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Lower Flow-mediated Dilation Research Articles

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Overview
370 Articles

Published in last 50 years

Related Topics

  • Artery Flow-mediated Dilation
  • Artery Flow-mediated Dilation
  • Reactive Hyperemia Index
  • Reactive Hyperemia Index
  • Brachial Flow-mediated Dilation
  • Brachial Flow-mediated Dilation
  • Nitroglycerin-mediated Dilation
  • Nitroglycerin-mediated Dilation
  • Flow-mediated Dilation
  • Flow-mediated Dilation

Articles published on Lower Flow-mediated Dilation

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Anthracyclines-Induced Vascular Endothelial Dysfunction in Cancer Patients and Survivors Using Brachial Flow-Mediated Dilation (FMD) Tool: A Systematic Review and Meta-Analysis

Anthracyclines are effective antineoplastic drugs; however, their use is constrained by dose-dependent cardiotoxicity. Vascular endothelial dysfunction is an early independent event in cardiovascular diseases and may precede anthracycline-induced cardiotoxicity. Brachial flow-mediated dilation (FMD) is a non-invasive technique for evaluating vascular endothelial function. We evaluated the evidence on anthracycline-induced vascular endothelial dysfunction in cancer patients and survivors using FMD. Studies measuring FMD in anthracycline-treated active cancer patients or survivors were retrieved from inception to August 2024 using PubMed, Embase, and Scopus. The primary outcome was the difference in FMD between anthracycline-treated patients and healthy controls or baseline. We performed the meta-analysis using a random-effects model and evaluated the certainty in effect estimates. Overall, 18 studies (n = 841 patients) met the inclusion criteria. Compared to the baseline, a non-significant change toward a decline in FMD was observed. However, a significant reduction in FMD was observed in anthracycline-treated patients compared to healthy controls (standardized mean difference (SMD): − 0.6082; 95% CI: − 0.8963 to − 0.3201; p < 0.0001). Subgroup analyses revealed consistent significant reductions in FMD for childhood cancers (SMD: − 0.7189; 95% CI: − 0.9903 to − 0.4476; p < 0.0001), while adult cancers showed no significant difference. No significant publication bias was detected overall for healthy control comparisons. High heterogeneity was observed in the included studies (I2 = 81.7808% versus healthy controls and I2 = 75.6876% for childhood cancers subgroup analysis). Anthracyclines induce vascular endothelial dysfunction, indicated by lower FMD in cancer patients and survivors, particularly among those with childhood cancers, who might be at risk of long-term cardiovascular complications.

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  • Journal IconCardiovascular Toxicology
  • Publication Date IconApr 3, 2025
  • Author Icon Lana A Kattan + 3
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Association between impaired brachial flow-mediated dilation and early neurological deterioration in acute ischemic stroke: a retrospective analysis.

Early neurological deterioration (END) occurs in individuals who had experienced acute ischemic stroke (AIS), impacting long-term functional outcomes. We aimed to investigate the association between endothelial function, measured via flow-mediated dilation (FMD), and END in patients with AIS. We retrospectively reviewed patients who had experienced AIS within 7 days of stroke onset and underwent FMD assessments during their hospitalization (%FMD = Peak diameter - baseline diameter)/baseline diameter x 100). END was defined as ≥ 2-point increase in the National Institutes of Health Stroke Scale total score or ≥ 1-point increase in the motor score within 72h post-stroke. Through multivariate analysis, we examined factors associated with END and explored the relationship between FMD and END with considering stroke mechanisms. Among 1,262 patients diagnosed with AIS, 184 (14.6%) experienced END. Those with END were on average older (69 ± 13 vs. 67 ± 13 years; P = 0.033), had a higher prevalence of stroke history (21.2 vs. 12.9%; P = 0.003), and lower FMD (5.0 ± 1.8 vs. 5.4 ± 2.2%; P = 0.029). Multivariate analysis revealed that a history of stroke (adjusted odds ratio [aOR] = 1.728; 95% confidence interval [CI] 1.159-2.578; P = 0.007) and low % were independently associated with END. Subgroup analysis revealed that low %FMD was significantly associated with END within the small vessel disease (SVD) category (aOR = 0.789; 95% CI 0.679-0.920; P = 0.002). Impaired FMD may be associated with END, particularly within the context of SVD.

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  • Journal IconBMC neurology
  • Publication Date IconFeb 4, 2025
  • Author Icon Sang Hee Ha + 5
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Higher amounts of habitual physical activity changes the relationship between hot flashes and subclinical cardiovascular disease risk.

The menopausal transition is associated with increased risk for cardiovascular disease (CVD). Hot flashes (HF), a cardinal symptom of menopause, have been associated with increased CVD risk, particularly in perimenopausal women. Flow-mediated dilation (FMD) is an indicator of endothelial function and a subclinical CVD risk factor. Lower FMD has been associated with more HF. As moderate to vigorous physical activity (MVPA) is recognized to reduce CVD risk, our goal was to determine whether higher levels of MVPA change the relationship between HF and FMD in perimenopausal women. Healthy perimenopausal women had HF measured objectively using sternal skin conductance for 24 h. MVPA was determined using 7 days of actigraphy. Endothelial function was measured via brachial artery FMD on the non-dominant arm. Pearson correlations and multiple regression analyses were used to evaluate relationships between variables. Simple slopes analysis was performed to understand how MVPA moderates the relationship between HF and FMD. Lower FMD tended to correlate with a higher objective HF rate, and this relationship was stronger for HF measured during waking hours. Controlling for age and BMI, HF and the interaction between HF and MVPA were significant predictors of FMD. Simple slope analysis showed a significant HF effect on FMD with lower (-1SD) MVPA, whereas there was no significant relationship between HF and FMD with higher (+1SD) MVPA. These results suggest that MVPA moderates the relationship between FMD and objective HFs in perimenopausal women.

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  • Journal IconPhysiological reports
  • Publication Date IconFeb 1, 2025
  • Author Icon Sarah Witkowski + 6
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Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV.

Posttraumatic Stress Disorder Is Associated With Endothelial Dysfunction in Women With HIV.

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  • Journal IconJACC. Advances
  • Publication Date IconFeb 1, 2025
  • Author Icon Nishant Vatsa + 19
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Endothelial Dysfunction and Oxidative Stress in Patients with Severe Coronary Artery Disease: Does Diabetes Play a Contributing Role?

Background and Objectives: Endothelial dysfunction (ED) and oxidative stress play major contributions in the initiation and progression of atherosclerosis. Diabetes is a pathological state associated with endothelial damage and enhanced oxidative stress. This study evaluated endothelial dysfunction and oxidative stress in patients with severe coronary artery disease (CAD) undergoing coronary artery bypass graft (CABG) surgery, comparing those with and without type 2 diabetes mellitus (T2DM). Materials and Methods: We included 84 patients with severe coronary artery disease (33 of whom had type 2 diabetes mellitus) who underwent clinical assessments, ultrasound, and coronaryangiography. The SYNTAXI score was calculated from the coronaryangiogram. Blood samples were collected to measure plasma serotonin (5-HT; SER) levels, as well as levels of superoxide dismutase 1(SOD-1) and lectin-like oxidized low-density lipoprotein receptor-1(LOX-1) to assess oxidative stress. Brachial flow-mediated dilation (FMD) was used as a surrogate for endothelial dysfunction (ED),along with serum concentrations of 5-HT. Results: The coronary atherosclerotic burden, assessed using the SYNTAX I score, was more severe in patients with CAD and associated T2DM compared to those with CAD without T2DM (30.5 (17-54) vs. 29 (17-48); p = 0.05). The SYNTAX score was found to be positively correlated with T2DM (p = 0.029; r = 0.238).ED measured by FMD was associated with T2DM (p = 0.042; r = -0.223), with lower FMD measurements in T2DM patients when compared with individuals without this pathology (2.43% (0.95-5.67) vs. 3.46% (1.02-6.75); p = 0.079). Also, in the studied population, T2DM was correlated with serum 5-HT levels (764.78 ± 201 ng/mL vs. 561.06 ± 224 ng/mL; p < 0.001; r = 0.423), with higher plasma circulating levels of 5-HT in patients with T2DM. No statistically significant differences for oxidative stress markers (SOD-1 and LOX-1) were obtained when comparing T2DM and non-T2DM patients with severe CAD. Conclusions: ED (as assessed by brachial FMD and serum 5-HT) is more severe in in diabetic patients with severe CAD scheduled for CABG surgery, while oxidative stress (as evaluated through serum SOD-1 and LOX-1 concentrations) was not influenced by the presence of T2DM in this specific population. The most important finding of the present study is that circulating 5-HT levels are markedly influenced by T2DM. 5-HT receptor-targeted therapy might be of interest in patients undergoing CABG, but further studies are needed to confirm this hypothesis.

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  • Journal IconMedicina (Kaunas, Lithuania)
  • Publication Date IconJan 15, 2025
  • Author Icon Alexandra Maria Boieriu + 4
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The effect of vitamin D supplementation on endothelial function: An umbrella review of interventional meta-analyses.

The effect of vitamin D supplementation on endothelial function: An umbrella review of interventional meta-analyses.

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  • Journal IconNutrition, metabolism, and cardiovascular diseases : NMCD
  • Publication Date IconJan 1, 2025
  • Author Icon Yirui Chen + 7
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Endothelial dysfunction in prediabetes and diabetes mellitus in patients with normal coronary arteries

BackgroundDiabetes mellitus (DM) is a global health issue associated with increased cardiovascular disease risk. Endothelial dysfunction is a known precursor to atherosclerosis and cardiovascular disease, and its role in the pathogenesis of DM complications is well-documented. There is limited information in the evaluation of endothelial function in prediabetic patients using flow-mediated dilation (FMD), and studies have not excluded patients with known atherosclerosis or coronary artery disease. Thus, in this study, we aimed to evaluate the endothelial functions using FMD from the brachial artery of DM and prediabetes patients who had normal coronary arteries.MethodsThis study included 73 participants: 25 with DM, 25 with prediabetes, and 23 normoglycemic controls, all with normal coronary arteries on angiography. FMD measurements were conducted following established protocols, and statistical analysis was performed using standard methods to compare FMD levels among groups.ResultsThe groups were comparable in clinical and demographic characteristics, except for fasting plasma glucose levels. Significant differences in FMD levels were observed: 10.1% in the DM group, 16.5% in the prediabetes group, and 14.8% in the control group (P = 0.004). Diabetic patients had significantly lower FMD levels than both prediabetic and normoglycemic individuals. No significant difference in FMD was found between prediabetic and control groups.ConclusionsDiabetic patients exhibited significant endothelial dysfunction compared to normoglycemic individuals, while prediabetic patients did not show similar dysfunction. These findings suggest a window of opportunity in the prediabetic stage for early intervention to prevent advanced endothelial dysfunction.Trial registration numberISRCTN Registry ISRCTN15351014. Registry date: 23/09/2024. Retrospectively registered.

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  • Journal IconBMC Cardiovascular Disorders
  • Publication Date IconNov 6, 2024
  • Author Icon Asli Inci Atar + 4
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Characterizing vascular and hormonal changes in women across the life span: a cross-sectional analysis.

Vascular dysfunction, marked by lower endothelial function and increased aortic stiffness, is a nontraditional risk factor that precedes the development of cardiovascular disease (CVD). However, the age at which these changes in vascular function occur in women and the degree to which reproductive hormones mediate these changes has not been characterized. Women free from major disease were enrolled across the adult life span (aged 18-70 yr, n = 140). Endothelial function was assessed as flow-mediated dilation (FMD) of the brachial artery during reactive hyperemia using duplex ultrasound and expressed as percent dilation. Aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV). Blood samples were obtained to quantify reproductive hormone concentration. Regression models determined age-related breakpoints and mediating factors between age and vascular outcomes. FMD declined with age with a breakpoint and steeper decline occurring at 47 yr of age. Thereafter, age was independently associated with lower FMD (B = -0.13, P < 0.001). cfPWV was relatively stable until a breakpoint at age 48, and age was independently associated with higher cfPWV thereafter (B = 0.10, P < 0.001). Path analysis revealed that the association between age and FMD was partially mediated by follicle-stimulating hormone (abind = 0.051, P = 0.01) and progesterone (abind = 0.513, P < 0.001) but not estradiol (abind = -0.004, P = 0.08). No mediation was present for cfPWV. Age was associated with endothelial dysfunction and aortic stiffness in women beginning at 47 and 48 yr old, respectively, 3 to 4 yr before the average age of menopause. The association between age and endothelial dysfunction was explained in part by elevations in follicle-stimulating hormone and progesterone, but not declining estradiol.NEW & NOTEWORTHY We demonstrate that the age at which endothelial function declines and aortic stiffness increases in healthy women is 47 and 48, respectively. The inflection point in flow-mediated dilation (FMD) is 6 yr earlier than previously reported, and the association between age and FMD was mediated by follicle-stimulating hormone (FSH) and progesterone (P4) but not estradiol (E2).

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  • Journal IconAmerican journal of physiology. Heart and circulatory physiology
  • Publication Date IconNov 1, 2024
  • Author Icon Megan M Wenner + 12
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Age and sex differences in the effects of short- and long-term exposure to air pollution on endothelial dysfunction

Abstract Background Endothelial dysfunction is an integrated index of risk factor burden and a marker of atherosclerotic cardiovascular disease. Air pollution is widely acknowledged as a significant non-traditional risk factor for cardiovascular disease. However, the impact of air pollutants at varying concentrations and exposure durations on endothelial function in different populations remains unclear. Purpose We aimed to use brachial artery flow-mediated dilatation (FMD) to identify demographic differences in the effects of short- and long-term exposure to air pollution on endothelial dysfunction. Methods We measured FMD in 850 participants from October 2016 to January 2020. Location-specific concentrations of fine particulate matter &amp;lt;2.5 μm aerodynamic diameter (PM2.5), inhalable particulate matter &amp;lt;10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- and long-term exposure assessment. We used the moving average 7- and 14-day exposures before the date of FMD measurements to estimate the short-term exposure effects and the moving average 12-month exposures before the date of FMD measurements to estimate the long-term exposure effects. Multiple linear regression models and restricted cubic splines were used to assess the associations before and after stratified by age and sex. Results This study eventually included 828 participants [551 (66.5%) younger than 65 years and 553 (66.8%) men]. Each 10 μg/m³ increase in 12-month exposure to PM10 and NO2 was significantly and linearly associated with -0.20% (95% CI: -0.37 to -0.03) and -0.58% (95% CI: -0.99 to -0.18) changes in FMD in all participants. 12-month exposure to gaseous pollutants was also significantly but nonlinearly associated with lower FMD. 7-day exposure to Quartile 4 of SO2 was significantly associated with a 0.70% decrease in FMD compared to Quartile 1 (β = -0.70, 95% CI: -1.40 to -0.008). No relationships were observed between 7- and 14-day exposure to PM2.5, PM10, NO2, CO, and endothelial dysfunction. Although interaction effects were limited to SO2 and sex, significant associations with different air pollutants were only found in men and those younger than 65 years after stratified. Conclusions Long-term exposure to air pollution is strongly associated with decreased endothelial function, and susceptibility to air pollution varies significantly with age and sex. Further identification of different susceptible populations and proactive measures to mitigate air pollution may be beneficial in reducing the burden of cardiovascular disease.

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  • Journal IconEuropean Heart Journal
  • Publication Date IconOct 28, 2024
  • Author Icon H Zhang + 1
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Impaired arterial dilation and increased NOX2 generated oxidative stress in subjects with ataxia-telangiectasia mutated (ATM) kinase

Impaired arterial dilation and increased NOX2 generated oxidative stress in subjects with ataxia-telangiectasia mutated (ATM) kinase

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  • Journal IconRedox Biology
  • Publication Date IconSep 12, 2024
  • Author Icon Lorenzo Loffredo + 25
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Association between endothelial function and skin advanced glycation end-products (AGEs) accumulation in a sample of predominantly young and healthy adults

BackgroundIn populations with chronic disease, skin autofluorescence (SAF), a measure of long-term fluorescent advanced glycation end-products (AGEs) accumulation in body tissues, has been associated with vascular endothelial function, measured using flow-mediated dilation (FMD). The primary aim of this study was to quantify the relationship between endothelial function and tissue accumulation of AGEs in adults from the general population to determine whether SAF could be used as a marker to predict early impairment of the endothelium.MethodsA cross-sectional study was conducted with 125 participants (median age: 28.5 y, IQR: 24.4–36.0; 54% women). Endothelial function was measured by fasting FMD. Skin AGEs were measured as SAF using an AGE Reader. Participant anthropometry, blood pressure, and blood biomarkers were also measured. Associations were evaluated using multivariable regression analysis and were adjusted for significant covariates.ResultsFMD was inversely correlated with SAF (ρ = -0.50, P < 0.001) and chronological age (ρ = -0.51, P < 0.001). In the multivariable analysis, SAF, chronological age, and male sex were independently associated with reduced FMD (B [95% CI]; -2.60 [-4.40, -0.80]; -0.10 [-0.16, -0.03]; 1.40 [0.14, 2.67], respectively), with the multivariable model adjusted R2 = 0.31, P < 0.001.ConclusionsHigher skin AGE levels, as measured by SAF, were associated with lower FMD values, in a predominantly young, healthy population. Additionally, older age and male participants exhibited significantly lower FMD values, corresponding with compromised endothelial function. These results suggest that SAF, a simple and inexpensive marker, could be used to predict endothelial impairment before the emergence of any structural artery pathophysiology or classic cardiovascular disease risk markers.Trial registrationThe study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000821897) and concurrently entered into the WHO International Clinical Trials Registry Platform under the same ID number.

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  • Journal IconCardiovascular Diabetology
  • Publication Date IconSep 9, 2024
  • Author Icon Juanita J Fewkes + 4
Open Access Icon Open Access
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Age and sex differences in the effects of short- and long-term exposure to air pollution on endothelial dysfunction

BackgroundThe effects of air pollution on endothelial function remain unclear across populations. We aimed to use brachial artery flow-mediated dilatation (FMD) to identify demographic differences in the effects of air pollution exposure on endothelial dysfunction.MethodsWe measured FMD in 850 participants from October 2016 to January 2020. Location-specific concentrations of fine particulate matter < 2.5 μm aerodynamic diameter (PM2.5), inhalable particulate matter < 10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) measured by fixed ambient air monitoring stations were collected for short- and long-term exposure assessment. Multiple linear regression models and restricted cubic splines were used to assess the associations before and after stratification by age and sex.ResultsThis study eventually included 828 participants [551 (66.5%) younger than 65 years and 553 (66.8%) men]. Each 10 µg/m3 increase in 7-day exposure to PM2.5 and PM10 was significantly linearly associated with a 0.07% (β = -0.07, 95% CI: -0.13 to -0.004) and 0.05% (β = -0.05, 95% CI: -0.10 to -0.004) decrease in FMD in the fully adjusted model. After full adjustment, long-term exposure to all air pollutants was significantly associated with impaired FMD. Each 10 µg/m3 increase in long-term exposure to PM2.5 and PM10 was significantly associated with a -0.18% (95% CI: -0.34 to -0.03) and − 0.23% (95% CI: -0.40 to -0.06) change in FMD, respectively. After stratification, the associations of lower FMD with long-term exposure to PM2.5, PM10, SO2, NO2, and CO significantly persisted in men and participants younger than 65 years instead of women or older participants. For short-term exposure, we observed differences consistent with long-term exposure and a stronger effect of 7-day exposure to SO2 in men due to a significant interaction effect.ConclusionShort- and long-term exposure to different air pollutants are strongly associated with decreased endothelial function, and susceptibility to air pollution varies significantly with age and sex.

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  • Journal IconEnvironmental Health
  • Publication Date IconJul 8, 2024
  • Author Icon Haoyu Zhang + 11
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Combined peripheral and central ultrasound for the diagnosis of PAH‐SSc patients

AbstractBackgroundSystemic Sclerosis (SSc), an intricate autoimmune disease causing tissue fibrosis, introduces cardiovascular complexities, notably pulmonary hypertension (PH), affecting both survival and quality of life. This study centers on evaluating echocardiographic parameters and endothelial function using flow‐mediated dilatation (FMD) in SSc patients, aiming to differentiate those with and without pulmonary arterial hypertension (PAH). The emphasis lies in early detection, given the heightened vulnerability of the right ventricle (RV) in the presence of PH.MethodsFifty‐nine SSc patients and 48 healthy subjects participated, undergoing clinical examinations, echocardiography, FMD assessments, blood analyses, and right heart catheterization (RHC) according to the ESC/ERS guidelines for diagnosis and treatment of PH.ResultsSSc‐PAH patients displayed lower FMD, higher frequency of TAPSE &lt; 18 mm, RA area &gt; 18 cm2, act RVOT &lt; 105 ms and TRV &gt; 280 cm/s compared to those without PAH and healthy controls. Resting resistivity index (RI) was higher in SSc patients, with no significant difference between those with and without PAH. Lower FMD% serves as a predictive marker for adverse cardiovascular outcomes in both SSc and SSc‐PAH patients. Stratification by TRV levels and PAH presence reveals notable FMD% variations, emphasizing its potential utility.ConclusionsEarly identification of endothelial dysfunction and impaired RV echocardiographic parameters, such as TAPSE and TRV, could aid in predicting right ventricular dysfunction and PAH in SSc patients.

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  • Journal IconEchocardiography
  • Publication Date IconJun 1, 2024
  • Author Icon Michele Correale + 10
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Association of inflammatory markers and ultrasonographic indicators of endothelial (dys)function in humans

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Austrian Science Fund (FWF) Introduction It has been widely known that chronic inflammation is a crucial factor in the process of atherogenesis and atherosclerosis. Also, endothelial dysfunction presents the first and still reversible step of that process.(1) It is a challenge to find a laboratory marker whose levels would be informative about the extent of endothelial dysfunction and atherogenesis in humans. Purpose The aim of the present study was to determine associations between markers of chronic, low-grade inflammation and ultrasonographic indicators of endothelial (dys)function in healthy volunteers (H) and in patients with metabolic syndrome (MS). Methods Any kind of clinically manifest acute inflammatory or infectious disease, as well as chronic inflammatory, autoimmune or malignant disease was an exclusion criterion for participation. Serum levels of C-reactive protein (CRP) were measured using standard clinical chemistry analyser, and serum levels of interleukin-6 (IL-6) using electro-chemiluminescence immunoassay. Blood vessel wall function was quantified as flow-mediated dilation (FMD) and nitroglycerin-mediated dilation (NMD), which were measured automatically and continuously using the ultrasound device with linear probe (10 MHz) and the software for ultrasound blood vessel diameter analysis,(2) following currently valid guidelines.(3,4,5) Results A total of 130 individuals were enrolled in the study (65 H and 65 MS), with a median age of 56 (IQR 50.0, 60.0) years and 47.7% women in each group. CRP and IL-6 levels, although being very low and within the intervals that are considered normal in everyday clinical practice for both groups [CRP - H: 1.2 (0.6, 2.3), MS: 2.4 (1.2, 5.5) μg/mL; IL-6 - H: 2.3 (1.7, 3.0), MS: 4.1 (2.7, 6.8) pg/mL], were significantly higher in the MS compared to H (both p&amp;lt;0.001). The MS group also had significantly lower FMD (p=0.013) and NMD (p=0.033) compared to H. In H, IL-6 levels were significantly negatively correlated with FMD (r=-0.46, p&amp;lt;0.001), but not with NMD; whereas no significant associations of IL-6 levels with FMD or NMD were observed in the MS group. CRP levels were not significantly associated with FMD or NMD in neither the H nor MS group. Conclusion Higher IL-6 serum levels in the absence of acute inflammatory or infectious disease are significantly associated with lower FMD values among individuals with low risk for cardiovascular diseases, who are still considered healthy. Direct correlation is attenuated and lost among individuals with developed clinical signs of metabolic syndrome, probably due to its complex pathophysiology, as well as redundant and interdependent mechanisms contributing to the occurrence of endothelial dysfunction in such an environment. Further investigation on larger cohorts is needed to determine whether IL-6 serum levels could serve as a marker of endothelial dysfunction in individuals without clinically developed traditional risk factors and symptoms of cardiovascular disease.

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  • Journal IconCardiovascular Research
  • Publication Date IconMay 29, 2024
  • Author Icon I Klobucar + 5
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Exposure to occupational air pollution and vascular endothelial dysfunction in workers of the steel industry in Iran.

Air pollution is recognized as a risk factor for cardiovascular diseases; however, the precise underlying mechanisms remain unclear. This study investigated the impact of occupational air pollution exposure on endothelial function in workers within the steel industry. Specifically, we examined male employees in the coke-making division of the Isfahan Steel Company in Iran, as well as those in administrative roles with no known history of cardiovascular risk. Data on age, body mass index, duration of employment, blood pressure, fasting blood sugar, and lipid profile were collected. To assess endothelial function, flow-mediated dilation (FMD) was measured. The baseline brachial artery diameter was greater (mean difference [95% CI] = 0.068mm [0.008 to 0.128]), while the FMD was lower (mean difference [95% CI] = -0.908 % [-1.740 to -0.075]) in the coke-making group than in the control group. After controlling for potential confounding variables, it was observed that working in the coke-making sector of the industry was associated with lower FMD (F = 3.954, p = .049). These findings indicated that occupational air pollution exposure among workers in the steel industry is linked to impaired endothelium-dependent vasodilation.

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  • Journal IconToxicology and Industrial Health
  • Publication Date IconMay 14, 2024
  • Author Icon Masoumeh Sadeghi + 6
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Association of serum CTRP4 levels with vascular endothelial function in patients with type 2 diabetes mellitus: CTRP4 ameliorating inflammation, proliferation and migration in human umbilical vein endothelial cells.

We investigated the correlation between serum C1q/TNF-related protein 4 (CTRP4) level and flow-mediated dilation (FMD) in patients with type 2 diabetes mellitus (T2DM), and evaluated the biological effects of CTRP4 on human umbilical vein endothelial cells (HUVECs). A group of 165 patients diagnosed with T2DM were included in this study. Endothelial function was measured with the examination of brachial artery FMD. ELISA kit was used to measure the levels of CTRP4 in serum. HUVECs were stimulated with recombinant CTRP4 protein to assess its biological functions. The levels of CTRP4 showed a significant variation among three groups based on FMD tertiles (p = 0.001). What's more, FMD had a significant difference among three CTRP4 tertile groups (p < 0.05) and was negatively related to serum CTRP4 levels (r = -0.270, p < 0.001). In T2DM patients, logistic regression analysis demonstrated that CTRP4 was the primary influence factor of low FMD (p < 0.01). In receiver operating characteristic curve analysis, the area under the curve of CTRP4 for predicting low FMD was 0.66 (95%CI 0.58-0.75). When stimulated HUVECs with recombinant CTRP4 protein, we found that CTRP4 could concentration-dependently ameliorate proliferation and migration of HUVECs in wounding healing and transwell assay. This protein could also decrease the expression of IL-6 and TNF-α and promote the release of NO in HUVEC supernatants, with suppression of NF-κB and STAT3 phosphorylation. Serum CTRP4 concentrations were negatively associated with FMD. CTRP4 alleviated proliferation, migration and inflammation in HUVECs through the suppression of NF-κB and STAT3 signaling pathways.

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  • Journal IconActa Diabetologica
  • Publication Date IconMay 1, 2024
  • Author Icon Jie Gao + 6
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The Effect of Dietary Sodium and Potassium Consumption on Intestinal Permeability and its Relation to Blood Pressure, and Endothelial Function: A Pilot Study

High sodium (HS) diets can reduce endothelial function (EF) and increase blood pressure (BP) while high potassium (HK) diets are shown to counter this effect. Furthermore, HS diets have also been shown to lead to gut dysbiosis, which is related to increased intestinal permeability (IP). However, the effect of HS diets on IP and whether the addition of HK can attenuate potential HS-induced changes to IP is unknown. Hypotheses: We hypothesized IP would increase on a HS diet and be mitigated by HK and that a higher IP would be related to elevations in BP and lower EF. Methods: Eleven healthy participants (5W/6M, age 32±8 yrs, BMI 23±1, BP 105±6/66±7 mmHg) consumed three 10-day diets of differing sodium and potassium content in randomized order: low sodium (LS)/low potassium (LK) (50mmol/65mmol), HS/LK (300mmol/65mmol), and HS/HK (300mmol/120mmol). On day 9 of each intervention, they collected their urine and wore an ambulatory BP monitor for 24-hr. On day 10, brachial artery flow-mediated dilation (FMD) was measured. Blood was collected and lipopolysaccharide-binding protein (LBP), a biomarker of IP and bacterial translocation, was measured by ELISA. Mixed design ANOVAs assessed sex differences in LBP, FMD, and BPs between diets. Simple linear regressions assessed relations between variables. Results: Twenty-four-hr urinary sodium excretion was higher on both HS diets compared to LS/LK diet (both p&lt;0.01) and 24-hr urinary potassium excretion was higher on HS/HK compared to LS/LK and HS/LK diets (both p&lt;0.01). LBP was different between diets (p&lt;0.01), and there was a significant diet*sex interaction (p=0.02) where men had increased LBP compared to women on the HS/LK and HS/HK diets (both p&lt;0.01). FMD was not different between diets (p=0.13) although men had a lower FMD compared to women after each diet (sex: p&lt;0.01). Twenty-four-hr mean arterial pressure (MAP) was different between diets (p=0.047) as men demonstrated higher 24-hr MAP on the HS/LK diet compared to LS/LK diet (p=0.03) and lower MAP on the HS/HK diet compared to HS/LK diet (p=0.01). LBP was inversely related to FMD (r=-0.82, p&lt;.01) and positively related to MAP (r=0.72, p&lt;.01), 24-hr systolic BP (r=0.66, p=0.03), and 24-hr diastolic BP (r=0.66, p=0.03) on the HS/LK diet for all participants, but not the LS/LK or HS/HK diets. Conclusions: These pilot data suggest that HS diets may increase IP in men, and, in the context of a HS/LK diet, greater IP is associated with lower FMD and higher BP in all participants. NIH R01 HL145055. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

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  • Journal IconPhysiology
  • Publication Date IconMay 1, 2024
  • Author Icon Kathryn Kaseman + 3
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The Influence of Resting Retrograde Shear Rate on Endothelial Function as Assessed by Flow Mediated Dilation

Shear stress profiles are an important determinant of endothelial function. Unidirectional blood flow enhances mean shear and protects endothelial function, whereas increased retrograde and oscillatory shear favors a proatherogenic environment. In this regard, acutely increasing retrograde shear has been shown to impair endothelial function. Also, previous studies have reported an elevation in retrograde shear in older adults that has been suggested to contribute to impaired endothelial function with age. However, the impact of having elevated retrograde shear at rest on endothelial function remains unclear. Therefore, we aimed to assess the associations between resting shear patterns and endothelial function, as measured by flow-mediated dilation (FMD) in a cohort of young and older adults. We hypothesized that higher retrograde shear rate and oscillatory shear index at rest would be related to a lower FMD value. Method: A total of 60 participants, 30 young adults (24 ± 5 years) and 30 older adults (62 ± 9 years), were studied. Resting brachial artery blood flow was measured using duplex Doppler ultrasound and retrograde shear rate and oscillatory shear index were calculated. Brachial artery FMD was used as a measure of endothelial function. Pearson correlations were used to investigate the associations between FMD, resting shear patterns, and age. Result: FMD was significantly lower in older compared to young adults (4.9 ± 2.7% vs. 7.6 ± 3.2%, p &lt; 0.01). Both retrograde shear rate and oscillatory shear index tended to be greater in older adults (-20.7 ± 15.1 s−1 vs. -15.2 ± 17 s−1, p = 0.062, and 10.7 ± 8% vs. 7.9 ± 8.0%, p = 0.056, respectively). FMD was not correlated with retrograde shear rate (r = -0.18, p = 0.17), or oscillatory shear index (r = -0.21, p = 0.11) in the entire cohort or in the young and older group alone. However, FMD, retrograde shear rate, and oscillatory index were moderately correlated with age: FMD (r = -0.45, p &lt; 0.01), retrograde shear rate (r = -0.32, p = 0.012), and oscillatory shear index (r = 0.33, p &lt; 0.01). Conclusion: These preliminary results suggest that resting retrograde shear and oscillatory shear index are not associated with reduced endothelial function in a cohort of young and old adults. Nevertheless, age-associated reductions in endothelial function and elevated retrograde shear were observed. This project was supported by the College of Nursing and Health Innovation. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

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  • Journal IconPhysiology
  • Publication Date IconMay 1, 2024
  • Author Icon Taha A Alhalimi + 4
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Endothelial dysfunction influences augmented aortic hemodynamic responses to metaboreflex activation in postmenopausal women.

Postmenopausal women experience augmented aortic hemodynamic responses to isometric handgrip (IHG) exercise and metaboreflex activation post-exercise muscle ischemia (PEMI). Relationships between endothelial function brachial artery flow-mediated dilation (FMD) and aortic stiffness carotid-femoral pulse wave velocity (cfPWV) with aortic pulsatile hemodynamics during IHG and PEMI have not been determined. The relationships between aortic hemodynamic responses to PEMI were evaluated. Aortic blood pressure (BP), wave reflection, and pressure of forward (Pf) and backward (Pb) waves were measured using arterial tonometry at rest, IHG at 30% maximal force, and PEMI in 30 (15/group) postmenopausal women with low (≤ 4.5%) and normal (≥ 5.5%) FMD. Hemodynamic responses were analyzed as the change (Δ) from rest to the last minute of IHG and PEMI. Brachial and aortic systolic BP (SBP) responses to IHG were higher in the low vs normal FMD group (P < 0.05). Aortic SBP (Δ20 ± 8 vs Δ11 ± 7mmHg), pulse pressure (PP) (Δ12 ± 8 vs Δ6 ± 4mmHg), augmented pressure (AP) (Δ5 ± 3 vs Δ2 ± 2mmHg), and Pb (Δ6 ± 4 vs Δ3 ± 2mmHg) responses to PEMI were greater (P < 0.05) in women with low vs. normal FMD. FMD was negatively correlated with aortic SBP, PP, AP, and Pb (P < 0.05) responses to PEMI. cfPWV was not correlated with responses to PEMI. Endothelial dysfunction relates to augmented aortic pulsatile load during metaboreflex activation, which may increase cardiovascular risk in postmenopausal women.

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  • Journal IconEuropean journal of applied physiology
  • Publication Date IconApr 12, 2024
  • Author Icon Mauricio A Martinez + 5
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Association between triglyceride-glucose index and endothelial dysfunction.

Triglyceride-glucose (TyG) index, a simple surrogate marker for insulin resistance (IR), has been reported as an independent predictor of arterial structural damage and future cardiovascular events. The association between TyG index and endothelial dysfunction remains uncertain. The purpose of this study was to investigate the association between TyG index and endothelial dysfunction. Endothelial dysfunction was measured using flow-mediated dilation (FMD). A total of 840 subjects, who voluntarily accepted FMD measurement at the Health Management Department of Xuanwu Hospital from October 2016 to January 2020, were included in this study. TyG index was calculated as Ln [fasting triglyceride (TG)(mg/dL) × fasting plasma glucose (FPG) (mg/dL)/2]. The mean age was 59.92 ± 10.28 years and 559 (66.55%) participants were male. The TyG index was correlated with FMD values (P = 0.022). Each unit increment in TyG index was associated with lower FMD values (β = -0.330, 95%CI -0.609 to -0.052, P = 0.020) after adjusting for covariates. Age (β = -0.069, 95%CI -0.088 to -0.051, P < 0.001), female (β = 0.592, 95%CI 0.172 to1.012, P = 0.006), smoking (β = -0.430, 95%CI -0.859 to -0.002, P = 0.049) and hypertension (β = -0.741, 95%CI -1.117 to -0.365, P < 0.001) were also independent predictors for endothelial dysfunction. A significant association between the TyG index and endothelial dysfunction was found only in populations younger than 60 years (β = -0.843, 95%CI -1.371 to -0.316, P = 0.002), females (β = -0.612, 95%CI -1.147 to -0.077, P = 0.025), and populations without diabetes mellitus (DM) (β = -0.594, 95%CI -1.042 to -0.147, P = 0.009). Subjects with an elevated TyG index are more likely to have endothelial dysfunction, particularly in populations without DM.

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  • Journal IconEndocrine
  • Publication Date IconMar 21, 2024
  • Author Icon Yan Li + 12
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