Endothelial dysfunction associated with left ventricular diastolic dysfunction in patients with coronary heart disease.
OBJECTIVE
We sought to assess the correlation between endothelial vasodilation and left ventricular diastolic function.


BACKGROUND
Previous studies have demonstrated that similar neurohumoral factors are involved in myocardial and vascular endothelial impairment. The degree of endothelial dysfunction is related to the clinical severity of the heart failure. However, it is not clear whether endothelial dysfunction develops with the progression of left ventricular diastolic dysfunction. We hypothesize that the endothelial dysfunction is associated with left ventricular diastolic dysfunction.


METHODS
Using high-resolution ultrasound, we measured the dilator response of the brachial artery to hyperemia (endothelium-dependent vasodilation) and to 0.5 mg nitroglycerin (endothelium-independent vasodilation), and measured peak velocities of the early wave (Evmax) and the atrial wave (Avmax) in 40 coronary heart disease (CHD) patients and 20 normal subjects. We analyzed the relationship between the Evmax/Avmax ratio and endothelium-dependent vasodilation.


RESULTS
The results showed that endothelium-dependent and endothelium-independent vasodilation as well as the Evmax/Avmax ratio were lower in the CHD group than those in the control group (4.29%+/-1.42%, 17.58%+/-2.99%, 0.81+/-0.24 vs. 9.62%+/-2.34%, 24.18%+/-3.15%, 1.07+/-0.29, respectively, P<0.01). The Evmax/Avmax ratio was related to endothelium-dependent vasodilation (r=0.45, P<0.01).


CONCLUSIONS
Our results showed that the development of endothelial dysfunction was associated with the progression of myocardial diastolic dysfunction, which suggests that the same mechanisms may be involved in the impairment of endothelium and myocardium.
Ma
L N
LN
Department of Cardiology, Second Affiliated Hospital, Hunan Medical University, Changsha, PR China.
Zhao
S P
SP
Gao
M
M
Zhou
Q C
QC
Fan
P
P
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D016022:Case-Control Studies; D003327:Coronary Disease / Q000503:physiopathology*; D003971:Diastole / Q000502:physiology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
D014665:Vasodilator Agents; D005996:Nitroglycerin