Esen Ali Metin, Barutcu Irfan, Acar Murat, Degirmenci Bumin, Kaya Dayimi, Turkmen Muhsin, Melek Mehmet, Onrat Ersel, Esen Ozlem Batukan, Kirma Cevat
Kosuyolu Heart Education and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Circ J. 2004 Dec;68(12):1123-6. doi: 10.1253/circj.68.1123.
Impaired flow mediated dilatation (FMD) and increased wall thickness (WT) of the brachial artery have been associated with atherosclerosis and its risk factors. In this study we sought to determine brachial artery wall thickness in chronic smokers and the instantaneous effect of smoking on brachial artery endothelium dependent vasodilator function in smokers and non-smokers.
Using a high-resolution ultrasound, WT of posterior brachial artery wall, the diameter of brachial artery at rest and during reactive hyperemia (FMD %), as well as after sublingual administration of nitroglycerine (nitroglycerine mediated dilatation (NMD) %) was measured in 20 smokers and 20 non-smokers. Wall thickness (WT) of the posterior brachial artery wall and the wall index (WI) were greater in smokers than non-smokers. The baseline brachial artery diameter was comparable in smokers and non-smokers. Flow mediated dilation (FMD) was found to be less in smokers than non-smokers. The NMD in smokers also did not differ significantly from that in non-smokers. Flow mediated dilation significantly reduced after smoking compared to baseline in both groups. However, NMD remained unchanged after smoking in both groups.
Increased WT and impaired endothelium-dependent dilatation of brachial artery suggests that cigarette smoking disrupts vessel wall morphology long before atherosclerosis is manifest.
肱动脉血流介导的血管舒张功能（FMD）受损和血管壁厚度（WT）增加与动脉粥样硬化及其危险因素有关。在本研究中，我们试图确定慢性吸烟者的肱动脉壁厚度，以及吸烟对吸烟者和非吸烟者肱动脉内皮依赖性血管舒张功能的即时影响。
使用高分辨率超声，测量了20名吸烟者和20名非吸烟者肱动脉后壁的WT、静息时和反应性充血时肱动脉的直径（FMD%），以及舌下含服硝酸甘油后（硝酸甘油介导的血管舒张（NMD）%）。吸烟者肱动脉后壁的壁厚度（WT）和壁指数（WI）大于非吸烟者。吸烟者和非吸烟者的肱动脉基线直径相当。发现吸烟者的血流介导的血管舒张（FMD）低于非吸烟者。吸烟者的NMD与非吸烟者也无显著差异。与基线相比，两组吸烟后血流介导的血管舒张均显著降低。然而，两组吸烟后NMD均保持不变。
肱动脉WT增加和内皮依赖性血管舒张受损表明，吸烟在动脉粥样硬化表现出来之前很久就破坏了血管壁形态。
