Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Am J Hypertens. 2012 May;25(5):528-34. doi: 10.1038/ajh.2012.8. Epub 2012 Feb 16.
Noninvasive measurements of endothelial function predict future adverse cardiovascular events, but offer limited opportunities for mechanistic insights into phenotypic observations. Subcutaneous adipose arterioles, accessible through minimally invasive methods, provide an opportunity for complimentary mechanistic studies. Limited data relating subcutaneous arteriolar endothelial function, cardiovascular risk factors, and noninvasive measurements of endothelial function currently exist.
Forty-four subjects underwent noninvasive studies of endothelial function (brachial reactivity (flow-mediated dilation (FMD) and digital pulse arterial tonometry (PAT)) and measurements of endothelial-dependent vasodilation of gluteal subcutaneous arterioles to acetylcholine. Arteriolar endothelial function was measured (i) percent vasodilation to maximal acetylcholine dose (10(-5) mol/l) and (ii) total area under the curve (AUC) for the entire acetylcholine dose-response curve (total AUC-acetylcholine (Ach), doses 10(-10)-10(-5) mol/l).
Acetylcholine responses were almost completely nitric oxide (NO) dependent. Total AUC-Ach predicted FMD and PAT, but maximal acetylcholine vasodilation was not associated with these measures. A history of hypertension, diabetes, smoking, and low-density lipoprotein cholesterol levels were independent predictors of total AUC-Ach. In regression models, total AUC-Ach independently predicted FMD.
Acetylcholine vasodilator responses in human gluteal subcutaneous arterioles are NO synthase dependent and correlate with cardiac risk factors and in vivo measures of endothelial function. These data suggest subcutaneous arterioles offer an opportunity for translational studies of mechanisms of modulating NO bioavailability relevant to in vivo endothelial function measures.
内皮功能的无创测量可预测未来不良心血管事件,但提供的机制见解有限,无法完全解释表型观察结果。通过微创方法可获得皮下脂肪动脉小动脉,为补充机制研究提供了机会。目前,与皮下小动脉内皮功能、心血管危险因素和内皮功能的无创测量相关的数据有限。
44 名受试者接受了内皮功能的无创研究(肱动脉反应性(血流介导的扩张(FMD)和数字脉搏动脉张力测定(PAT))和乙酰胆碱对臀部下皮动脉小动脉的内皮依赖性血管舒张的测量。测量了小动脉内皮功能(i)最大乙酰胆碱剂量(10(-5) mol/l)的血管舒张百分比和(ii)乙酰胆碱剂量反应曲线的总面积(整个乙酰胆碱 AUC-Ach(Ach),剂量 10(-10)-10(-5) mol/l)。
乙酰胆碱反应几乎完全依赖于一氧化氮(NO)。总 AUC-Ach 预测 FMD 和 PAT,但最大乙酰胆碱血管舒张与这些测量值无关。高血压、糖尿病、吸烟和低密度脂蛋白胆固醇水平的病史是总 AUC-Ach 的独立预测因子。在回归模型中,总 AUC-Ach 可独立预测 FMD。
人类臀部下皮动脉小动脉的乙酰胆碱舒张反应依赖于一氧化氮合酶,与心脏危险因素和体内内皮功能测量值相关。这些数据表明,皮下小动脉为研究与体内内皮功能测量相关的调节一氧化氮生物利用度的机制提供了转化研究的机会。