemporary society since short sleep durations are associated with increased cardiovascular disease risk and atherosclerotic plaque development. Vascular endothelial dysfunction is an antecedent to atherosclerosis and cardiovascular disease. Herein, we review seminal literature indicating that short sleep durations attenuate endothelial function and explore more recent evidence indicating that sleep deprivation perturbs autonomic balance and the circadian rhythmicity of peripheral vascular clock components. We further examine literature that indicates a mechanistic link between short sleep duration and endothelial dysfunction and subsequent morbidity. Understanding the mechanisms that regulate endothelial function in the context of sleep deprivation facilitates the development and optimization of interventions, such as exercise, that mitigate the ramifications of inadequate sleep on vascular function and cardiovascular health. Listen to this article’s corresponding podcast at https://ajpheart.podbean.com/e/sleep-deprivation-and-endothelial-function/

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Effects of Blackcurrant Anthocyanin on Endothelial Function and Peripheral Temperature in Young Smokers

Molecules ◽

10.3390/molecules24234295 ◽

2019 ◽

Vol 24 (23) ◽

pp. 4295 ◽

Cited By ~ 2

Author(s):

Toshiko Tomisawa ◽

Naoki Nanashima ◽

Maiko Kitajima ◽

Kasumi Mikami ◽

Shizuka Takamagi ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Endothelial Function ◽

Skin Temperature ◽

Healthy Male ◽

Double Blind ◽

Beneficial Effects ◽

Flow Mediated Dilatation ◽

Young Smokers ◽

Peripheral Temperature ◽

Level 2

Background: Blackcurrant anthocyanin (BCA) is expected to repair endothelial dysfunction, but it remains unclear whether beneficial effects are present in young healthy persons. This study examines whether supplements containing blackcurrant anthocyanin improve endothelial function and peripheral temperature in young smokers. Methods: Young, healthy male nonsmokers (N group: n = 11; mean age 22 ± 2 years) and smokers (S group: n = 13; mean age 21 ± 1 years) were enrolled. A randomized and double-blind trial was designed to compare the effects of no supplement, a supplement containing 50 mg of blackcurrant anthocyanin (supplement A), and a supplement containing 50 mg of blackcurrant anthocyanin plus vitamin E (supplement B) on flow-mediated dilatation (FMD) and skin temperature. Results: Under no supplement, FMD was unchanged during the 2 h period after smoking in the N group, whereas it was decreased during the 2 h period after smoking in the S group. Under the A supplement, FMD was decreased 1 h after smoking and returned to the baseline level 2 h after smoking in the S group. The skin temperature in the area of the foot dorsum was decreased in the S group after smoking compared with that in the N group, who did not smoke, whereas under A and B supplements, it was higher in the S group compared with that in the N group. Conclusions: BCA could attenuate the smoking-induced acute endothelial dysfunction and improve peripheral temperature in young smokers.

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Protective Effects of Polyphenols Present in Mediterranean Diet on Endothelial Dysfunction

Oxidative Medicine and Cellular Longevity ◽

10.1155/2020/2097096 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

K. Stromsnes ◽

C. Mas-Bargues ◽

J. Gambini ◽

L. Gimeno-Mallench

Keyword(s):

Cardiovascular Disease ◽

Weight Loss ◽

Endothelial Dysfunction ◽

Mediterranean Diet ◽

Microvascular Complications ◽

Additional Benefit ◽

Protective Effects ◽

Beneficial Effects ◽

Positive Effects ◽

Effects Of Aging

Endothelial dysfunction tends to be the initial indicator in proinflammatory state and macro- and microvascular complications, such as atherosclerosis and cardiovascular diseases. It has been shown that certain compounds in diet can generate beneficial effects on cardiovascular disease due to its interactions with endothelial cells. Thus, this review is aimed at investigating whether certain polyphenols present in the Mediterranean diet, specifically catechin, quercetin, resveratrol, and urolithin, could exert positive effects on endothelial dysfunction. After analysis of numerous papers, we found that polyphenols aiding endothelial function is beneficial not only for patients with cardiovascular disease, diabetes, or endothelial dysfunction but for all people as it can improve the effects of aging on the endothelia. The additional benefit of these polyphenols on weight loss further improves health and lowers the risk of several diseases, including those caused by endothelial dysfunction. However, it is important to note that the dosages in the majorities of the studies mentioned in this review were of supplemental rather than nutritionally relevant quantities, and therefore, the recommended dosages are difficult to determine.

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Effects of Hydroxychloroquine on endOthelial function in eLDerly with sleep apnea (HOLD): study protocol for a randomized clinical trial

10.21203/rs.3.rs-345739/v1 ◽

2021 ◽

Author(s):

Letícia Maria Tedesco Silva ◽

Antonio Cortes ◽

Beatriz Rossi ◽

Liliana Boll ◽

Gustavo Waclawovsky ◽

...

Keyword(s):

Coronary Artery Disease ◽

Clinical Trial ◽

Coronary Artery ◽

Sleep Apnea ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Randomized Clinical Trial ◽

Cardiovascular Events ◽

Gold Standard Method ◽

Artery Disease

Abstract BACKGROUND: Sleep apnea and coronary artery disease are prevalent and relevant diseases. The mechanism by which sleep apnea leads to coronary artery disease remains unclear. Intermittent hypoxia, caused by sleep apnea, leads to inflammation and consequent endothelial dysfunction. Endothelial dysfunction precedes the development of atherosclerotic disease and the occurrence of cardiovascular events. Agents that potentially act to improve endothelial function can help prevent cardiovascular events. Patients using immunomodulators due to rheumatic diseases have a lower prevalence of cardiovascular diseases. However, the potential cardio protective effect of these drugs in patients without autoimmune diseases is not clear. Hydroxychloroquine (HCQ) is an immunomodulator used to treat rheumatoid arthritis and systemic lupus erythematosus. In addition to its anti-inflammatory properties, HCQ reduces cholesterol and blood glucose levels and has antithrombotic effects. The drug is inexpensive and widely available. Adverse effects of HCQ are rare and occur more frequently with high doses.OBJECTIVE: In this randomized clinical trial, the effect of HCQ treatment on endothelial function will be tested in seniors with sleep apnea.METHODS: We will recruit participants over the age of 65 and with moderate-severe sleep apnea from an ongoing cohort. We chose to use this sample already evaluated for sleep apnea for reasons of convenience, but also because the elderly with sleep apnea are vulnerable to heart disease. Endothelial function will be assessed by examining flow-mediated dilation of the brachial artery, the gold standard method, considered an independent predictor of cardiovascular events in the general population and by peripheral arterial tonometry, the most recent and most easily obtained method. Hydroxychloroquine will be used at a dose of 400 mg/daily for eight weeks.DISCUSSION: Our study aim to obtain evidence, albeit preliminary, of the efficacy of hydroxychloroquine in improving endothelial function and reducing cardiovascular risk markers. If the improvement occurs, we plan to design a randomized multicenter clinical trial to confirm the findings.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04161339

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Effects of Wine and Tyrosol on the Lipid Metabolic Profile of Subjects at Risk of Cardiovascular Disease: Potential Cardioprotective Role of Ceramides

Antioxidants ◽

10.3390/antiox10111679 ◽

2021 ◽

Vol 10 (11) ◽

pp. 1679

Author(s):

Jose Rodríguez-Morató ◽

Anna Boronat ◽

Gabriele Serreli ◽

Laura Enríquez ◽

Alex Gomez-Gomez ◽

...

Keyword(s):

Cardiovascular Disease ◽

Endothelial Function ◽

Blood Lipid ◽

White Wine ◽

Cvd Risk ◽

Blood Lipid Profile ◽

Beneficial Effects ◽

Before And After ◽

Risk Biomarkers

Ceramides are a class of sphingolipids which have recently been shown to be better cardiovascular disease (CVD) risk predictors than traditional CVD risk biomarkers. Tyrosol (TYR) is a dietary phenolic compound known to possess cardioprotective effects per se or through its in vivo active metabolite hydroxytyrosol. The purpose of this study was to evaluate the effects of the co-administration of white wine (WW) and TYR on circulating levels of ceramides and other lipids in humans at high CVD risk. Volunteers underwent a randomized controlled crossover clinical trial (4-week duration per intervention) with three different interventions: control, WW, and WW enriched with a capsule of TYR (WW + TYR). Endothelial function cardiovascular biomarkers and plasma lipidomic profile were assessed before and after each intervention. It was found that the WW + TYR intervention resulted in lower levels of three ceramide ratios, associated with an improvement of endothelial function (Cer C16:0/Cer C24:0, Cer C18:0/Cer C24:0, and Cer C24:1/Cer C24:0), when compared to the control intervention. Moreover, WW + TYR was able to minimize the alterations in plasma diacylglycerols concentrations observed following WW. Overall, the results obtained show that the antioxidant TYR administered with WW exerts beneficial effects at the cardiovascular level, in part by modulating blood lipid profile.

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Endothelial Dysfunction: Is There a Hyperglycemia-Induced Imbalance of NOX and NOS?

International Journal of Molecular Sciences ◽

10.3390/ijms20153775 ◽

2019 ◽

Vol 20 (15) ◽

pp. 3775 ◽

Cited By ~ 23

Author(s):

Cesar A. Meza ◽

Justin D. La Favor ◽

Do-Houn Kim ◽

Robert C. Hickner

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Blood Flow ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Vascular Dysfunction ◽

Vascular Complications ◽

Enzymatic Production

NADPH oxidases (NOX) are enzyme complexes that have received much attention as key molecules in the development of vascular dysfunction. NOX have the primary function of generating reactive oxygen species (ROS), and are considered the main source of ROS production in endothelial cells. The endothelium is a thin monolayer that lines the inner surface of blood vessels, acting as a secretory organ to maintain homeostasis of blood flow. The enzymatic production of nitric oxide (NO) by endothelial NO synthase (eNOS) is critical in mediating endothelial function, and oxidative stress can cause dysregulation of eNOS and endothelial dysfunction. Insulin is a stimulus for increases in blood flow and endothelium-dependent vasodilation. However, cardiovascular disease and type 2 diabetes are characterized by poor control of the endothelial cell redox environment, with a shift toward overproduction of ROS by NOX. Studies in models of type 2 diabetes demonstrate that aberrant NOX activation contributes to uncoupling of eNOS and endothelial dysfunction. It is well-established that endothelial dysfunction precedes the onset of cardiovascular disease, therefore NOX are important molecular links between type 2 diabetes and vascular complications. The aim of the current review is to describe the normal, healthy physiological mechanisms involved in endothelial function, and highlight the central role of NOX in mediating endothelial dysfunction when glucose homeostasis is impaired.

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The role of insulin and the adipocytokines in regulation of vascular endothelial function

Clinical Science ◽

10.1042/cs20040190 ◽

2004 ◽

Vol 107 (6) ◽

pp. 519-532 ◽

Cited By ~ 65

Author(s):

Stuart A. RITCHIE ◽

Marie-Ann EWART ◽

Colin G. PERRY ◽

John M. C. CONNELL ◽

Ian P. SALT

Keyword(s):

Insulin Resistance ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Insulin Signalling ◽

Direct Effects ◽

Paracrine Factors ◽

Vascular Integrity ◽

Beneficial Effects ◽

Glucose Homoeostasis ◽

No Bioavailability

Vascular integrity in the healthy endothelium is maintained through the release of a variety of paracrine factors such as NO (nitric oxide). Endothelial dysfunction, characterized by reduced NO bioavailability, is associated with obesity, insulin resistance and Type II diabetes. Insulin has been demonstrated to have direct effects on the endothelium to increase NO bioavailability. Therefore altered insulin signalling in the endothelium represents a candidate mechanism underlying the association between insulin resistance and endothelial dysfunction. In recent years, it has become apparent that insulin sensitivity is regulated by the adipocytokines, a group of bioactive proteins secreted by adipose tissue. Secretion of adipocytokines is altered in obese individuals and there is increasing evidence that the adipocytokines have direct effects on the vascular endothelium. A number of current antidiabetic strategies have been demonstrated to have beneficial effects on endothelial function and to alter adipocytokine concentrations in addition to their effects on glucose homoeostasis. In this review we will explore the notion that the association between insulin resistance and endothelial dysfunction is accounted for by adipocytokine action on the endothelium. In addition, we examine the effects of weight loss, exercise and antidiabetic drugs on adipocytokine availability and endothelial function.

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Protective Effects of Pomegranate in Endothelial Dysfunction

Current Pharmaceutical Design ◽

10.2174/1381612826666200406152147 ◽

2020 ◽

Vol 26 (30) ◽

pp. 3684-3699 ◽

Cited By ~ 1

Author(s):

Nathalie T.B. Delgado ◽

Wender N. Rouver ◽

Roger L. dos Santos

Keyword(s):

Oxidative Stress ◽

Cardiovascular Diseases ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Common Factor ◽

Blood Lipid ◽

Punica Granatum ◽

Protective Effects ◽

Beneficial Effects ◽

Anti Inflammatory

Background: Punica granatum L. is an infructescence native of occidental Asia and Mediterranean Europe, popularly referred to as pomegranate. It has been used in ethnomedicine for several applications, including the treatment of obesity, inflammation, diabetes, and the regulation of blood lipid parameters. Thus, pomegranate has been linked to the treatment of cardiovascular diseases that have endothelial dysfunction as a common factor acting mainly against oxidative stress due to its high polyphenol content. Its biocomponents have antihypertensive, antiatherogenic, antihyperglycemic, and anti-inflammatory properties, which promote cardiovascular protection through the improvement of endothelial function. Methods: Different electronic databases were searched in a non-systematic way to uncover the literature of interest. Conclusion: This review article presents updated information on the role of pomegranate in the context of endothelial dysfunction and cardiovascular diseases. We have shown that pomegranate, or rather its components (e.g., tannins, flavonoids, phytoestrogens, anthocyanins, alkaloids, etc.), have beneficial effects on the cardiovascular system, improving parameters such as oxidative stress and the enzymatic antioxidant system, reducing reactive oxygen species formation and acting in an anti-inflammatory way. Thus, this review may contribute to a better understanding of pomegranate's beneficial actions on endothelial function and possibly to the development of strategies associated with conventional treatments of cardiovascular diseases.

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A body shape index is associated with endothelial dysfunction in both men and women

Scientific Reports ◽

10.1038/s41598-021-97325-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Masato Kajikawa ◽

Tatsuya Maruhashi ◽

Shinji Kishimoto ◽

Takayuki Yamaji ◽

Takahiro Harada ◽

...

Keyword(s):

Clinical Trial ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Cardiovascular Events ◽

Body Shape ◽

Shape Index ◽

Clinical Trial Registration ◽

Cross Sectional ◽

Men And Women ◽

A Body Shape Index

AbstractA body shape index (ABSI) was proposed for estimation of abdominal adiposity. ABSI has been reported to have associations with cardiovascular risk factors and cardiovascular events. However, there is no information on the association between ABSI and endothelial function. We examined cross-sectional associations of ABSI with endothelial function in 8823 subjects (6773 men and 2050 women). Subjects with a lower quartile of flow-mediated vasodilation (FMD) were defined as subjects having endothelial dysfunction. Pearson’s correlation coefficient analysis revealed that ABSI was negatively correlated with FMD (men, r = − 0.23, P = 0.003; women, r = − 0.32, P < 0.001). The areas under the curves of ABSI and body mass index to predict endothelial dysfunction were 0.64 (95% confidence interval [CI] 0.62–0.65) and 0.58 (95% CI 0.57–0.60) in men, and 0.68 (95% CI 0.66–0.71) and 0.59 (95% CI 0.56–0.61) in women, respectively. The cutoff values of ABSI for predicting subjects with endothelial dysfunction were 0.0796 (sensitivity, 55.2%; specificity, 65.5%) in men and 0.0823 (sensitivity, 56.2%; specificity, 73.4%) in women. Multivariate analysis revealed that an ABSI value higher than the cutoff value remained an independent predictor of endothelial dysfunction in both sexes. The results of our study suggest that ABSI calculation should be performed for evaluation of risk of cardiovascular events in both men and women.Clinical trial registration information URL for Clinical Trial: https://www.umin.ac.jp/ctr/index.htm; Registration Number for Clinical Trial: UMIN000012952 (01/05/2010).

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