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Flow-mediated dilation.

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Beth A Parker, David N Proctor. 2005. Flow-mediated dilation.. https://doi.org/10.1152/japplphysiol.00864.2005

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Relationship between changes in brachial artery flow-mediated dilation and basal release of nitric oxide in subjects with Type 2 diabetes.

Assessment of flow-mediated dilation (FMD) after forearm ischemia is widely used as a noninvasive bioassay of stimulated nitric oxide (NO)-mediated conduit artery vasodilator function in vivo. Whether this stimulated endothelial NO function reflects basal endothelial NO function is unknown. To test this hypothesis, retrospective analysis of randomized crossover studies was undertaken in 17 subjects with Type 2 diabetes; 9 subjects undertook an exercise training or control period, whereas the remaining 8 subjects were administered an angiotensin II receptor blocker or placebo. FMD was assessed by using wall tracking of high-resolution brachial artery ultrasound images in response to reactive hyperemia. Resistance vessel basal endothelium-dependent NO function was assessed by using intrabrachial administration of NG-monomethyl-L-arginine (L-NMMA) and plethysmographic assessment of forearm blood flow (FBF). FMD was higher after intervention compared with control/placebo (6.15+/-0.53 vs. 3.81+/-0.72%, P<0.001). There were no significant changes in the FBF responses to L-NMMA. Regression analysis between FMD and L-NMMA responses at entry to the study revealed an insignificant correlation (r=-0.10, P=0.7), and improvements in FMD with the interventions were not associated with changes in the L-NMMA responses (r=-0.04, P=0.9). We conclude that conduit artery-stimulated endothelial NO function (FMD) does not reflect basal resistance vessel endothelial NO function in subjects with Type 2 diabetes.

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Exercise training improves low-density lipoprotein oxidability in untrained subjects with coronary artery disease.

UNLABELLED: Exercise training improves low-density lipoprotein oxidability in untrained subjects with coronary artery disease. OBJECTIVE: To test the hypothesis that regular exercise alters low-density lipoprotein (LDL) oxidability in patients with coronary artery disease. DESIGN: Longitudinal study. SETTING: General hospital and community. PARTICIPANTS: Thirteen patients. INTERVENTIONS: Training program comprising running bouts twice weekly over 2 months. MAIN OUTCOME MEASURES: Plasma lipid profile, oxidized LDL, and rate (Ox(rate)) and amount (Ox(amount)) of LDL reaction products were measured at baseline and after 2 months of training. Brachial artery endothelium-dependent and -independent vasodilation was assessed by use of ultrasound. RESULTS: Lipid profile and oxidized LDL remained unchanged, but mean Ox(rate) and Ox(amount) +/- standard deviation were reduced from 2.5+/-1.5nmol.mgLDL(-1).min(-1) and 120.3+/-75.3nmol/mgLDL at baseline to 0.4+/-0.2nmol.mgLDL(-1).min(-1) and 21.3+/-11.4nmol/mgLDL after training (P<.05), respectively. Brachial artery vasodilation was suggested to be improved, but statistical significance was not reached in the small cohort under study. CONCLUSIONS: Aerobic training enhances the resistance of LDL to oxidation in patients with coronary artery disease, which may play a role in the favorable effects of exercise.

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Is reversal of endothelial dysfunction by tea related to flavonoid metabolism?

Dietary flavonoids can improve endothelial function, but the response varies between individuals. Wide variability is also seen in flavonoid O-methylation, a major pathway of flavonoid metabolism. The O-methylation of flavonoids could alter activity, and thus influence any effect on endothelial function. The objective of the current analysis was to investigate whether variability in the endothelial function response to ingestion of tea, a rich source of flavonoids, is related to the degree of O-methylation of flavonoids. This relationship was investigated in two studies in which endothelium-dependent flow-mediated dilatation (FMD) of the brachial artery was assessed and urinary 4-O-methylgallic acid (4OMGA) excretion was used as a marker of the O-methylation of tea-derived flavonoids. In the first study, amongst participants consuming five cups of tea per day for 4 weeks, the degree of increase in 4OMGA excretion was inversely associated with the change in FMD responses (r -078, P=0.008). In the second study, there was a significant difference in the FMD responses to acute ingestion of three cups of tea between individuals with a low ( median) 4OMGA response (1.94 (sem 0.79) % and -0.25 (sem 0.53) %, respectively; P=0.03). That is, any improvement in FMD following ingestion of tea may be enhanced in individuals who O-methylate less of the absorbed flavonoids. The present results are consistent with the suggestion that differences in flavonoid metabolism may influence their effect on endothelial function. Thus, differences in flavonoid metabolism could be related to the level of benefit of dietary flavonoids on the risk of CVD.

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