1. Impaired flow-mediated dilation in hospitalized patients with community-acquired pneumonia
- Author
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Cristiana Franchi, Michela Mordenti, Marco Falcone, Ludovica Perri, Maurizio De Angelis, Elisabetta Rossi, Daniele Pastori, Filippo Toriello, Lucia Fontanelli Sulekova, Giulio Francesco Romiti, Rozenn Esvan, Paolo Marinelli, Luisa Solimando, Marco Antonio Casciaro, Stefano Trapè, Paolo De Marzio, Elisa Catasca, Lorenzo Loffredo, Roberto Carnevale, Eleonora Ruscio, S. Grieco, Camilla Calvieri, Alessandro Russo, Cinzia Myriam Calabrese, Francesco Violi, Andrea Celestini, Cristina Nocella, Simona Battaglia, Gloria Taliani, Roberto Cangemi, Laura Giordo, Maria Gabriella Scarpellini, Elisa Biliotti, Francesco Equitani, Lucia Fazi, Elisa Manzini, Giuliano Bertazzoni, Pasquale Pignatelli, Domenico Ferro, Sergio Morelli, Marco Rivano Capparuccia, Tommaso Bucci, and Paolo Palange
- Subjects
Lipopolysaccharides ,Male ,medicine.medical_specialty ,Brachial Artery ,Pneumonia severity index ,Flow mediated dilation ,Isoprostanes ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Nitric oxide ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Community-acquired pneumonia ,Internal medicine ,Internal Medicine ,medicine ,Humans ,oxidative stress ,pneumonia ,flow-mediated dilation ,Prospective Studies ,030212 general & internal medicine ,Myocardial infarction ,Endothelial dysfunction ,Intensive care medicine ,Nitrites ,Aged ,Ultrasonography ,Aged, 80 and over ,Nitrates ,business.industry ,Type 2 Diabetes Mellitus ,Middle Aged ,medicine.disease ,infection ,Community-Acquired Infections ,Hospitalization ,Vasodilation ,chemistry ,Cardiology ,Female ,Endothelium, Vascular ,internal medicine ,business ,Oxidative stress - Abstract
Community-acquired pneumonia (CAP) is complicated by cardiovascular events as myocardial infarction and stroke but the underlying mechanism is still unclear. We hypothesized that endothelial dysfunction may be implicated and that endotoxemia may have a role.Fifty patients with CAP and 50 controls were enrolled. At admission and at discharge, flow-mediated dilation (FMD), serum levels of endotoxins and oxidative stress, as assessed by serum levels of nitrite/nitrate (NOx) and isoprostanes, were studied.At admission, a significant difference between patients with CAP and controls was observed for FMD (2.1±0.3 vs 4.0±0.3%, p0.001), serum endotoxins (157.8±7.6 vs 33.1±4.8pg/ml), serum isoprostanes (341±14 vs 286±10 pM, p=0.009) and NOx (24.3±1.1 vs 29.7±2.2μM). Simple linear correlation analysis showed that serum endotoxins significantly correlated with Pneumonia Severity Index score (Rs=0.386, p=0.006). Compared to baseline, at discharge CAP patients showed a significant increase of FMD and NOx (from 2.1±0.3 to 4.6±0.4%, p0.001 and from 24.3±1.1 to 31.1±1.5μM, p0.001, respectively) and a significant decrease of serum endotoxins and isoprostanes (from 157.8±7.6 to 55.5±2.3pg/ml, p0.001, and from 341±14 to 312±14 pM, p0.001, respectively). Conversely, no changes for FMD, NOx, serum endotoxins and isoprostanes were observed in controls between baseline and discharge. Changes of FMD significantly correlated with changes of serum endotoxins (Rs=-0.315; p=0.001).The study provides the first evidence that CAP is characterized by impaired FMD with a mechanism potentially involving endotoxin production and oxidative stress.
- Published
- 2016
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