Open AccessImpaired microvascular reactivity and endothelial function in patients with Cushing’s syndrome: influence of arterial hypertension
Author(s) -
Martin Prázný,
J Ježková,
Eva Horová,
V. Lazarova,
Václav Hána,
Jan Kvasnička,
Ladislav Pecen,
Josef Marek,
J Škrha,
Michal Kršek
Publication year - 2008
Publication title -
physiological research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 70
eISSN - 1802-9973
pISSN - 0862-8408
DOI - 10.33549/physiolres.931126
Subject(s) - medicine , endocrinology , endothelial dysfunction , fibrinolysis , malondialdehyde , oxidative stress , perfusion , reactive hyperemia , laser doppler velocimetry , hyperaemia , vasodilation , blood flow
The aim of the study was to evaluate skin microvascularreactivity (MVR) and possible influencing factors (fibrinolysis,oxidative stress, and endothelial function) in patients withCushing’s syndrome. Twenty-nine patients with active Cushing’ssyndrome (ten of them also examined after a successfuloperation) and 16 control subjects were studied. Skin MVR wasmeasured by laser Doppler flowmetry during post-occlusive(PORH) and thermal hyperemia (TH). Malondialdehyde andCu,Zn-superoxide dismutase were used as markers of oxidativestress. Fibrinolysis was estimated by tissue plasminogen activator(tPA) and its inhibitor (PAI-1). N-acetyl-β-glucosaminidase,E-selectin, P-selectin, and ICAM-1 were used as markers ofendothelial function. Oxidative stress and endothelial dysfunctionwas present in patients with hypercortisolism, however,increased concentration of ICAM-1 was also found in patientsafter the operation as compared to controls (290.8±74.2 vs.210.9±56.3 ng.ml-1, p<0.05). Maximal perfusion was significantlylower in patients with arterial hypertension during PORH and TH(36.3±13.0 vs. 63.3±32.4 PU, p<0.01, and 90.4±36.6 vs.159.2±95.3 PU, p<0.05, respectively) and similarly the velocityof perfusion increase during PORH and TH was lower (3.2±1.5vs. 5.2±3.4 PU.s-1, p<0.05, and 0.95±0.6 vs. 1.8±1.1 PU.s-1,p<0.05, respectively). The most pronounced impairment ofmicrovascular reactivity was present in patients with combinationof arterial hypertension and diabetes mellitus.