Circulation, Vol 88, 2139-2148, Copyright © 1993 by American Heart Association
C Seiler, OM Hess, M Buechi, TM Suter and HP Krayenbuehl
BACKGROUND. It has been shown that there is impairment of the vasodilatory
response to acetylcholine in patients with hypercholesterolemia and
angiographically normal coronary arteries. Moreover, in patients with
angiographically smooth coronary arteries, the number of coronary risk
factors is associated with a loss of endothelium-dependent vasodilation.
The purpose of the present analysis was to evaluate in patients with and
without coronary artery disease coronary vasomotor response to dynamic
exercise in angiographically normal and stenosed coronary arteries and to
relate the response to serum cholesterol levels as well as to other
coronary risk factors. METHODS AND RESULTS. Luminal area change during
exercise (delta-ex, percent change compared with rest = 100%) was
determined by biplane quantitative coronary arteriography in three groups:
Group 1 consisted of 14 patients with normal total serum cholesterol of
< 200 mg/100 mL; mean, 173 mg/100 mL (mean age, 51 years). Group 2
comprised 23 patients with a slightly elevated cholesterol of 200 to 250
mg/100 mL; mean, 223 mg/100 mL (mean age, 53 years). Group 3 had 24
patients with markedly elevated cholesterol of > 250 mg/100 mL; mean,
288 mg/100 mL (mean age, 54 years). Serum cholesterol levels and
categorical risk factors such as positive family history, history of
hypertension, smoking, obesity, and diabetes were related to
exercise-induced vasomotor response. The three groups did not differ with
regard to clinical characteristics, exercise work load, and hemodynamic
data measured during exercise. However, delta-ex in normal vessels was
significantly different between all three groups (ANOVA, P < .01): +31%
(group 1), +18% (group 2), and +4% (group 3). Delta-ex in stenotic vessels
did not differ between the groups: -5% (group 1), -13% (group 2), and -12%
(group 3). Delta-ex of the nonstenosed vessel correlated significantly and
inversely with total cholesterol, with low-density lipoprotein cholesterol,
with the ratio of total to high-density lipoprotein cholesterol, and with
the number of coronary risk factors present in a patient. High total
cholesterol and a history of hypertension were independent risk factors for
impaired coronary vasomotion. CONCLUSIONS. In patients with and without
coronary artery disease, hypercholesterolemia and a history of hypertension
independently impair exercise-induced coronary vasodilation in
angiographically normal coronary arteries. In the stenotic vessel,
vasomotion during exercise does not appear to be influenced by the actual
serum cholesterol. The precise mechanism by which the impaired vasomotion
of the angiographically normal coronary arteries is mediated is unknown,
but a direct negative effect of hypercholesterolemia on endothelial
function or early undetected atherosclerosis appears to be the most likely
explanation.
ARTICLES
Influence of serum cholesterol and other coronary risk factors on vasomotion of angiographically normal coronary arteries
Division of Cardiology, University Hospital, Zurich, Switzerland.
This article has been cited by other articles:
 |
|
 |
|
  V. Vaccarino, J. Votaw, T. Faber, E. Veledar, N. V. Murrah, L. R. Jones, J. Zhao, S. Su, J. Goldberg, J. P. Raggi, et al. Major Depression and Coronary Flow Reserve Detected by Positron Emission Tomography Arch Intern Med, October 12, 2009; 169(18): 1668 - 1676. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Saglam, O. Karakaya, I. Barutcu, A. M. Esen, M. Turkmen, R. Kargin, O. Esen, N. Ozdemir, and C. Kaymaz Identifying Cardiovascular Risk Factors in a Patient Population With Coronary Artery Ectasia Angiology, January 1, 2008; 58(6): 698 - 703. [Abstract] [PDF]
|
|
|
|
 |
|
 M. I. Worthley, R. S. Kanani, Y.-H. Sun, Y. Sun, D. M. Goodhart, M. J. Curtis, and T. J. Anderson Effects of tetrahydrobiopterin on coronary vascular reactivity in atherosclerotic human coronary arteries Cardiovasc Res, December 1, 2007; 76(3): 539 - 546. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Sezgin, I. Barutcu, N. Sezgin, H. Gullu, A. M. Esen, N. Acikgoz, E. Topal, and R. Ozdemir Contribution of Plasma Lipid Disturbances to Vascular Endothelial Function in Patients With Slow Coronary Flow Angiology, January 1, 2007; 57(6): 694 - 701. [Abstract] [PDF]
|
|
|
|
 |
|
 D Fukuda, M Yoshiyama, K Shimada, H Yamashita, S Ehara, Y Nakamura, K Kamimori, A Tanaka, T Kawarabayashi, and J Yoshikawa Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease Heart, June 1, 2006; 92(6): 759 - 762. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Kaufmann and P. G. Camici Myocardial Blood Flow Measurement by PET: Technical Aspects and Clinical Applications J. Nucl. Med., January 1, 2005; 46(1): 75 - 88. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Matsumoto, H. Takashima, N. Ohira, Y. Tarutani, Y. Yasuda, T. Yamane, S. Matsuo, and M. Horie Plasma level of oxidized low-density lipoprotein is an independent determinant of coronary macrovasomotor and microvasomotor responses induced by bradykinin J. Am. Coll. Cardiol., July 21, 2004; 44(2): 451 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. M. Maggi, S. Raselli, L. Grigore, L. Redaelli, S. Fantappie, and A. L. Catapano Lipoprotein Remnants and Endothelial Dysfunction in the Postprandial Phase J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2946 - 2950. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Barbato, J. Bartunek, E. Wyffels, W. Wijns, G. R. Heyndrickx, and B. De Bruyne Effects of intravenous dobutamineon coronary vasomotion in humans J. Am. Coll. Cardiol., November 5, 2003; 42(9): 1596 - 1601. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Frank, S. E. Woodman, D. S. Park, and M. P. Lisanti Caveolin, Caveolae, and Endothelial Cell Function Arterioscler Thromb Vasc Biol, July 1, 2003; 23(7): 1161 - 1168. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Maier, S. Windecker, A. Kung, R. Lutolf, F. R. Eberli, B. Meier, and O. M. Hess Exercise-Induced Coronary Artery Vasodilation Is Not Impaired by Stent Placement Circulation, May 21, 2002; 105(20): 2373 - 2377. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kelm Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects Am J Physiol Heart Circ Physiol, January 1, 2002; 282(1): H1 - H5. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Otsuka, H. Watanabe, K. Hirata, K. Tokai, T. Muro, M. Yoshiyama, K. Takeuchi, and J. Yoshikawa Acute Effects of Passive Smoking on the Coronary Circulation in Healthy Young Adults JAMA, July 25, 2001; 286(4): 436 - 441. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Rubenfire, S. Rajagopalan, and L. Mosca Carotid artery vasoreactivity in response to sympathetic stress correlates with coronary disease risk and is independent of wall thickness J. Am. Coll. Cardiol., December 1, 2000; 36(7): 2192 - 2197. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kaufmann, T. Gnecchi-Ruscone, M. di Terlizzi, K. P. Schafers, T. F. Luscher, and P. G. Camici Coronary Heart Disease in Smokers : Vitamin C Restores Coronary Microcirculatory Function Circulation, September 12, 2000; 102(11): 1233 - 1238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kaufmann, T. Gnecchi-Ruscone, K. P. Schafers, T. F. Luscher, and P. G. Camici Low density lipoprotein cholesterol and coronary microvascular dysfunction in hypercholesterolemia J. Am. Coll. Cardiol., July 1, 2000; 36(1): 103 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. G. Stroes, E. E. van Faassen, M. Yo, P. Martasek, P. Boer, R. Govers, and T. J. Rabelink Folic Acid Reverts Dysfunction of Endothelial Nitric Oxide Synthase Circ. Res., June 9, 2000; 86(11): 1129 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Heusch, D. Baumgart, P. Camici, W. Chilian, L. Gregorini, O. Hess, C. Indolfi, and O. Rimoldi {alpha}-Adrenergic Coronary Vasoconstriction and Myocardial Ischemia in Humans Circulation, February 15, 2000; 101(6): 689 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M Dart and J. P.F Chin-Dusting Lipids and the endothelium Cardiovasc Res, August 1, 1999; 43(2): 308 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Nappo, N. De Rosa, R. Marfella, D. De Lucia, D. Ingrosso, A. F. Perna, B. Farzati, and D. Giugliano Impairment of Endothelial Functions by Acute Hyperhomocysteinemia and Reversal by Antioxidant Vitamins JAMA, June 9, 1999; 281(22): 2113 - 2118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Baller, G. Notohamiprodjo, U. Gleichmann, J. Holzinger, R. Weise, and J. Lehmann Improvement in Coronary Flow Reserve Determined by Positron Emission Tomography After 6 Months of Cholesterol-Lowering Therapy in Patients With Early Stages of Coronary Atherosclerosis Circulation, June 8, 1999; 99(22): 2871 - 2875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. S. Duvernoy, C. Meyer, V. Seifert-Klauss, F. Dayanikli, I. Matsunari, J. Rattenhuber, C. Hoss, H. Graeff, and M. Schwaiger Gender differences in myocardial blood flow dynamics: Lipid profile and hemodynamic effects J. Am. Coll. Cardiol., February 1, 1999; 33(2): 463 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. John, M. Schlaich, M. Langenfeld, H. Weihprecht, G. Schmitz, G. Weidinger, and R. E. Schmieder Increased Bioavailability of Nitric Oxide After Lipid-Lowering Therapy in Hypercholesterolemic Patients : A Randomized, Placebo-Controlled, Double-blind Study Circulation, July 21, 1998; 98(3): 211 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kaufmann, J. Frielingsdorf, L. Mandinov, C. Seiler, R. Hug, and O. M. Hess Reversal of Abnormal Coronary Vasomotion by Calcium Antagonists in Patients With Hypercholesterolemia Circulation, April 14, 1998; 97(14): 1348 - 1354. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-C. Veille, L. Gorsuch, W. Weeks, and D. Zaccaro Hyperemic Response of the Brachial Artery During the Second Half of Pregnancy Reproductive Sciences, January 1, 1998; 5(1): 38 - 43. [Abstract] [PDF]
|
|
|
|
|
|
G. D. Plotnick, M. C. Corretti, and R. A. Vogel Effect of Antioxidant Vitamins on the Transient Impairment of Endothelium--Dependent Brachial Artery Vasoactivity Following a Single High-Fat Meal JAMA, November 26, 1997; 278(20): 1682 - 1686. [Abstract] [PDF]
|
|
|
|
|
|
M. K. Hong, J. Vossoughi, G. S. Mintz, R. D. Kauffman, R. F. Hoyt Jr, J. F. Cornhill, E. E. Herderick, M. B. Leon, and J. M. Hoeg Altered Compliance and Residual Strain Precede Angiographically Detectable Early Atherosclerosis in Low-Density Lipoprotein Receptor Deficiency Arterioscler Thromb Vasc Biol, October 1, 1997; 17(10): 2209 - 2217. [Abstract] [Full Text]
|
|
|
|
|
|
M. Weis and W. von Scheidt Cardiac Allograft Vasculopathy : A Review Circulation, September 16, 1997; 96(6): 2069 - 2077. [Abstract] [Full Text]
|
|
|
|
|
|
A. A. Voors, M. Oosterga, H. Buikema, J. F. May, J. G. Grandjean, A. van Buiten, and W. H. van Gilst Dyslipidemia and endothelium-dependent relaxation in internal mammary arteries used for coronary bypass surgery Cardiovasc Res, June 1, 1997; 34(3): 568 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Yokoyama, T. Ohtake, S.-i. Momomura, J. Nishikawa, Y. Sasaki, and M. Omata Reduced Coronary Flow Reserve in Hypercholesterolemic Patients Without Overt Coronary Stenosis Circulation, December 15, 1996; 94(12): 3232 - 3238. [Abstract] [Full Text]
|
|
|
|
|
|
R. Marchioli, R. M. Marfisi, F. Carinci, and G. Tognoni Meta-analysis, Clinical Trials, and Transferability of Research Results Into Practice: The Case of Cholesterol-Lowering Interventions in the Secondary Prevention of Coronary Heart Disease Arch Intern Med, June 10, 1996; 156(11): 1158 - 1172. [Abstract] [PDF]
|
|
|
|
|
|
W. J. Paulus, P. J. Vantrimpont, and A. M. Shah Paracrine Coronary Endothelial Control of Left Ventricular Function in Humans Circulation, October 15, 1995; 92(8): 2119 - 2126. [Abstract] [Full Text]
|
|
|
|
|
|
K. Shinozaki, M. Suzuki, M. Ikebuchi, H. Takaki, Y. Hara, M. Tsushima, and Y. Harano Insulin Resistance Associated With Compensatory Hyperinsulinemia as an Independent Risk Factor for Vasospastic Angina Circulation, October 1, 1995; 92(7): 1749 - 1757. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. J. Anderson, I. T. Meredith, A. C. Yeung, B. Frei, A. P. Selwyn, and P. Ganz The Effect of Cholesterol-Lowering and Antioxidant Therapy on Endothelium-Dependent Coronary Vasomotion N. Engl. J. Med., February 23, 1995; 332(8): 488 - 493. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Windecker, Y. Allemann, M. Billinger, T. Pohl, D. Hutter, T. Orsucci, L. Blaga, B. Meier, and C. Seiler Effect of endurance training on coronary artery size and function in healthy men: an invasive followup study Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2216 - H2223. [Abstract] [Full Text] [PDF]
|
|