Skip to main content

Ultrasound Assessment of Endothelial Vasomotor Function

  • Chapter
Diagnostics of Vascular Diseases

Abstract

The normal vascular endothelium regulates vasomotor tone, fibrinolysis, thrombosis, platelet adhesion, intimal growth, and leukocyte recruitment to the vascular wall. Disturbances of these endothelial functions have been suggested to be important mechanisms in both the pathogenesis and the clinical expression of coronary atherosclerosis. Among the many regulatory functions of the endothelium, release of nitric oxide, a potent vasodilator and platelet-inhibitor, has been the focus of a large number of studies. Over the past decade, nitric oxide-dependent vasodilation has emerged as a readily measurable and clinically relevant marker of more generalized endothelial function in patients. Studies of nitric oxide action have been performed in the coronary and peripheral circulations and have examined both conduit arteries and the microcirculation using a variety of invasive techniques. However, the requirement for intra-arterial infusion of nitric oxide-dependent agonists in such studies has placed limits on the number of subjects that can be studied and the number of studies that can be performed in each individual.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Furchgott RF, Zawadzki JV (1980). The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 288: 373–376

    Article  PubMed  CAS  Google Scholar 

  2. Ignarro LJ, Buga GM, Wood KS, Byrns RE, Chaudhuri G (1987) Endothelium-derived relaxing factor produced and released from artery and vein is nitric oxide. Proc Natl Acad Sci USA 84: 9265–9269

    Article  PubMed  CAS  Google Scholar 

  3. Stamler JS, Singel DJ, Loscalzo J (1992) Biochemistry of nitric oxide and its redox-activated forms. Science 258: 1898–1902

    Article  PubMed  CAS  Google Scholar 

  4. Palmer RM, Ashton DS, Moncada S (1988) Vascular endothelial cells synthesize nitric oxide from 1-arginine. Nature 333: 664–666

    Article  PubMed  CAS  Google Scholar 

  5. Ignarro LJ, Burke TM, Wood KS, Wolin MS, Kadowitz PJ (1984) Association between cyclic GMP accumulation and acetylcholine-elicited relaxation of bovine intrapulmonary artery. J Pharmacol Exp Ther 228: 682–690

    PubMed  CAS  Google Scholar 

  6. Furchgott R (1983) Role of endothelium in responses of vascular smooth muscle. Circ Res 35: 557–573

    Google Scholar 

  7. Rubanyi GM, Romero JC, Vanhoutte PM (1986) Flow- induced release of endothelium-derived relaxing factor. Am J Physiol 250: H1145–H1149

    PubMed  CAS  Google Scholar 

  8. Olesen SP, Clapham DE, Davies PF (1988) Haemodynamic shear stress activates a K+ current in vascular endothelial cells. Nature 331: 168–170

    Article  PubMed  CAS  Google Scholar 

  9. Cooke JP, Rossitch E Jr, Andon NA, Loscalzo J, Dzau VJ (1991) Flow activates an endothelial potassium channel to release endogenous nitrovasodilator. J Clin Invest 88: 1663–1671

    Article  PubMed  CAS  Google Scholar 

  10. Oates JA, Fitzgerald GA, Branch RA, Jackson EK, Knapp HR, Roberts LJ (1988) Clincal implications of prostaglandin and thromboxane A2 formation. N Engl J Med 319: 689–698

    Article  PubMed  CAS  Google Scholar 

  11. Frangos JA, Erskin SG, Chintire LV, Ives CL (1984) Flow effects on prostacyclin production by cultured human endothelial cells. Science 227: 1477–1479

    Article  Google Scholar 

  12. Ludmer PL, Selwyn AP, Shook TL, Wayne RR, Mudge GH, Alexander RW, Ganz P (1986) Paradoxical vasoconstriction induced by acetylcholine in atherosclerotic coronary arteries. N Engl J Med 315: 1046–1051

    Article  PubMed  CAS  Google Scholar 

  13. Vita JA, Treasure CB, Nabel EG, McLenachan JM, Fish RD, Yeung AC, Vekshtein VI, Selwyn AP, Ganz P (1990) Coronary vasomotor response to acetylcholine relates to risk factors for coronary artery disease. Circulation 81: 491–497

    Article  PubMed  CAS  Google Scholar 

  14. Creager MA, Cooke JP, Mendelsohn ME, Gallagher SJ, Coleman SM, Loscalzo J, Dzau VJ (1990) Impaired vasodilation of forearm resistance vessels in hypercholesterolemic humans. J Clin Invest 86: 228–234

    Article  PubMed  CAS  Google Scholar 

  15. Nitenberg A, Valersi P, Sachs R, Dali M, Aptecar E, Attali JR (1993) Impairment of coronary vascular reserve in and ACH-induced coronary vasodilation in diabetic patients with angiographically normal coronary arteries and normal left ventricular systolic function. Diabetes 42: 1017–1025

    Article  PubMed  CAS  Google Scholar 

  16. Johnstone MT, Creager SJ, Scales KM; Cusco JA, Lee BK, Creager MA (1993) Impaired endothelium-dependent vasodilation in patients with insulin-dependent diabetes mellitus. Circulation 88: 2510–2516

    PubMed  CAS  Google Scholar 

  17. Treasure CB, Manoukian SV, Klein JL, Vita JA, Nabel EG, Renwick GH, Selwyn AP, Alexander RW, Ganz P (1992) Epicardial coronary artery responses to acetylcholine are impaired in hypertensive patients. Circ Res 71: 776–781

    PubMed  CAS  Google Scholar 

  18. Panza JA, Quyyumi A A, Brush JE, Epstein SE (1990) Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med 323: 22–27

    Article  PubMed  CAS  Google Scholar 

  19. Nitenberg A, Antony I, Foult JM (1993) Acetylcholine- induced coronary vasoconstriction in young, heavy smokers with normal coronary arteriographic findings. Am J Med 95: 71–77

    Article  PubMed  CAS  Google Scholar 

  20. Yeung AC, Vekshtein VI, Krantz DS, Vita JA, Ryan TJ Jr, Ganz P, Selwyn AP (1991) The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress. N Engl J Med 325: 1551–1556

    Article  PubMed  CAS  Google Scholar 

  21. Okumura K, Yasue H, Matsuyama K, Ogawa H, Morikami Y, Obata K, Sakaino N (1992) Effect of acetylcholine on the highly stenotic coronary artery: difference between the constrictor response of the infarct-related coronary artery and that of the noninfarct-related artery. J Am Coll Cardiol 19: 752–758

    Article  PubMed  CAS  Google Scholar 

  22. Bogaty P, Hackett D, Davies G, Maseri A (1994) Vaso reactivity of the culprit lesion in unstable angina. Circulation 90: 5–11

    PubMed  CAS  Google Scholar 

  23. Leung WH, Lau CP, Wong CK (1993) Beneficial effect of cholesterol-lowering therapy on coronary endothelium-dependent relaxation in hypercholesterolemic patients. Lancet 341: 1496–1500

    Article  PubMed  CAS  Google Scholar 

  24. Treasure CB, Klein JL, Weintraub WS, Talley JD, Stillabower ME, Kosinski AS, Zhang J, Boccuzzi SJ, Cedarholm JC, Alexander RW (1995) Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients with coronary artery disease. N Engl J Med 332: 481–487

    Article  PubMed  CAS  Google Scholar 

  25. Anderson TJ, Meredith IT, Yeung AC, Frei B, Selwyn A, Ganz P (1995) The effect of cholesterol lowering and antioxidant therapy on endothelium-dependent coronary vasomotion. N Engl J Med 332: 488–493

    Article  PubMed  CAS  Google Scholar 

  26. Levine GN, Keaney JF Jr, Vita JA (1995) Cholesterol reduction in cardiovascular disease: clinical benefits and possible mechanisms. N Engl J Med 332: 512–521

    Article  PubMed  CAS  Google Scholar 

  27. Vita JA, Keaney JF Jr, Loscalzo J (1996) Endothelial dysfunction in vascular disease. In: Loscalzo J, Creager MA, Dzau V (eds) Vascular medicine, 2nd edn. Little Brown, Boston, pp 245–263

    Google Scholar 

  28. Laurent S, Brunei P, Lacolley P, Billaud E, Annier B, Safar M (1988) Flow-dependent vasodilation of the brachial artery in essential hypertension: preliminary report. J Hypertens 6: S182–S184

    CAS  Google Scholar 

  29. Laurent S, Lacolley P, Brunei P, Laloux B, Pannier B, Safar M (1990) Flow-dependent vasodilation of brachial artery in essential hypertension. Am J Physiol 258: H1004–H1011

    PubMed  CAS  Google Scholar 

  30. Safar ME, Peronneau PA, Levenson JA, Toto-Moukouo JA, Simon AC (1981) Pulsed Doppler: diameter, blood flow velocity and volumic flow of the brachial artery in sustained essential hypertension. Circulation 63: 393–400

    Article  PubMed  CAS  Google Scholar 

  31. Anderson EA, Mark AL (1989) Flow-mediated and re-flex changes in large peripheral artery tone in humans. Circualtion 79: 93–100

    Article  CAS  Google Scholar 

  32. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE (1992) Noninvasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 340: 1111–1115

    Article  PubMed  CAS  Google Scholar 

  33. Celermajer DS, Sorensen K, Ryalls M, Robinson J, Thomas O, Leonard RB, Deanfield JE (1993) Impaired endothelial function occurs in the systemic arteries of children with homozygous homocystinuria but not in their heterozygous parents. J Am Coll Cardiol 22: 854–858

    Article  PubMed  CAS  Google Scholar 

  34. Sorensen KE, Celermajer DS, Georgakopoulos D, Hatcher G, Betteridge DJ, Deanfield JE (1994) Impairment of endothelium-dependent dilation is an early event in children with familial hypercholesterolemia and is related to the lipoprotein (a) level. J Clin Invest 93: 50–55

    Article  PubMed  CAS  Google Scholar 

  35. Celermajer DS, Sorensen KE, Georgakopoulos D, Bull C, Thomas O, Robinson J, Deanfield J (1993) Cigarette smoking is associated with dose-related and potentially reversible impairment of endothelium-dependent dilation in healthy young adults. Circulation 88: 2149–2155

    PubMed  CAS  Google Scholar 

  36. Celermajer DS, Sorensen KE, Spiegelhalter DJ, Georgakopoulos D, Robinson J, Deanfield JE (1994) Aging is associated with endothelial dysfunction in healthy men years before the age-related decline in women. J Am Coll Cardiol 24: 471–476

    Article  PubMed  CAS  Google Scholar 

  37. Sorensen KE, Celermajer DS, Spiegelhalter DS, Georgakopoulos D, Robinson J, Thomas O, Deanfield JE (1995) Noninvasive measurement of endothelium dependent arterial responses in man: accuracy and reproducibility. Br Heart J 74: 247–253

    Article  PubMed  CAS  Google Scholar 

  38. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE (1994) Endothelium-dependent dilation in the systemic arteries of asymptomatic subject relates to coronary risk factors and their interaction. J Am Coll Cardiol 24: 1468–1474

    Article  PubMed  CAS  Google Scholar 

  39. Celermajer DS, Adams MR, Clarkson P, Robinson J, McCredie R, Donald A, Deanfield JE (1996) Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults. N Engl J Med 334: 150–154

    Article  PubMed  CAS  Google Scholar 

  40. Uehata A, Lieberman EH, Meredith I, Anderson T, Polak J, Ganz P, Selwyn A, Creager M, Yeung A (1992) Noninvasive assessment of flow-mediated vasodilation in brachial arteries: diminished response in young males compared to females. Circulation 86: 1–620

    Google Scholar 

  41. Uehata A, Gerhard MD, Meredith IT, Lieberman EL, Selwyn AP, Creager M, Polak J, Ganz P, Yeung AC, Anderson TJ (1993) Close relationship of endothelial dysfunction in coronary and brachial artery. Circulation 88: 1–618

    Google Scholar 

  42. Lieberman EH, Uehata A, Polak J, Ganz P, Selwyn AP, Creager MA, Yeung AC (1993) Flow-mediated vasodilation is impaired in the brachial artery of patients with coronary disease or diabetes mellitus ( Abstr. ). Clin Res 41: 217A

    Google Scholar 

  43. Gerhard MD, Roddy M-A, Creager SJ, Creager MA (1993) Aging reduces endothelium-dependent vasodilation in humans ( Abstr. ). Circulation 88: 1–369

    Google Scholar 

  44. Lieberman EH, Knab ST, Creager MA (1994) Nitric oxide mediates the vasodilator response to flow in humans. Circulation 90: 1–138

    Google Scholar 

  45. Lieberman EH, Gerhard MD, Uehata A, Walsh BW, Selwyn AP, Ganz P, Yeung AC, Creager MA (1994) Estrogen improves endothelium-dependent, flow mediated vasodilation in post menopausal women. Ann Intern Med 121: 936–941

    PubMed  CAS  Google Scholar 

  46. Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D, Leiberman EH, Ganz P, Creager MA, Yeung AC, Selwyn AP (1995) Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 26: 1235–1241

    Article  PubMed  CAS  Google Scholar 

  47. Corretti MC, Plotnick GD, Vogel RA (1995) Technical aspects of evaluating brachial artery endothelium-dependent vasodilatation using high frequency ultrasound. Am J Physiol 268: H1397–H1404

    PubMed  CAS  Google Scholar 

  48. Levine GN, Frei B, Koulouris SN, Gerhard MD, Keaney JF Jr, Vita JA (1996) Absorbic acid reverses endothelial vasomotor dysfunction in patients with coronary artery disease. Circulation 96: 1107–1113

    Google Scholar 

  49. Kool MJF, Hoeks APG, Struyker Boudier HAJ, Reneman RS, Van Bortel LMAB (1994) Short- and longterm effects of smoking on arterial wall properties in habitual smokers. J Am Coll Cardiol 22: 1881–1886

    Article  Google Scholar 

  50. Corretti MC, Plotnick GD, Vogel RA (1995) Correlation of cold pressor and flow-mediated brachial artery diameter responses with the presence of coronary artery disease. Am J Cardiol 75: 783–787

    Article  PubMed  CAS  Google Scholar 

  51. Joannides R, Haefeli WE, Linder L, Richard V, Bakkali EH, Thuillez C, Luscher TF (1995) Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation 91: 1314–1319

    PubMed  CAS  Google Scholar 

  52. Hornig B, Maier V, Drexler H (1996) Physical training improves endothelial function in patients with chronic heart failure. Circulation 93: 210–214

    PubMed  CAS  Google Scholar 

  53. Tagawa T, Imaizumi T, Endo T, Shiramoto M, Harasawa Y, Takeshita A (1994) Role of nitric oxide in reactive hyperemia in human forearm vessels. Circulation 90: 2285–2290

    PubMed  CAS  Google Scholar 

  54. Pallares LCM, Deane CR, Baudouin SV, Evans TW (1993) Strain gauge plethysmography and Doppler ultrasound in the measurement of limb blood flow. Eur J Clin Invest 24: 279–286

    Article  Google Scholar 

  55. Lipsitz LA, Bui M, Stiebeling M, McArdle C (1991) Forearm blood flow response to posture change in the very old: non-invasive measurement by venous occlusion plethysmography. J Am Geriatr Soc 39: 53–59

    PubMed  CAS  Google Scholar 

  56. Gilligan DM, Panza JA, Kilcoyne CM, Waclawiw MA, Casino PR, Quyyumi AA (1994) Contribution of endothelium-derived nitric oxide to exercise-induced vasodilation. Circulation 90: 2853–2858

    PubMed  CAS  Google Scholar 

  57. Meredith IT, Yeung AC, Weidinger FF, Anderson TJ, Uehata A, Ryan TJ Jr, Selwyn AP, Ganz P (1993) Role of impaired endothelium-dependent vasodilation in ischemic manifestations of coronary artery disease. Circulation 87: V56–V66

    Google Scholar 

  58. Dodge JT, Brown BG, Bolson EL, Dodge T (1992) Lu-men diameter of normal human coronary arteries; influence of age sex anatomic variation, and left ventricular hypertrophy or dilation. Circulation 86: 232–246

    PubMed  Google Scholar 

  59. Vogel RA, Corretti M, Plotnick GD (1995) Changes in flow-mediated brachial artery vasoactivity with lowering of desirable cholesterol levels in healthy, middle- aged men. Am J Cardiol 77: 37–140

    Article  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Vita, J.A., Keaney, J.F. (1997). Ultrasound Assessment of Endothelial Vasomotor Function. In: Lanzer, P., Lipton, M. (eds) Diagnostics of Vascular Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60512-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-60512-3_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64437-5

  • Online ISBN: 978-3-642-60512-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics