Abstract 11137: Nitroglycerine-Induced Vasodilation Was Significantly Smaller in Peripheral Artery Diesase-Patients With Critical Limb Ischemia Compared With Those Without
Introduction: Nitroglycerine-induced vasodilation is usually used as a control test for flow-mediated vasodilation (FMD). However, nitroglycerine-induced vasodilation per se has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationship between nitroglycerine-induced vasodilation and the clinical severity of peripheral artery disease (PAD).
Methods: We measured nitroglycerine-induced vasodilation and FMD in 144 subjects (mean age: 63.8±15.1 years), including 32 PAD patients with critical limb ischemia (CLI group), 28 PAD patients without CLI (non-CLI group), 60 age- and sex-matched patients without established cardiovascular disease (at-risk group), and 24 healthy subjects (healthy group).
Results: Nitroglycerine-induced vasodilation was significantly impaired in the CLI group compared to that in the other three groups (healthy group, 16.0±5.3%; at-risk group, 12.9±3.8%; non-CLI group, 10.3±5.1%; CLI group, 6.7±3.9%; P<0.05, respectively). Even after multivariate adjustment, the differences remained significant. On the other hand, FMD was significantly impaired in the at-risk, non-CLI, and CLI group compared with that in the healthy group (healthy group, 7.1±2.9%; at-risk group, 3.4±2.3; non-CLI group, 3.5±2.7%; CLI group, 3.0±2.8%; P<0.001, respectively), but the differences among the at-risk, non-CLI, and CLI groups were not significant. Multivariate analysis revealed that nitroglycerine-induced vasodilation (odds ratio: 0.77, 95% confidence interval [CI]: 0.61-0.97) and diabetes mellitus (odds ratio: 8.75, 95% CI: 1.74-44.2) were independent variables for CLI in PAD patients.
Conclusions: There was no significant difference in FMD between PAD patients with and those without CLI, but nitroglycerine-induced vasodilation was significantly smaller in PAD patients with CLI compared with those without CLI. We should distinguish PAD patients with CLI as being different from those without CLI from the point of view of vascular function. Pronounced abnormality of vascular function in PAD patients with CLI might be associated with more increased risk of cardiovascular events and poorer prognosis compared with those in PAD patients without CLI.
Author Disclosures: T. Maruhashi: None. Y. Higashi: None. A. Nakashima: None. T. Matsumoto: None. N. Oda: None. Y. Iwamoto: None. A. Iwamoto: None. M. Kajikawa: None. K. Noma: None. Y. Kihara: None.
- © 2014 by American Heart Association, Inc.