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Advanced peripheral microvascular endothelial dysfunction and polyvascular disease in patients with high

Hirofumi Maeda1, Seigo Sugiyama2, Hideaki Jinnouchi3

  • 1Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan; Maeda Clinic of Internal Medicine, Kumamoto, Japan.

Journal of Cardiology
|September 8, 2015
PubMed

Insights

Microvascular endothelial dysfunction is linked to polyvascular disease (PolyVD), a condition involving multiple arterial diseases. Impaired peripheral microvascular function may be a key factor in PolyVD development.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Endothelial Function Research

Background:

  • Polyvascular disease (PolyVD) signifies coexisting coronary artery disease (CAD), peripheral arterial disease (PAD), and/or cerebrovascular disease (CVD), posing a high risk for cardiovascular mortality.
  • Endothelial dysfunction is a critical element in cardiovascular pathophysiology.
  • This study explores the connection between PolyVD and microvascular endothelial dysfunction.

Purpose of the Study:

  • To investigate the association between polyvascular disease (PolyVD) and microvascular endothelial dysfunction.
  • To determine if impaired peripheral microvascular function is a component of PolyVD.

Main Methods:

  • 533 stable patients with diabetes and/or cardiovascular risk factors were analyzed.
  • Peripheral microvascular endothelial function was assessed using the reactive hyperemia peripheral arterial tonometry index (RHI).
  • PolyVD was defined by the presence of two or more vascular diseases (CAD, PAD, CVD).

Main Results:

  • Patients with PolyVD exhibited significantly lower logarithmic RHI (Ln-RHI) values compared to those without PolyVD or with a single vascular disease (p<0.001).
  • Ln-RHI showed an independent correlation with the presence of PolyVD (OR: 0.724, p<0.001).
  • Receiver-operating characteristic analysis confirmed Ln-RHI's significant correlation with PolyVD (AUC=0.682, p<0.001), with an optimal cut-off of 0.479.

Conclusions:

  • A significant association exists between microvascular endothelial dysfunction and the presence of PolyVD.
  • Impaired endothelial function in the peripheral microvasculature appears to be a crucial pathophysiological factor in PolyVD.
Abstract

Keywords:
ArteriosclerosisEndothelial functionPeripheral arterial diseasePolyvascular diseaseRisk

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