title: Nitroglycerine-induced vasodilation for assessment of vascular function: a comparison with flow-mediated vasodilation.
abstract: OBJECTIVE
  Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors.
  
  
  RESULTS
  We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 ± 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r=0.42; P<0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P<0.001), systolic blood pressure (r=-0.32; P<0.001), diastolic blood pressure (r=-0.24; P<0.001), heart rate (r=-0.21; P<0.001), glucose (r=-0.23; P<0.001), and smoking pack-year (r=-0.12; P=0.01), as well as Framingham risk score (r=-0.30; P<0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 ± 5.6% versus 13.7 ± 5.4% and 15.3 ± 4.3%; P<0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation.
  
  
  CONCLUSIONS
  These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.
authors.affiliation: Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Maruhashi
authors.forename: Junko
authors.initials: J
authors.lastname: Soga
authors.forename: Noritaka
authors.initials: N
authors.lastname: Fujimura
authors.forename: Naomi
authors.initials: N
authors.lastname: Idei
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Mikami
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Iwamoto
authors.forename: Masato
authors.initials: M
authors.lastname: Kajikawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hidaka
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Kensuke
authors.initials: K
authors.lastname: Noma
authors.forename: Ayumu
authors.initials: A
authors.lastname: Nakashima
authors.forename: Chikara
authors.initials: C
authors.lastname: Goto
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Higashi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000792:Angiography / Q000379:methods; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D001783:Blood Flow Velocity; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D005996:Nitroglycerin / Q000494:pharmacology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D014654:Vascular Patency / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects*; D055815:Young Adult
chemical_list: D005996:Nitroglycerin
keywords: atherosclerosis; cardiovascular risk factors; flow-mediated vasodilation; nitroglycerine-induced vasodilation