Circulation · 2002 · 501 citations · 30 references
MedicinePharmacologyPhysiologyHemodynamic ManagementMechanobiologyPharmacodynamicsCardiovascular PhysiologyHemodynamicsVasodilator TherapyAcetylcholine PharmacologyArterial Blood Pressure MeasurementArterial StiffnessNitric OxidePressure SensingPulse Wave Velocity AnalysisStiffnessVascular Stiffness
BACKGROUND: Arterial stiffness is an important determinant of cardiovascular risk. Several lines of evidence support a role for the endothelium in regulating arterial stiffness by release of vasoactive mediators. We hypothesized that nitric oxide (NO) acting locally regulates arterial stiffness in vivo, and the aim of this experiment was to test this hypothesis in an ovine hind-limb preparation. METHODS AND RESULTS: All studies were conducted in anesthetized sheep. Pulse wave velocity (PWV) was calculated by the foot-to-foot methodology from 2 pressure waveforms recorded simultaneously with a high-fidelity dual pressure-sensing catheter placed in the common iliac artery. Intra-arterial infusion of N(G)-monomethyl-L-arginine (L-NMMA) increased iliac PWV significantly, by 3+/-2% (P<0.01). Infusion of acetylcholine and glyceryl trinitrate reduced PWV significantly, by 6+/-4% (P=0.03) and 5+/-2% (P<0.01), respectively. Only the effect of acetylcholine, however, was significantly inhibited during coinfusion of L-NMMA (P=0.03). There was no change in systemic arterial pressure throughout the studies. Importantly, infusion of L-NMMA or acetylcholine distal to the common iliac artery (via the sheath) did not affect PWV. CONCLUSIONS: These results demonstrate, for the first time, that basal NO production influences large-artery distensibility. In addition, exogenous acetylcholine and glyceryl trinitrate both increase arterial distensibility, the former mainly through NO production. This may help explain why conditions that exhibit endothelial dysfunction are also associated with increased arterial stiffness. Therefore, reversal of endothelial dysfunction or drugs that are large-artery vasorelaxants may be effective in reducing large-artery stiffness in humans, and thus cardiovascular risk.
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Is Pulse Pressure Useful in Predicting Risk for Coronary Heart Disease?
Stanley S. Franklin, Shehzad Akbar Khan, Nathan D. Wong et al. · Circulation · 1999 · 1.8K citations · Full text
Aortic Pulse Wave Velocity as a Marker of Cardiovascular Risk in Hypertensive Patients
Jacques Blacher, Roland Asmar, Saliha Djane et al. · Hypertension · 1999 · 1.5K citations