Dalton Brad S, Fassett Rob G, Geraghty Dominic P, De Ryke Rex, Coombes Jeff S
School of Human Movement Studies, University of Queensland, Room 535 Connell Building, St. Lucia, Queensland, Brisbane 4072, Australia.
Int J Cardiol. 2005 Mar 18;99(2):307-14. doi: 10.1016/j.ijcard.2004.02.004.
Relationships between low-density lipoprotein cholesterol and endothelial function in hemodialysis patients have yet to be investigated. Furthermore, current reporting of endothelial function data using flow-mediated dilatation has recognised limitations. The aims of the study were to determine the relationship between low-density lipoproteins and endothelial function in hemodialysis patients and to investigate the validity of determining the area under the curve for data collected during the flow-mediated dilatation technique.
Brachial artery responses to reactive hyperemia (endothelial-dependent) and glyceryl trinitrate (endothelial-independent) were assessed in 19 hemodialysis patients using high-resolution ultrasound. Lipid profiles and other factors known to effect brachial artery reactivity were also measured prior to the flow-mediated dilatation technique.
There were no significant relationships between serum low-density lipoproteins and endothelial-dependent or -independent vasodilation using absolute change (mm), relative change (%), time to peak change (s) or area under the curve (mm x s). In hemodialysis patients with atherosclerosis, area under the curve analysis showed a significantly (p<0.05) decreased endothelial-dependent response (mean+/-S.D.: 19.2+/-17.4) compared to non-atherosclerotic patients (42.3+/-28.6). However, when analysing these data using absolute change, relative change or time to peak dilatation, there were no significant differences between the two groups.
In summary, there was no relationship between low-density lipoproteins and endothelial function in hemodialysis patients. In addition, area under the curve analysis of flow-mediated vasodilatation data may be a useful method of determining the temporal vascular response during the procedure.
血液透析患者中低密度脂蛋白胆固醇与内皮功能之间的关系尚未得到研究。此外,目前使用血流介导的血管舒张来报告内皮功能数据存在公认的局限性。本研究的目的是确定血液透析患者中低密度脂蛋白与内皮功能之间的关系,并研究在血流介导的血管舒张技术过程中收集的数据确定曲线下面积的有效性。
使用高分辨率超声评估了19名血液透析患者肱动脉对反应性充血(内皮依赖性)和硝酸甘油(内皮非依赖性)的反应。在进行血流介导的血管舒张技术之前,还测量了血脂谱和其他已知影响肱动脉反应性的因素。
使用绝对变化(mm)、相对变化(%)、达到峰值变化的时间(s)或曲线下面积(mm×s),血清低密度脂蛋白与内皮依赖性或非依赖性血管舒张之间均无显著关系。在患有动脉粥样硬化的血液透析患者中,曲线下面积分析显示,与非动脉粥样硬化患者(42.3±28.6)相比,内皮依赖性反应显著降低(p<0.05)(平均值±标准差:19.2±17.4)。然而,当使用绝对变化、相对变化或达到最大扩张的时间来分析这些数据时,两组之间没有显著差异。
总之,血液透析患者中低密度脂蛋白与内皮功能之间没有关系。此外,血流介导的血管舒张数据的曲线下面积分析可能是确定该过程中血管时间反应的一种有用方法。