Physical activity, vasomotor endothelial function, and arterial stiffness

Abstract

Aim. To study the prevalence of selected parameters of subclinical atherosclerosis and their association with muscle function and muscle volume in patients with different levels of cardiovascular risk (CVR). Material and methods. The study included 20 patients (11 men and 9 women; mean age 54,5±8,5 years) with chronic coronary heart disease (CCHD; mean duration 6,4±2,3 years) in the main group (MG), as well as 20 CCHD-free people in the control group (CG). Arterial stiffness was assessed by pulse wave velocity (PWV) and calculated carotid-femoral index (CFI). Endothelial function was assessed by endothelium-dependent vasodilatation (EDVD) in the reactive hyperemia (RH) test. Common carotid artery (CCA) ultrasound was performed in order to assess intima-media thickness (IMT) of carotid arteries. All participants underwent veloergometry (VEM); exercise capacity (EC) was measured by calculated metabolic equivalents (MET). Muscle tissue volume was assessed using a bioelectrical impedance analyser. The percentage of active muscle mass (%AMM) and fat-free muscle mass (%FFM), out of the total body mass, was calculated. Results. Increased CFI values >12 m/s, as a marker of adverse prognosis, were observed in 20% CCHD patients and in 10% of controls (z=0,17; p=0,87). Vasomotor endothelial dysfunction (EDVD <10%) was registered in 65% and 50%, respectively (z=0,74; p=0,46), while increased IMT values >0,9 mm were observed in 55% and 15%, respectively (z=2,3; p=0,02). Most patients with pathologically increased arterial stiffness and vasomotor endothelial dysfunction had low EC. In CCHD patients with low EC, CFI significantly correlated with %AMM and %FFM (r=-0,32; p<0,05; and r=-0,36; p<0,05, respectively). EDVD significantly correlated with both %AMM and %FFM (r=0,47; p<0,05; and r=0,5; p<0,05, respectively). There was a significant correlation between CFI and EDVD (r=-0,3; p<0,05). In CG participants with low EC, EDVD correlated with %AMM and %FFM (r=0723; p<0,05 and r=0,7; p<0,05, respectively). In both groups, %AMM and %FFM correlated with MET (r=0,49; p<0,05 and r=0,55; p<0,05, respectively; r=0,34; p<0,05 and r=0,31; p<0,05, respectively). Conclusion. EDVD and PWV reflect the lower PA levels and functional disadaptation of CCHD patients, which can result in a faster progression of atherosclerosis.