Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects.
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Blood Vessels↗
Biomedical subjects
Malte Kelm
Publications and source records attributed to Malte Kelm.
Indexes of NO bioavailability in human blood.
Disturbances of nitric oxide (NO) bioavailability may play a key role in vascular dysfunction and in the development of atherosclerotic lesions. Thus assessment of a reduced NO bioavailability in human circulation is of particular interest. Here we summarize potential biomarkers of NO availability in human blood and critically discuss their respective significance and application fields.
Arteriosclerosis↗
Evidence for in vivo transport of bioactive nitric oxide in human plasma.
Although hitherto considered as a strictly locally acting vasodilator, results from recent clinical studies with inhaled nitric oxide (NO) indicate that NO can exert effects beyond the pulmonary circulation. We therefore sought to investigate potential remote vascular effects of intra-arterially applied aqueous NO solution and to identify the mechanisms involved. On bolus application of NO into the brachial artery of 32 healthy volunteers, both diameter of the downstream radial artery and forearm blood flow increased in a dose-dependent manner. Maximum dilator responses were comparable to those after stimulation of endogenous NO formation with acetylcholine and bradykinin. Response kinetics and pattern of NO decomposition suggested that despite the presence of hemoglobin-containing erythrocytes, a significant portion of NO was transported in its unbound form. Infusion of NO (36 micromol/min) into the brachial artery increased levels of plasma nitroso species, nitrite, and nitrate in the draining antecubital vein (by < 2-fold, 30-fold, and 4-fold, respectively), indicative of oxidative and nitrosative chemistry. Infused N-oxides were inactive as vasodilators whereas S-nitrosoglutathione dilated conduit and resistance arteries. Our results suggest that NO can be transported in bioactive form for significant distances along the vascular bed. Both free NO and plasma nitroso species contribute to the dilation of the downstream vasculature.
Arteries↗
The L-arginine nitric oxide pathway: avenue for a multiple-level approach to assess vascular function.
Endothelial dysfunction is an early stage of atherosclerosis and has been attributed to impaired nitric oxide (NO) bioactivity and enhanced formation of oxygen-derived free radicals. Given that endothelial dysfunction is at least in part reversible, the assessment of altered NO availability is of important diagnostic and prognostic significance. Identification of such alterations may help to target asymptomatic individuals who are at risk for cardiovascular diseases and would likely benefit from preventive measures. Focusing on a single signaling pathway, we present here a multi-level approach for the early diagnosis of cardiovascular diseases by assessing molecular, biochemical, structural, and functional changes in the vascular wall.
Animals↗