Currie Katharine D, McKelvie Robert S, Macdonald Maureen J
Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1.
Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1 ; Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1 ; Hamilton Health Sciences, 237 Barton Street East, Hamilton, ON, Canada L8L 2X2.
Biomed Res Int. 2014;2014:591918. doi: 10.1155/2014/591918. Epub 2014 Mar 3.
This study examined the acute endothelial responses to an exercise bout in coronary artery disease (CAD) patients. Nineteen males with CAD (63 ± 8 years) were assessed at rest and 15 minutes following a submaximal exercise bout (recovery). Brachial artery endothelial-dependent function was assessed using flow-mediated dilation (FMD). Brachial artery diameters and velocities were measured using Duplex ultrasound at baseline, and for 3 minutes following a 5-minute ischemic period. Endothelial-independent function was assessed using a 0.4 mg dose of nitroglycerin (NTG). FMD responses were unchanged from rest to recovery; however, there were 2 types of responses: negative and positive FMD responders. Post-hoc analysis revealed that positive responders had lower resting FMD compared to negative responders (3.2 ± 1.7 versus 6.0 ± 2.5%, P < 0.05). NTG-mediated dilation was reduced in recovery (22.0 ± 5.6 versus 14.4 ± 5.7%, P < 0.001 for rest versus recovery). In conclusion, acute endothelial-dependent responses to submaximal exercise are affected by the degree of resting endothelial dysfunction. The observation of attenuated NTG-mediated dilation during recovery is novel and warrants the investigation of possible mechanisms and clinical significance. Furthermore, it highlights the necessity of both endothelial-dependent and endothelial-independent assessments when evaluating endothelial function changes with an intervention.
本研究检测了冠心病(CAD)患者对一次运动 bout 的急性内皮反应。19 名 CAD 男性患者(63±8 岁)在静息状态及一次次极量运动 bout 后 15 分钟(恢复阶段)接受评估。使用血流介导的血管舒张(FMD)评估肱动脉内皮依赖性功能。在基线以及 5 分钟缺血期后的 3 分钟,使用双功超声测量肱动脉直径和血流速度。使用 0.4mg 剂量的硝酸甘油(NTG)评估内皮非依赖性功能。从静息状态到恢复阶段,FMD 反应无变化;然而,有两种类型的反应:FMD 阴性反应者和阳性反应者。事后分析显示,与阴性反应者相比,阳性反应者的静息 FMD 较低(3.2±1.7 对 6.0±2.5%,P<0.05)。NTG 介导的血管舒张在恢复阶段降低(静息状态与恢复阶段相比,分别为 22.0±5.6 对 14.4±5.7%,P<0.001)。总之,次极量运动的急性内皮依赖性反应受静息内皮功能障碍程度的影响。恢复阶段 NTG 介导的血管舒张减弱这一观察结果是新颖的,值得对可能的机制和临床意义进行研究。此外,这突出了在评估干预引起的内皮功能变化时,同时进行内皮依赖性和内皮非依赖性评估的必要性。