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Assessment of vascular function in systemic sclerosis: indications of the development of nitrate tolerance as a result of enhanced endothelial nitric oxide production.
- Source :
-
Arthritis and rheumatism [Arthritis Rheum] 2002 May; Vol. 46 (5), pp. 1324-32. - Publication Year :
- 2002
-
Abstract
- Objective: To investigate the relationship between endothelium-dependent and endothelium-independent functions and the stiffness of conduit arteries as well as levels of endothelial activation markers in patients with systemic sclerosis (SSc).<br />Methods: Endothelium-dependent (i.e., flow-mediated) and endothelium-independent (i.e., nitroglycerin-induced) dilation of the brachial artery was measured as the percentage of change from baseline (FMD% and NTG%, respectively) in 24 SSc patients and 24 age- and sex-matched healthy controls by high-resolution ultrasound imaging. The maximum increase in systolic pressure per unit of time (dP/dt(max)), as a measure of arterial wall stiffness, was assessed in the radial artery by pulse applanation tonometry. Plasma nitrate, the most important metabolite of nitric oxide, and 24-hour urinary excretion of nitrate were measured by gas chromatography mass spectrometry. Soluble E-selectin and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured by enzyme-linked immunosorbent assay.<br />Results: Brachial artery FMD% and NTG% did not differ between SSc patients and controls. Radial artery dP/dt(max) was significantly increased in the patients and correlated significantly with elevated levels of plasma nitrate and sVCAM-1. Twenty-four-hour urinary nitrate excretion tended to be elevated. Brachial artery NTG% was significantly inversely correlated with levels of plasma nitrate and soluble endothelial adhesion molecules.<br />Conclusion: The ability of the brachial arteries to dilate in response to hyperemia and nitroglycerin challenge is preserved in SSc. Stiffness of the radial artery is increased, however. Endothelial activation seems to determine the extent of the brachial artery NTG% and the radial artery dP/dt(max). The data are compatible with the hypothesis that nitrate tolerance is present in the vascular smooth muscle cells of the brachial artery wall in SSc.
- Subjects :
- Adult
Aged
Cyclic GMP urine
E-Selectin blood
Endothelium, Vascular metabolism
Endothelium, Vascular physiopathology
Female
Humans
Male
Middle Aged
Nitrates blood
Nitrates urine
Nitric Oxide metabolism
Regional Blood Flow
Solubility
Vascular Cell Adhesion Molecule-1 blood
Brachial Artery physiology
Radial Artery physiology
Scleroderma, Systemic metabolism
Scleroderma, Systemic physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0004-3591
- Volume :
- 46
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Arthritis and rheumatism
- Publication Type :
- Academic Journal
- Accession number :
- 12115240
- Full Text :
- https://doi.org/10.1002/art.10191