Division of Internal Medicine, Ospedale della Valdichiana "S Margherita", Cortona, Italy.
Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Vasc Med. 2021 Aug;26(4):394-400. doi: 10.1177/1358863X211001927. Epub 2021 Apr 12.
Endothelial dysfunction, evaluated by flow-mediated dilatation (FMD), predicts adverse cardiovascular events in patients with intermittent claudication (IC). IC is an example of repeated ischemia/reperfusion injury that may contribute to the progression of vascular disease by worsening endothelial function, a trigger for acute cardiovascular events. The predictive value of effort-induced endothelial dysfunction for cardiovascular events in patients with IC has not been studied previously. The objective of this study was to assess whether exercise-induced endothelial dysfunction is predictive of adverse cardiovascular outcome in IC. In 44 patients with IC, we measured brachial artery FMD by B-mode ultrasonography at rest and 10 minutes after a maximal treadmill exercise. Treadmill exercise halved the FMD (from 3.5 ± 0.6% to 1.45 ± 0.46%, < 0.05). After a follow-up period of 85 (72-98) months, a total of 20 major cardiovascular events occurred. In a multivariate analysis, a post-exercise reduction of brachial FMD > 1.3% was predictive for cardiovascular events. Maximal exercise-induced endothelial dysfunction is predictive of cardiovascular events in patients with IC.
内皮功能障碍，通过血流介导的扩张（FMD）来评估，可以预测间歇性跛行（IC）患者的不良心血管事件。IC 是反复缺血/再灌注损伤的一个例子，通过恶化内皮功能，即急性心血管事件的触发因素，可能导致血管疾病的进展。以前尚未研究过运动引起的内皮功能障碍对 IC 患者心血管事件的预测价值。本研究旨在评估运动引起的内皮功能障碍是否可预测 IC 患者的不良心血管结局。在 44 名 IC 患者中，我们通过 B 型超声测量静息时和最大跑步机运动后 10 分钟的肱动脉 FMD。跑步机运动使 FMD 减半（从 3.5±0.6%降至 1.45±0.46%， < 0.05）。在 85（72-98）个月的随访期间，共发生 20 例主要心血管事件。在多变量分析中，肱动脉 FMD 运动后降低>1.3%可预测心血管事件。最大运动诱导的内皮功能障碍可预测 IC 患者的心血管事件。
