Endothelial vasomotor function and global arterial distensibility in ischaemic cerebrovascular diseases and arterial hypertension

Cover Page


Cite item

Full Text

Abstract

The study of endothelial vasomotor function (EVF) and global arterial distensibility (glAD) aimed at determining their role in the development and progression of cerebral disturbances in arterial hypertension (AH) was conducted. We investigated 292 patients with different clinical forms of hypertensive cerebrovascular diseases (CVD). EVF was assessed with the use of endothelium-dependent flow-mediated vasodilatation of the brachial artery, and glAD was calculated as stroke volume (by echocardiography)/pulse pressure ratio (ml/mm Hg). Reduced EVF was revealed in patients versus controls: 7.2% (5.9; 8.2) and 10.5% (10.0; 12.9), respectively (p<0.001). EVF values were similar in patients with both early and late progressive stages of CVD. glAD was inversely correlated with the grade and duration of AH, patient age, and presence of deformations or atherosclerotic lesions of brachiocephal arteries, and it was diminished only in hypertensive encephalopathy, stage II–III [1.34 ml/mm Hg (1.11; 1.56) and 1.33 ml/mm Hg (1.13; 1.73)]. Thus, endothelial dysfunction is the earliest abnormality of vascular functional properties in AH and may be regarded as a universal factor of cerebrovascular complications. Reduced glAD reflects the loss of arteasticity and may represent a predictor of progressive course of CVD.

 
 

About the authors

Lyudmila A. Geraskina

Research Center of Neurology

Author for correspondence.
Email: neurocor@mail.ru
ORCID iD: 0000-0002-1253-1082
Russian Federation, Moscow, Volokolamskoe shosse,80

Andrey V. Fonyakin

Research Center of Neurology

Email: neurocor@mail.ru
Russian Federation, Moscow

Z. A. Suslina

Research Centre of Neurology

Email: neurocor@mail.ru
Russian Federation, Moscow

References

  1. Бойцов С.А. Сосуды как плацдарм и мишень артериальной гипертонии. Акт. вопр. болезней сердца и сосудов 2006; 1: 35–40.
  2. Верещагин Н.В., Моргунов В.А., Гулевская Т.С. Патология головного мозга при атеросклерозе и артериальной гипертонии. М.: Медицина, 1997.
  3. Власова И.В., Ваизова О.Е., Федосова Н.Н. и др. Состояние эндотелий-зависимой вазодилатации у больных цереброваскулярной болезнью. Клин. мед. 2000; 11: 26–29.
  4. Ганнушкина И.В., Лебедева Н.В. Гипертоническая энцефалопатия. М.: Медицина, 1987.
  5. Домашенко М.А., Орлов С.В., Костырева М.В. и др. Дисфункция эндотелия при ишемических нарушениях мозгового кровообращения. Сердце 2006; 5: 376–378.
  6. Мартынов А.И., Остроумова О.Д., Синицын В.Е. и др. Растяжимость аорты при артериальной гипертензии. Кардиология 2001; 2: 59–65.
  7. Мартынов А.И., Аветян Н.Г., Акатова Е.В. и др. Дисфункция эндотелия у больных гипертонической болезнью. Кардиология 2005; 10: 101–104.
  8. р. лоОва Я.А., Агеев Ф.Т. Жесткость артерий как интегральный показатель сердечно-сосудистого риска: физиология, методы оценки и медикаментозной коррекции. Сердце 2006; 5: 65–69.
  9. Шиллер Н., Осипов М.А. Клиническая эхокардиография. М.: Практика, 2005.
  10. Шмидт Е.В. Классификация сосудистых поражений головного и спинного мозга. Журн. невропатол. и психиатрии им. С.С. Корсакова 1985; 9: 1281–1288.
  11. Шутов А.А., Байдина Т.В., Агафонов А.В. и др. Дисфункция эндотелия у больных с ишемическим инсультом. Журн. неврол. и психиатрии им. С.С. Корсакова 2005; Приложение «Инсульт», № 14: 42–45.
  12. Agata J., Nagahara D., Kinoshita S. et al. Angiotensin II receptor blocker prevents increased ariatel rstiffness in patients with essential hypertension. Circ. J. 2004; 68: 1194–1198.
  13. Bateman G.A. Pulse wave encephalopathy: a comparative study of the hemodynamics of leukoaraiosis and normal pressure hydrocephalus. Neuroradiology 2002; 44: 740–748.
  14. Benetos A., Adamopoulos C., Bureau J.M. et al. Determination of accelerated progreisosn of arterial stiffness in normotensive subject and treated hypertensive subject over a 62year period. Circulation 2002; 105: 1202–1207.
  15. Celermajer D.S., Corretti T.C., Anderson T.J. et al. Guidelines for the ultrasound assessment of endothelium-dependent flow-mediated vasodilatation of the brachial artery. JACC 2002; 39: 257–265.
  16. Ch.eHn.C, Nakayama M., Talbot M. et al. Verapamil acutely reduces ventricular – vascular stiffening and improves aerobic exercise performance in elderly individuals. J. Am. Coll. Cardiol. 2000; 35: 1697–1698.
  17. de Simone G., Roman M.J., Koren M.J. et al. Stroke volume/pulse pressure ratio and cardiovascular risk in arterial hypertension.yHpertension 1999; 33: 800–805.
  18. Fegard R.H., Pardaens K., Staessen J.A. et al. The pulse pressure-to-stroke index ratio predicts cardiovascular events and death in uncomplicated hypertension. J. Аm. Coll. Cardiol. 2001; 38: 227–231.
  19. Feugeas M.C.H., De Marco G., Peretti I.I. et al. Age2related cerebral white matter changes and pulse-wave enceopatahl y: observations
  20. with three-dimensional MRI. Magn. Reson. Imaging 2005; 23: 929–937.
  21. Frohlich E.D., Tarazi R.C. Is arterial pressure the sole factor responsible for cardiac hypertrophy? Am. J. Cardiol. 1988; 61: 117–121.
  22. Guidelines for the management of arterial hypertension. The Task Force for the management of the European Society of Hypertension (ESH) and the European Society of Cardiogl y (ESC). J. Hypert. 2007; 25: 1105–1187.
  23. Hansen T.W., Staessen J.A., Torp Pedersen C. et al. Ambulatory arterial stiffness index predicts stroke in a general population. J. Hypertension 2006; 24: 2247–2253.
  24. Laurent S., Katsahian S., Fassot C. et al. Aortic stiffness is independent predictor of fatal stroke in essential hypertension. Se t-r0o0k3; 34: 1203–1206.
  25. London G.M. Cardiovascular disease in chronic renal failure: pathophysiologic aspects. Semin. Dial. 2003; 16: 85–94.
  26. London G.M., Asmar R.G., O’Rourke M.F. et al. Mechanism(s) of selective systolic blood pressure reduction after a low2dose combination of perindopril/indapamide in hypertensive subjects: comparison with atenolol. J. Am. Coll. Cardiol. 2004; 43: 92–99.
  27. Mattace Raso F.U., van der Cammen T.J., Hofman A. et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study. Circulation 2006; 113: 657–663.
  28. McEniery C.M., Schmitt M., Qasem A. et al. Nebivolol increases arterial distensibility in vivo. Hypertensio00n42; 44: 305–310.
  29. O`Rourke M.F., Safar M.E. Relationship between aortic stiffness and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 2005; 46: 200–204.
  30. Van Popele N.M., Grobbee D.E., Bots M.L. et al. Association between arterial stiffness and atherosclerosis: the Rotterdam Study. Stroke 2001; 32: 454–460.
  31. l0l.iaWmis B., Lacy P.S., Thom S.M. et al. The CAFE Investigators, for the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Investigators. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluatin (CAFE) study. Circulation 2006; 113: 1213–1225.
  32. Yang Z., Ming X. F. Recent advances in understanding endothelial dysfunction in atherosclerosis. Clin. Med. Res. 2006; 4: 53–65.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2009 Geraskina L.A., Fonyakin A.V., Suslina Z.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77-83204 от 12.05.2022.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies