Comprehensive assessment of impaired peripheral and coronary artery endothelial functions in smokers using brachial artery ultrasound and oxygen-15-labeled water PET

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• 作者：Noriki Ochi ; MSc^a ; Keiichiro Yoshinaga ; MD ; PhD ; FACC ; FJCC^b ; ^c ; ^{kyoshi@nirs.go.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoichi M. Ito ; PhD^d ; Yuuki Tomiyama ; MSc^b ; Mamiko Inoue ; LT^a ; Mutsumi Nishida ; PhD^a ; Osamu Manabe ; MD ; PhD^b ; Hitoshi Shibuya ; PhD^a ; Chikara Shimizu ; MD ; PhD^a ; Eriko Suzuki ; LT^b ; Satoshi Fujii ; MD ; PhD ; FACC ; FJCC^e ; Chietsugu Katoh ; MD ; PhD^f ; Nagara Tamaki ; MD ; PhD ; FJCC^b
• 关键词：Endothelium ; Positron emission tomography ; Smoking ; Ultrasound ; Vascular
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：68
• 期：4
• 页码：316-323
• 全文大小：1145 K

文摘

Comprehensive evaluation of endothelium-dependent and endothelium-independent vascular functions in peripheral arteries and coronary arteries in smokers has never been performed previously. Through the use of brachial artery ultrasound and oxygen-15-labeled water positron emission tomography (PET), we sought to investigate peripheral and coronary vascular dysfunctions in smokers.

Methods and results

Eight smokers and 10 healthy individuals underwent brachial artery ultrasound at rest, during reactive hyperemia [250 mmHg cuff occlusion (flow-mediated dilatation (FMD)], and following sublingual nitroglycerin (NTG) administration. Myocardial blood flow (MBF) was assessed through O-15-labeled water PET at rest, during adenosine triphosphate (ATP) administration, and during a cold pressor test (CPT). Through ultrasound, smokers were shown to have significantly reduced %FMD compared to controls (6.62 ± 2.28% vs. 11.29 ± 2.75%, p = 0.0014). As assessed by O-15-labeled water PET, smokers were shown to have a significantly lower CPT response than were controls (21.1 ± 9.5% vs. 50.9 ± 16.9%, p = 0.0004). There was no relationship between %FMD and CPT response (r = 0.40, p = 0.097). Endothelium-independent vascular dilatation was similar for both groups in terms of coronary flow reserve with PET (p = 0.19). Smokers tended to have lower %NTG in the brachial artery (p = 0.055).

Conclusions

Smokers exhibited impaired coronary endothelial function as well as peripheral brachial artery endothelial function. In addition, there was no correlation between PET and ultrasound measurements, possibly implying that while smokers may have systemic vascular endothelial dysfunction, the characteristics of that dysfunction may be different in peripheral arteries and coronary arteries.