The Anatolian Journal of Cardiology
Original Investigation

Impaired endothelium-dependent and endothelium independent systemic vasodilatory reserve in pulmonary hypertension regardless the clinical group: A generalized dysfunction beyond the pulmonary arteries?

1.

Department of Cardiology, University of Health Sciences, Hamidiye Faculty of Medicine, Koşuyolu Yüksek İhtisas Training and Research Hospital; İstanbul-Turkey

2.

University Health Science, Kartal Koşuyolu Heart and Research Hospital, Department of Cardiology, İstanbul, Turkey

3.

Department of Cardiology, Koşuyolu High Specialization Training and Research Hospital; İstanbul-Turkey

4.

Department of Cardiology, Bingöl State Hospital; Bingöl-Turkey

5.

Department of Cardiology, University of Health Sciences, Koşuyolu Heart Training and Research Hospital; İstanbul-Turkey

6.

Department of Cardiology, Hisar Intercontinental Hospital; İstanbul-Turkey

Anatol J Cardiol 2021; 25: 733-740
DOI: 10.5152/AnatolJCardiol.2021.474
Read: 237 Downloads: 121 Published: 01 October 2021

Objective: Endothelium-dependent (ED) and endothelium-independent (EI) flow-mediated vasodilatation (FMD) have been used as measures of systemic arterial vasodilatory reserve. In this study, we aimed to assess both ED-FMD and EI-FMD in different groups with pulmonary hypertension (PH), and to investigate the relationship of these measures with clinical, echocardiographic, and invasive parameters of diseases severity and targeted treatment status.

Methods: Our study population comprised 41 patients with PH [28 (68.2%) women, age 46.3±19.6 years] including idiopathic pulmonary arterial hypertension, Eisenmenger syndrome, and chronic thromboembolic PH in whom diagnosis were confirmed in accordance with current guidelines and 17 age and sex-matched healthy controls. The brachial artery (BA) was used for assessment of FMD with Duplex ultrasound, and serial changes in diameter were recorded at baseline, 1, and 3 minutes after termination of 2-minute external occlusive compression for ED-FMD, and after sublingual intake of glycerol trinitrate for EI-FMD, respectively.

Results: Compared with controls, overall the PH group showed significantly lower ED-FMD (0.65±0.21 vs. 0.30±0.23 and 0.65±0.18 vs. 0.24±0.21) and EI-FMD (0.67±0.15 vs. 0.37±0.25 and 0.75±0.20 vs. 0.32±0.24) responses at 1st and 3rd min (p0.05).

Conclusion: Our results suggest an impaired BA vasodilatory reserve in patients with PH regardless of the clinical subgroup. Although these findings seem to be consistent with systemic dysfunction, acute FMD may not reflect the severity of PH and cannot be used as a potential surrogate for outcome in this setting.

Cite this article as: Demirel M, Külahçıoğlu Ş, Tokgöz HC, Akbal ÖY, Hakgör A, Karagöz A, et al. Impaired endothelium-dependent and endothelium-independent systemic vasodilatory reserve in pulmonary hypertension regardless the clinical group: A generalized dysfunction beyond the pulmonary arteries? Anatol J Cardiol 2021; 25: 733-40

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ISSN 2149-2263 EISSN 2149-2271