Aim: The aim of this study was to determine the effect of training on endothelium-dependent vasodilatation in patients with coronary artery disease (CAD) after revascularization and healthy young men. Background: Impa...Aim: The aim of this study was to determine the effect of training on endothelium-dependent vasodilatation in patients with coronary artery disease (CAD) after revascularization and healthy young men. Background: Impaired endothelial function has been observed in patients with CAD and those with CAD risk factors. Studies have shown that exercise can enhance endothelial function. Methods: This experimental cross-sectional study was conducted on patients with CAD (3 months after CABG and PCI) and students of medical school in 2011. Endothelium dependent dilation of the brachial artery was determined by using high-resolution vascular ultrasonography through flow-mediated vasodilatation (FMD) after induction of ischemia, and the data were analyzed using SPSS, dependent t-test and ANCOVA. Findings: The findings showed that at baseline, FMD was reduced in revascularized patients, when compared with healthy young men, after 8 weeks, and exercise training significantly improved FMD in patients underwent training group [from 4.31 ± 1.45 (SD)% to 6.15 ± 0.773 (SD)%, p p ed unchanged, and even after aerobic training, it did not significantly modify the brachial artery diameter in these groups. Conclusion: Our study demonstrates that endothelial dysfunction persisting in CAD patients after revascularization and aerobic training can improve endothelial function in different vascular beds in CAD patients and healthy young men. This may contribute to the benefit of regular exercise in preventing and restricting cardiovascular disease.展开更多
Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium,thereby leading to functional and structural adaptations that lower cardiovascular risk.The patterns of blood f...Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium,thereby leading to functional and structural adaptations that lower cardiovascular risk.The patterns of blood flow and endothelial shear stress during exercise lead to atheroprotective hemodynamic stimuli on the endothelium and contribute to adaptations in vascular function and structure.The structural adaptations observed in arterial lumen dimensions after prolonged exercise supplant the need for acute functional vasodilatation in case of an increase in endothelial shear stress due to repeated exercise bouts.In contrast,wall thickness is affected by rather systemic factors,such as transmural pressure modulated during exercise by generalized changes in blood pressure.Several mechanisms have been proposed to explain the exercise-induced benefits in patients with coronary artery disease(CAD).They include decreased progression of coronary plaques in CAD,recruitment of collaterals,enhanced blood rheological properties,improvement of vascular smooth muscle cell and endothelial function,and coronary blood flow.This review describes how exercise via alterations in hemodynamic factors influences vascular function and structure which contributes to cardiovascular risk reduction,and highlights which mechanisms are involved in the positive effects of exercise on CAD.展开更多
Context: Endothelial dysfunction is an early predictor of adverse cardiovascular events. The present study evaluated asymptomatic metabolic syndrome (MS) patients with brachial artery endothelial dysfunction to determ...Context: Endothelial dysfunction is an early predictor of adverse cardiovascular events. The present study evaluated asymptomatic metabolic syndrome (MS) patients with brachial artery endothelial dysfunction to determine whether a reversal of endothelial dysfunction occurs with statin treatment. Aim: To evaluate the short term effects of statins on endothelial function in asymptomatic metabolic syndrome patients. Methodology: This was a prospective, single centre, case-control study. We evaluated 50 recently diagnosed newly detected asymptomatic MS patients who underwent an assessment of endothelial function by brachial artery flow-mediated dilation (FMD) before and after treatment with 40 mg atorvastatin for one week. Results: A total of 50 MS patients, including 36 (62%) females and 14 (38%) males, were included in the study. The mean age of the patients was 49.70 ± 8.84 y. We identified a significant difference between cases and age- and sex-matched controls regarding baseline brachial artery FMD% (6.73 ± 2.55 vs. 11.03 ± 1.85, respectively;p < 0.001). Significant negative correlations were detected between FMD% and HDL-cholesterol (r = -0.34, p = 0.01), fasting blood sugar (r = -0.40, p = 0.004), and systolic blood pressure (r = -0.34, p = 0.015). Multiple linear regression analysis indicated that HDL-cholesterol was an independently associated factor for FMD. MS patients treated with 40 mg atorvastatin for one week showed a significant improvement in brachial artery FMD% (6.73 ± 2.55 before treatment vs. 10.19 ± 3.01 after treatment, p < 0.001). Conclusions: MS is associated with endothelial dysfunction and decreased brachial artery FMD compared with controls. Statin treatment for one week significantly improved brachial artery endothelial function in MS patients.展开更多
文摘Aim: The aim of this study was to determine the effect of training on endothelium-dependent vasodilatation in patients with coronary artery disease (CAD) after revascularization and healthy young men. Background: Impaired endothelial function has been observed in patients with CAD and those with CAD risk factors. Studies have shown that exercise can enhance endothelial function. Methods: This experimental cross-sectional study was conducted on patients with CAD (3 months after CABG and PCI) and students of medical school in 2011. Endothelium dependent dilation of the brachial artery was determined by using high-resolution vascular ultrasonography through flow-mediated vasodilatation (FMD) after induction of ischemia, and the data were analyzed using SPSS, dependent t-test and ANCOVA. Findings: The findings showed that at baseline, FMD was reduced in revascularized patients, when compared with healthy young men, after 8 weeks, and exercise training significantly improved FMD in patients underwent training group [from 4.31 ± 1.45 (SD)% to 6.15 ± 0.773 (SD)%, p p ed unchanged, and even after aerobic training, it did not significantly modify the brachial artery diameter in these groups. Conclusion: Our study demonstrates that endothelial dysfunction persisting in CAD patients after revascularization and aerobic training can improve endothelial function in different vascular beds in CAD patients and healthy young men. This may contribute to the benefit of regular exercise in preventing and restricting cardiovascular disease.
文摘Exercise exerts direct effects on the vasculature via the impact of hemodynamic forces on the endothelium,thereby leading to functional and structural adaptations that lower cardiovascular risk.The patterns of blood flow and endothelial shear stress during exercise lead to atheroprotective hemodynamic stimuli on the endothelium and contribute to adaptations in vascular function and structure.The structural adaptations observed in arterial lumen dimensions after prolonged exercise supplant the need for acute functional vasodilatation in case of an increase in endothelial shear stress due to repeated exercise bouts.In contrast,wall thickness is affected by rather systemic factors,such as transmural pressure modulated during exercise by generalized changes in blood pressure.Several mechanisms have been proposed to explain the exercise-induced benefits in patients with coronary artery disease(CAD).They include decreased progression of coronary plaques in CAD,recruitment of collaterals,enhanced blood rheological properties,improvement of vascular smooth muscle cell and endothelial function,and coronary blood flow.This review describes how exercise via alterations in hemodynamic factors influences vascular function and structure which contributes to cardiovascular risk reduction,and highlights which mechanisms are involved in the positive effects of exercise on CAD.
文摘Context: Endothelial dysfunction is an early predictor of adverse cardiovascular events. The present study evaluated asymptomatic metabolic syndrome (MS) patients with brachial artery endothelial dysfunction to determine whether a reversal of endothelial dysfunction occurs with statin treatment. Aim: To evaluate the short term effects of statins on endothelial function in asymptomatic metabolic syndrome patients. Methodology: This was a prospective, single centre, case-control study. We evaluated 50 recently diagnosed newly detected asymptomatic MS patients who underwent an assessment of endothelial function by brachial artery flow-mediated dilation (FMD) before and after treatment with 40 mg atorvastatin for one week. Results: A total of 50 MS patients, including 36 (62%) females and 14 (38%) males, were included in the study. The mean age of the patients was 49.70 ± 8.84 y. We identified a significant difference between cases and age- and sex-matched controls regarding baseline brachial artery FMD% (6.73 ± 2.55 vs. 11.03 ± 1.85, respectively;p < 0.001). Significant negative correlations were detected between FMD% and HDL-cholesterol (r = -0.34, p = 0.01), fasting blood sugar (r = -0.40, p = 0.004), and systolic blood pressure (r = -0.34, p = 0.015). Multiple linear regression analysis indicated that HDL-cholesterol was an independently associated factor for FMD. MS patients treated with 40 mg atorvastatin for one week showed a significant improvement in brachial artery FMD% (6.73 ± 2.55 before treatment vs. 10.19 ± 3.01 after treatment, p < 0.001). Conclusions: MS is associated with endothelial dysfunction and decreased brachial artery FMD compared with controls. Statin treatment for one week significantly improved brachial artery endothelial function in MS patients.