Endothelial dysfunction as assessed by flow-mediated dilation in patients with cardiac syndrome X: role of inflammation.
BACKGROUND
Endothelial dysfunction, reduced coronary flow reserve and increased markers of inflammation are detectable in cardiac syndrome X (CSX). In this study we investigated the relation between inflammation and systemic endothelial function in CSX patients.


METHODS
We studied 42 CSX patients (55 +/- 6 years, 14 men) and 20 healthy subjects (52 +/- 7 years, 9 men). Systemic endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery after 5-minute of forearm cuff inflation. Serum C-reactive protein (CRP) was measured by a high-sensitivity method.


RESULTS
FMD was significantly lower in CSX patients compared to controls (4.8 +/- 4.4 vs. 13.7 +/- 4%, p < 0.001), whereas CRP levels were higher in CSX patients than in controls (2.7 +/- 2.4 vs. 0.7 +/- 0.4 mg/L, p = 0.001). In CSX patients FMD showed a significant inverse correlation with CRP levels, even after adjustment for potentially confounding variables (r = -0.34, p = 0.006).


CONCLUSIONS
An impaired FMD is detectable in CSX patients, suggesting a generalized abnormality in vascular function. Subclinical inflammation se is to play a significant role in the impairment of endothelium-dependent vasodilator function of these patients.
Institute of Medical Pathology, School of Medicine, Catholic University of the Sacred Heart, Rome, Italy. paolotondi@yahoo.it
P
P
Tondi
A
A
Santoliquido
A
A
Di Giorgio
A
A
Sestito
G A
GA
Sgueglia
R
R
Flore
G
G
Careri
G
G
Pinnacchio
G A
GA
Lanza
F
F
Crea
D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood*; D007558:Italy; D008297:Male; D017566:Microvascular Angina / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D008875:Middle Aged; D018617:Ultrasonography, Doppler, Pulsed; D015854:Up-Regulation; D014664:Vasodilation
D018836:Inflammation Mediators; D002097:C-Reactive Protein