Abstract 11254: Flow-Mediated Vasodilation Is Augmented in Corkscrew Collaterals in Patients with Thromboangitis Obliterans (Buerger's Disease)
Background: Endothelial dysfunction is the initial step in the pathogenesis of atherosclerosis, resulting in cardiovascular outcomes. It is clinically important to assess endothelial function. Recently, we have shown that development of large corkscrew collateral arteries reduces the prevalence of ischemic ulcers. The purpose of this study was to evaluate flow-mediated vasodilation (FMD), an index of endothelial function, of corkscrew artery in Buerger's disease.
Methods and Results: We measured leg arterial diameter in response to reactive hyperemia (FMD, cuff inflated to 50 mmHg above systolic blood pressure for 5 min) using ultrasonography, an automated edge tracking system, in 30 patients with Buerger's disease and 30 age-matched healthy subjects. There were no significant differences in clinical parameters, including baseline leg artery diameter, between patients with Buerger's disease and healthy control subjects. Reactive hyperemic flow, change in reactive hyperemic flow, and FMD were smaller in corkscrew arteries in patients with Buerger's diseaase than in control arteries in healthy subjects (98±90 vs. 164±108 mL/min, increase: 80±82% vs. 377±348%, FMD: 5.8±3.2% vs. 8.0±3.2%, P<0.05, respectively). However, the ratio of FMD to hyperemic flow was significantly greater in corkscrew arteries than in arteries in healthy subjects (3.6±2.2% vs. 2.1±1.2%, P<0.05). In addition, the ratio of FMD to hyperemic flow was significantly greater in corkscrew arteries than in natural arteries (3.6±2.6% vs. 2.0±1.6%, P<0.05) in the same patients (n=9). Nitroglycerin-induced vasodilation was similar in all leg arteries.
Conclusions: These findings suggest that endothelial function of corkscrew collateral artery in Buerger's disease is augmented. Augmentation of endothelial function in corkscrew collaterals may have various beneficial effects, including reduction in the prevalence of ischemic ulcers.
- © 2011 by American Heart Association, Inc.