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Cytotoxin associated gene (Cag) A+ Helicobacter pylori (HP) is the most virulent HP strain, and its association with endothelial dysfunction remains unclear. Thus we investigated the effects of CagA+ HP on endothelial dependent dilatation and its relationship with C-reactive protein (CRP) in normotensive subjects. Patients and Methods: Sixty individuals with CagA+ HP infection were compared with 40 individuals with CagA(-) HP infection and 50 individuals with no infection in terms of flow-mediated dilatation (FMD), nonendothelium-dependent dilatation (NED) and CRP. Results: In the CagA+ subjects the mean percentage of FMD was 6.3±2.7, which was significantly lower than that of the CagA- subjects (9.8±3.3, p<0.01) and the uninfected controls (10.1±2.6, p<0.01). The mean level of CRP in the CagA+ subjects was 3.9 mg/dL (range 0.1-9.8), which was significantly higher than that of the CagA- subjects (2.3 mg/dL, range 0.1-5.4, p=0.01) and the uninfected controls (1.9 mg/dL, range 0.1-5.3, p<0.01). In the CagA+ group CRP levels were inversely correlated with FMD (r=0.318, p=0.013), however not with non-endotheliumdependent dilatation (NED) (r=0.216, p=0.097). Conclusion: Attenuated FMD and low-grade inflammation were associated with CagA+ infection, however not

Cytotoxin Associated Gene A+ Helicobacter pylori Infection is Related with Endothelial Dysfunction in Normotensive Individuals