Open AccessImpaired endothelial function in patients with rapidly stabilized unstable angina: Assessment by noninvasive brachial artery ultrasonography
Author(s) -
Bereziuk Eulalio,
Bolaño Alberto L.,
Suarez Daniel H.,
Kura Marta,
Esper Ricardo J.,
Vilariño Jorge,
Cacharrón José L.,
Machado Rogelio,
Ingino Carlos A.,
GarcGuiñaz Carlos A.
Publication year - 1999
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960221104
Subject(s) - medicine , brachial artery , endothelial dysfunction , cardiology , unstable angina , coronary artery disease , diabetes mellitus , angina , artery , basal (medicine) , chest pain , myocardial infarction , blood pressure , endocrinology , insulin
Background:Endothelial dysfunction may contribute to symptoms of instability in patients with acute coronary syndromes. High‐resolution external ultrasound assessment of the brachial artery responses allows noninvasive determination of endothelial function. Hypothesis:This study was conducted to assess endothelial function in patients with unstable angina using a noninvasive technique. Methods:We studied 189 patients who were subdivided into three groups. Group 1:60 apparently healthy subjects with no cardiovascular risk factors or symptoms of coronary artery disease; Group 2: 105 subjects with cardiovascular risk factors—arterial hypertension, hypercholesterolemia, cigarette smoking, diabetes, and obesity, but no evidence of coronary artery disease; and Group 3: 24 patients with unstable angina (chest pain at rest within the 24 h preceding study entry). All patients underwent pre‐ and postischemic brachial artery test evaluation with measurements of internal arterial diameters and blood flow. Results:Results are expressed as percentage change from basal values. Subjects in Groups 1 and 2 showed a diameter increase of 19.1 and 11.9%, respectively, whereas patients in Group 3 showed a diameter change of 1.2% (p < 0.002 and < 0.0001, respectively). Calculated blood flow did not differ significantly in Groups 1 or 2 (74.4 and 56.4%), but was notably lower in Group 3 (18.4%, p<0.005 vs. Groups 1 and 2). In nine patients of Group 3, the brachial studies were repeated 4 weeks after symptom stabilization and showed values comparable with those in Group 2. Conclusions:Patients with unstable angina showed endothelial dysfunction compared with control individuals. It is of interest that in patients whose symptoms were stabilized by medical therapy, endothelial function was restored 4 weeks after hospital discharge.