title: Contrast agent suppresses endothelium-dependent arterial dilation after digital subtraction angiography procedure in patients with diabetic foot.
abstract: Recent studies showed that contrast agents can induce renal injury. Thus, the present study was designed to assess whether the contrast agents used during digital subtraction angiography (DSA) procedure can damage endothelium. Fow-mediated endothelium-dependent vasodilation (FMD) was measured at baseline, 1, 3, and 7 days after DSA in 198 subjects with diabetic foot. We also measured the levels of thiobarbituric acid-reactive substances (TBARS) and von Willebrand factor (vWF), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP). Compared with baseline (3.60 ± 0.47 %), FMD at 1 day decreased (2.74 ± 0.47 %), and increased significantly from 1 to 3 days (p < 0.01), and returned to baseline level at 7 days after DSA. The plasma TBARS increased at 1 day and decreased from 1 to 3 days (p < 0.01), and returned to baseline level at 7 days after DSA. CRP, IL-6, and TNF-α had similar changes before and after DSA procedure. FMD was significantly correlated to vWF, IL-6, TNF-α, CRP, and TBARS (p < 0.01). A negative correlation between contrast volume and FMD, positive correlation between contrast volume and vWF, TBARS, CRP, IL-6 at 1 or 3 days after DSA exist in diabetic group (p < 0.05). Contrast medium suppresses FMD, probably through an increased production of oxygen-derived free radicals and inflammation although adequate hydration was given in type 2 diabetes. Therefore, an effective prophylaxis should allow to prevent this complication.
authors.affiliation: Department of Endocrinology, Wuhan General Hospital of Guangzhou Command, Wuluo Road 627, Wuhan, 430070, Hubei, People's Republic of China, Xianglin832010@hotmail.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Xiang
authors.forename: Guangda
authors.initials: G
authors.lastname: Xiang
authors.forename: Junxia
authors.initials: J
authors.lastname: Zhang
authors.forename: Ling
authors.initials: L
authors.lastname: Yue
authors.forename: Linshuang
authors.initials: L
authors.lastname: Zhao
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003287:Contrast Media / Q000009:adverse effects / Q000494:pharmacology*; D017719:Diabetic Foot / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D003287:Contrast Media; D015850:Interleukin-6; D017392:Thiobarbituric Acid Reactive Substances; D014409:Tumor Necrosis Factor-alpha; D014841:von Willebrand Factor; D002097:C-Reactive Protein