Agewall Stefan, Henareh Loghman, Kublickiene Karolina
Department of Cardiology, Karolinska University Hospital-Huddinge Campus, Karolinska Institute, 141 86 Stockholm, Sweden.
Atherosclerosis. 2006 Jan;184(1):130-6. doi: 10.1016/j.atherosclerosis.2005.03.025. Epub 2005 Jun 23.
The aims of this study were to determine whether non-invasive measurement of endothelial function in conduit arteries reflects that of subcutaneous resistance arteries measured in vitro and to examine whether there is an endothelial dysfunction also in resistance arteries in patients with a previous myocardial infarction. The brachial artery diameter responses to a hyperemic flow stimulus and an in vitro method, pressure myography, to directly evaluate flow-mediated responses in arteries obtained from biopsies of subcutaneous fat were measured in 25 patients with a previous myocardial infarction and in 8 aged matched healthy subjects. Flow-mediated dilatation of the brachial artery was more pronounced in the healthy group compared with the group with coronary disease, 5.1 +/- 2.5% and 2.6 +/- 2.1%, respectively (p < 0.05). The flow-mediated dilatation in subcutaneous arteries from CHD patients was significantly reduced compared to control subjects (e.g. percent change from initial preconstriction at maximum flow rate of 204 microl/min: 42 +/- 7% CHD (n = 25) versus 84 +/- 24% control (n = 8), ANOVA, p = 0.03). There was a significant correlation between flow-mediated dilatation of the brachial artery and maximum flow-mediated dilatation at microvascular level, (p < 0.01). In conclusion this study demonstrates endothelial dysfunction in both conduit and resistance circulation in patients after myocardial infarction compared to an aged-matched healthy control group. Furthermore, a significant and independent relationship between endothelial function by means of flow-mediated dilatation in large conduit arteries and resistance arteries was observed.
本研究的目的是确定在传导动脉中对内皮功能进行的非侵入性测量是否反映了体外测量的皮下阻力动脉的内皮功能，并检查既往有心肌梗死的患者的阻力动脉是否也存在内皮功能障碍。在25例既往有心肌梗死的患者和8例年龄匹配的健康受试者中，测量了肱动脉对充血血流刺激的直径反应以及一种体外方法——压力肌动描记法，以直接评估从皮下脂肪活检获得的动脉中的血流介导反应。与冠心病组相比，健康组肱动脉的血流介导舒张更为明显，分别为5.1±2.5%和2.6±2.1%（p<0.05）。与对照组相比，冠心病患者皮下动脉的血流介导舒张明显降低（例如，在最大流速为204微升/分钟时，相对于初始预收缩的变化百分比：冠心病组为42±7%（n=25），对照组为84±24%（n=8），方差分析，p=0.03）。肱动脉的血流介导舒张与微血管水平的最大血流介导舒张之间存在显著相关性（p<0.01）。总之，本研究表明，与年龄匹配的健康对照组相比，心肌梗死后患者的传导循环和阻力循环均存在内皮功能障碍。此外，还观察到在大传导动脉和阻力动脉中，通过血流介导舒张所测得的内皮功能之间存在显著且独立的关系。
