Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
Arterioscler Thromb Vasc Biol. 2013 Jun;33(6):1401-8. doi: 10.1161/ATVBAHA.112.300934. Epub 2013 Mar 21.
Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors.
We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 ± 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r=0.42; P<0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P<0.001), systolic blood pressure (r=-0.32; P<0.001), diastolic blood pressure (r=-0.24; P<0.001), heart rate (r=-0.21; P<0.001), glucose (r=-0.23; P<0.001), and smoking pack-year (r=-0.12; P=0.01), as well as Framingham risk score (r=-0.30; P<0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 ± 5.6% versus 13.7 ± 5.4% and 15.3 ± 4.3%; P<0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation.
These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.
硝酸甘油诱导的血管舒张已被用作血流介导的血管舒张（FMD）的对照试验，以区分人类内皮功能中的内皮依赖性和非内皮依赖性反应。最近，也有报道称动脉粥样硬化患者的硝酸甘油诱导的血管舒张受损。本研究的目的是确定硝酸甘油诱导的血管舒张与心血管危险因素之间的关系。
我们在 436 名接受健康检查的受试者（平均年龄 53 ± 19 岁；年龄范围 19-86 岁）中测量了硝酸甘油诱导的血管舒张和 FMD，包括患有心血管疾病的患者。硝酸甘油诱导的血管舒张与 FMD 呈显著相关（r=0.42；P<0.001）。单因素回归分析显示，硝酸甘油诱导的血管舒张与年龄（r=-0.34；P<0.001）、收缩压（r=-0.32；P<0.001）、舒张压（r=-0.24；P<0.001）、心率（r=-0.21；P<0.001）、血糖（r=-0.23；P<0.001）和吸烟包年数（r=-0.12；P=0.01）以及弗雷明汉风险评分（r=-0.30；P<0.001）相关。与无心血管危险因素的受试者相比，患有心血管疾病的患者的硝酸甘油诱导的血管舒张明显更小（分别为 10.5 ± 5.6%、13.7 ± 5.4%和 15.3 ± 4.3%；P<0.001），而无心血管危险因素的受试者之间的硝酸甘油诱导的血管舒张无显著差异。多因素分析显示，男性、体重指数、高血压、糖尿病、基线肱动脉直径和 FMD 是硝酸甘油诱导的血管舒张的独立预测因子。
这些发现表明，硝酸甘油诱导的血管舒张可能是动脉粥样硬化程度的标志物。在硝酸甘油诱导的血管舒张受损的患者中，FMD 应被解释为反映内皮依赖性血管舒张和非内皮依赖性血管舒张的血管功能指标。
