title: Peripheral vascular endothelial function correlates with exercise capacity in women.
abstract: BACKGROUND
  Vascular endothelial function has been observed to correlate with exercise capacity in predominantly male populations. Gender-based differences exist in the clinical course of coronary artery disease, and previous studies indicate that estrogen may influence endothelial function. These observations raise the possibility that the relationship between endothelial function and exercise capacity in women may differ from that in men.
  
  
  OBJECTIVE
  This study aimed to determine whether peripheral vascular endothelial function correlates with exercise capacity in women.
  
  
  METHODS
  Women who were referred for clinically indicated exercise testing with technetium-99 myocardial perfusion imaging were consecutively recruited. To ensure a population free of exercise limitation due to ischemic heart disease, women without myocardial perfusion defects were included for analysis in this study (n = 105). Endothelial function was assessed by brachial artery ultrasound flow-mediated vasodilation (FMD). Exercise capacity was defined as the duration of exercise on a symptom-limited Bruce protocol.
  
  
  RESULTS
  Mean FMD was 11.8 +/- 0.6%, and median FMD was 12%. Subjects with an FMD less than the median of 12% had a significantly shorter exercise time than those with FMD > or = 12% (411 +/- 17 vs. 482 +/- 24 s, p = 0.014). There was a significant correlation between FMD and exercise time (r = 0.34, p < 0.001). Age and body mass index were additional predictors of exercise time; however, the relationship between FMD and exercise time was independent of these variables.
  
  
  CONCLUSIONS
  Brachial artery FMD correlates with exercise capacity in women, even in the absence of ischemic heart disease.
authors.affiliation: Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA. apatel@tufts-nemc.org
authors.forename: Ayan R
authors.initials: AR
authors.lastname: Patel
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Kuvin
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Sliney
authors.forename: William M
authors.initials: WM
authors.lastname: Rand
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.forename: Richard H
authors.initials: RH
authors.lastname: Karas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D001916:Brachial Artery / Q000502:physiology; D004730:Endothelium, Vascular / Q000502:physiology*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000503:physiopathology; D015425:Myocardial Reperfusion; D005996:Nitroglycerin / Q000008:administration & dosage; D010807:Physical Endurance / Q000502:physiology; D013318:Stroke Volume / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000008:administration & dosage; D016387:Women's Health
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin