Published online before print September 1, 2005, doi: 10.1161/01.ATV.0000184769.22061.da
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2005 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
A Comparison of Three Different Methods to Evaluate Endothelium-Dependent Vasodilation in the Elderly
The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) Study
From the Department of Medicine (L.L., N.F., J.H., K.M., A.S.), Uppsala University Hospital and AstraZeneca R&D (L.L.) Mölndal, Sweden.
Correspondence to Lars Lind, MD, Departmentt of Medicine, University Hospital, 751 85 Uppsala, Sweden. E-mail lars.lind{at}medsci.uu.se
Background— Three different techniques to evaluate endothelium-dependent vasodilation in the peripheral circulation have been described but not simultaneously tested in a large-scale population-based setting. This study aimed to evaluate the feasibility and usefulness of these techniques in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
Methods and Results— In the population-based PIVUS study (1016 subjects aged 70 years), the invasive forearm technique with acetylcholine given in the brachial artery (EDV), the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD), and the pulse wave analysis method with ß-2-agonist (terbutaline) provocation were successfully used in 87%, 97%, and 86% of the sample, respectively. The results of EDV and pulse wave analysis were interrelated (r=0.12, P=0.0013), but no relationships were found with FMD measurements. All 3 techniques were correlated to the Framingham risk score (r=0.10 to 0.12, P=0.0007 to 0.001). In multiple regression analysis, however, only EDV and FMD were independently associated with the Framingham score.
Conclusions— All 3 evaluated techniques were feasible to perform in a general elderly population. Both the invasive forearm technique and FMD were independently associated with increased coronary risk, suggesting that information on conduit artery and resistance artery endothelial function carry different, but important, information in the elderly. If the invasive technique cannot be used, the pulse wave based technique is an alternative.
In the population-based PIVUS study (1016 subjects aged 70 years), endothelium-dependent vasodilation was evaluated with 3 different methods. The invasive forearm technique with acetylcholine and flow-mediated dilatation were independently associated with the Framingham score, suggesting that conduit artery and resistance artery endothelial function carry different, but important, information in the elderly.
Key Words: endothelium • vasodilation • cardiovascular • risk • elderly
This article has been cited by other articles:
 |
|
 |
|
  M. A. I. Mirza, T. Hansen, L. Johansson, H. Ahlstrom, A. Larsson, L. Lind, and T. E. Larsson Relationship between circulating FGF23 and total body atherosclerosis in the community Nephrol. Dial. Transplant., October 1, 2009; 24(10): 3125 - 3131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Lind, L. Wallentin, T. Kempf, H. Tapken, A. Quint, B. Lindahl, S. Olofsson, P. Venge, A. Larsson, J. Hulthe, et al. Growth-differentiation factor-15 is an independent marker of cardiovascular dysfunction and disease in the elderly: results from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) Study Eur. Heart J., October 1, 2009; 30(19): 2346 - 2353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Pemp, G. Weigert, K. Karl, U. Petzl, M. Wolzt, L. Schmetterer, and G. Garhofer Correlation of Flicker-Induced and Flow-Mediated Vasodilatation in Patients With Endothelial Dysfunction and Healthy Volunteers Diabetes Care, August 1, 2009; 32(8): 1536 - 1541. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Engstrom, M. Gerhardsson de Verdier, M. Dahlback, C. Janson, and L. Lind BP Variability and Cardiovascular Autonomic Function in Relation to Forced Expiratory Volume: A Population-Based Study Chest, July 1, 2009; 136(1): 177 - 183. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ingelsson and L. Lind Circulating Retinol-Binding Protein 4 and Subclinical Cardiovascular Disease in the Elderly Diabetes Care, April 1, 2009; 32(4): 733 - 735. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Eggers, A. S. Jaffe, L. Lind, P. Venge, and B. Lindahl Value of Cardiac Troponin I Cutoff Concentrations below the 99th Percentile for Clinical Decision-Making Clin. Chem., January 1, 2009; 55(1): 85 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Michaelsson, L. Lind, J. Frystyk, A. Flyvbjerg, R. Gedeborg, C. Berne, B. Zethelius, H. Mallmin, S. Soderberg, and H. Melhus Serum Adiponectin in Elderly Men Does Not Correlate with Fracture Risk J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 4041 - 4047. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Eggers, L. Lind, H. Ahlstrom, T. Bjerner, C. Ebeling Barbier, A. Larsson, P. Venge, and B. Lindahl Prevalence and pathophysiological mechanisms of elevated cardiac troponin I levels in a population-based sample of elderly subjects Eur. Heart J., September 2, 2008; 29(18): 2252 - 2258. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Settergren, F. Bohm, L. Ryden, and J. Pernow Cholesterol lowering is more important than pleiotropic effects of statins for endothelial function in patients with dysglycaemia and coronary artery disease Eur. Heart J., July 2, 2008; 29(14): 1753 - 1760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Sundstrom, J Arnlov, K Stolare, and L Lind Blood pressure-independent relations of left ventricular geometry to the metabolic syndrome and insulin resistance: a population-based study Heart, July 1, 2008; 94(7): 874 - 878. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. L. Pierce, S. D. Beske, B. R. Lawson, K. L. Southall, F. J. Benay, A. J. Donato, and D. R. Seals Weight Loss Alone Improves Conduit and Resistance Artery Endothelial Function in Young and Older Overweight/Obese Adults Hypertension, July 1, 2008; 52(1): 72 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ebeling Barbier, T. Bjerner, T. Hansen, J. Andersson, L. Lind, J. Hulthe, L. Johansson, and H. Ahlstrom Clinically Unrecognized Myocardial Infarction Detected at MR Imaging May Not Be Associated with Atherosclerosis Radiology, October 1, 2007; 245(1): 103 - 110. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Stenborg, H. Kalimo, M. Viitanen, A. Terent, and L. Lind Impaired Endothelial Function of Forearm Resistance Arteries in CADASIL Patients Stroke, October 1, 2007; 38(10): 2692 - 2697. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Melikian, M. T. Kearney, M. R. Thomas, B. De Bruyne, A. M. Shah, and P. A. MacCarthy A simple thermodilution technique to assess coronary endothelium-dependent microvascular function in humans: validation and comparison with coronary flow reserve Eur. Heart J., September 2, 2007; 28(18): 2188 - 2194. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. de Bree, L. A van Mierlo, and R. Draijer Folic acid improves vascular reactivity in humans: a meta-analysis of randomized controlled trials Am. J. Clinical Nutrition, September 1, 2007; 86(3): 610 - 617. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Hansen, J. Wikstrom, L.O. Johansson, L. Lind, and H. Ahlstrom The Prevalence and Quantification of Atherosclerosis in an Elderly Population Assessed by Whole-Body Magnetic Resonance Angiography Arterioscler Thromb Vasc Biol, March 1, 2007; 27(3): 649 - 654. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Ebeling Barbier, T. Bjerner, L. Johansson, L. Lind, and H. Ahlstrom Myocardial Scars More Frequent Than Expected: Magnetic Resonance Imaging Detects Potential Risk Group J. Am. Coll. Cardiol., August 15, 2006; 48(4): 765 - 771. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Eskurza, Z. D. Kahn, and D. R. Seals Xanthine oxidase does not contribute to impaired peripheral conduit artery endothelium-dependent dilatation with ageing J. Physiol., March 15, 2006; 571(3): 661 - 668. [Abstract] [Full Text] [PDF]
|
|