[Disturbance of endothelium-dependent vasodilation and morphological changes of the radial artery in patients with coronary heart disease].
OBJECTIVE
To elucidate whether endothelium-dependent vasodilation (EDVD) is a method of early diagnosis of endothelial dysfunction or is a sign of established morphological changes in the vascular wall.


METHODS
Endothelialfunction was studied in 44 males with essential hypertension (EH) (mean age 46.9 +/- 0.9 years), in 52 patients with coronary heart disease (CHD) (mean age 50.0 +/- 0.9 years) after mammary-coronary and aortocoronary bypass operation with use of radial artery (RA), and in 28 healthy males (mean age 44.2 +/- 1.2 years). Intraoperative RA biopsy results for patients with ischemic heart disease after coronary artery bypass grafting with RA as an arterial graft were analysed.


RESULTS
Patients with CHD showed thicker complex intima-media (TIM) of the common carotid arteries compared to control and hypertensive patients free of CHD clinical symptoms. This is associated with lowering of EDVD in RA and, therefore, suggests systemic occurrence of endothelial dysfunction. The histological study of RA has found hyperplasia of the internal vascular intima of 1.1 +/- 0.2 degree in 97% of CHD patients. Combination of CHD with hypertension showed thicker intima, higher index of intima thickness and RA narrowing percentage vs such parameters in CHD free of hypertension.


CONCLUSIONS
Impaired EDVD in the test with reactive hyperemia is due to morphological changes in the radial artery, its intima. The degree of changes in endothelial vascular reactions in RA is closely related to severity of systemic atherosclerosis. In CHD, RA has a marked intimal hyperplasia which leads to vasospasticity and may result in development of stenosis in its use as a graft for myocardial revascularization. One of the basic factors influencing the degree of intimal hyperplasia of the radial artery is severity of arterial hypertension.
Shliakhto
E V
EV
Moiseeva
O V
OV
Liasnikova
E A
EA
Kozlov
P S
PS
Chuev
D V
DV
Gordeev
M L
ML
D000328:Adult; D003327:Coronary Disease / Q000175:diagnosis*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D014664:Vasodilation