title: Small artery dilation and endothelial markers in cardiovascular risk patients.
abstract: BACKGROUND
  The use of methods based on reactive hyperaemia of small distal arteries to assess endothelial function (EF) is increasing; however, the mechanisms regulating vascular function in large and small arteries are probably different. We studied the correlations between the hyperaemia reactivity of small peripheral arteries determined by peripheral artery tonometry (PAT) and the levels of serum biomarkers of EF, inflammation and oxidation in patients with cardiovascular (CV) risk factors.
  
  
  METHODS
  Four hundred and seven patients with intermediate CV risk were recruited into a cross-sectional study to examine whether soluble endothelial, inflammatory and lipid oxidative biomarkers correlate with small artery reactive hyperaemia index (saRHI) values, which were measured by PAT.
  
  
  RESULTS
  A significant correlation was found between saRHI values and the concentrations of soluble E-selectin (sE-selectin) and soluble vascular cell adhesion molecule 1 (sVCAM-1). These correlations were stronger when only non-metabolic syndrome patients (46%) were analysed (r = -0·310, P < 0·0001; r = -0·264, P < 0·0001, respectively). In this subgroup, the oxidised low-density lipoprotein/LDL (oxLDL/LDL) was also correlated with saRHI (r = -0·193, P = 0·009). A stepwise regression study showed that sE-selectin was the only biomarker significantly correlated with saRHI values (P < 0·0001). In multivariate linear regression analysis, this relationship was still strong when the main confounding covariates were taken into consideration.
  
  
  CONCLUSIONS
  Elevated levels of sE-selectin and, to a smaller degree, sVCAM-1 and oxLDL/LDL are associated with lower postischemic reactivity in the small distal arteries. sE-selectin is the main determinant biomarker of saRHI as assessed by regression analysis. The presence of multiple risk factors weakens this association.
authors.affiliation: Internal Medicine Department, Universitat Rovira i Virgili, Sant Joan University Hospital, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Aragonès
authors.forename: Raimon
authors.initials: R
authors.lastname: Ferré
authors.forename: Josefa
authors.initials: J
authors.lastname: Girona
authors.forename: Núria
authors.initials: N
authors.lastname: Plana
authors.forename: Jordi
authors.initials: J
authors.lastname: Merino
authors.forename: Mercedes
authors.initials: M
authors.lastname: Heras
authors.forename: Lluís
authors.initials: L
authors.lastname: Masana
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000502:physiology; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood*; D015815:Cell Adhesion Molecules / Q000097:blood; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006801:Humans; D008074:Lipoproteins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012306:Risk; D055815:Young Adult
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; D008074:Lipoproteins; D002097:C-Reactive Protein