Association between endothelial dysfunction and major cardiovascular events in peripheral arterial disease.
BACKGROUND
Patients with peripheral arterial disease (PAD) are characterized by a high mortality for cardiovascular events. An impairment of endothelial function, expressed as brachial-artery flow-mediated vasodilation (FMV), has been described in PAD patients. Aim of this study was to investigate the association between FMV and cardiovascular events in patients with PAD.


METHODS
Thirty-eight patients with intermittent claudication (71% men, mean age 71 years) were divided into two groups according to the presence or absence of previous major cardiovascular events (myocardial infarction or stroke).


RESULTS
Brachial FMV was significantly lower in patients with a history of myocardial infarction or stroke (n = 16) than in patients without cardiovascular events (3.2 +/- 3.6% vs. 5.7 +/- 3.6%; p = 0.042). In the group with cardiovascular events there was a significantly higher proportion of subjects in the lower FMV tertile (56% vs. 18%), and a lower proportion of subjects in the upper tertile (25% vs. 41%; chi 2 test, p = 0.047).


CONCLUSIONS
We conclude that FMV of the brachial artery is significantly reduced in PAD patients with a history of stroke and myocardial infarction. These cross-sectional results suggest a potential role of FMV as a marker of major cardiovascular events.
Pasqualini
L
L
Unit of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Italy. lpasqua@unipg.it
Marchesi
S
S
Vaudo
G
G
Siepi
D
D
Angeli
F
F
Paris
L
L
Schillaci
G
G
Mannarino
E
E
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012008:Recurrence; D012016:Reference Values; D018570:Risk Assessment; D018608:Ultrasonography, Doppler; D014664:Vasodilation / Q000502:physiology