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Published on: November 3, 2016
Impact of catheterization on shear-mediated arterial dilation in healthy young men
Andrea Tryfonos1, Matthew Cocks1, Debar Rasoul2
1Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, L3 3AF, UK.
Insights
Catheterization impairs artery function in healthy young men, reducing shear-mediated dilation. This suggests the procedure itself, not just pre-existing conditions, can negatively impact vascular health.
Area of Science:
- Cardiovascular Physiology
- Endothelial Function Research
- Medical Device Impact Studies
Background:
- Animal studies indicate endothelial denudation eliminates shear stress-mediated vasodilation.
- Coronary artery disease (CAD) patients show reduced, but not abolished, shear-mediated dilation post-catheterization.
- Prior endothelial function in CAD patients remains a confounding factor for catheterization effects.
Purpose of the Study:
- To investigate shear-mediated dilation in healthy young men following catheterization.
- To determine if catheterization impairs endothelial function in individuals without pre-existing vascular disease.
- To assess the impact of transradial catheterization on radial artery vasodilation.
Main Methods:
- Twenty-six healthy males (mean age 24.4 years) underwent unilateral transradial catheterization.
- Flow-mediated dilation (FMD) was measured in both radial arteries before and 7 days after catheterization.
- Vascular parameters including baseline and peak diameters during FMD were analyzed.
Main Results:
- FMD significantly decreased in the catheterized arm (9.3% to 4.3%, P < 0.001) 7 days post-procedure.
- No significant change in FMD was observed in the control arm (8.4% to 7.3%, P = 0.168).
- Complete abolition of FMD occurred in five participants in the catheterized arm; baseline and peak diameters increased.
Conclusions:
- This is the first study demonstrating impaired shear-mediated dilation in healthy young individuals post-catheterization.
- Results suggest that catheterization itself can impair artery function, independent of pre-existing endothelial dysfunction.
- Combined with prior findings in CAD patients, the data indicate catheterization negatively impacts human artery function.
Purpose:
Animal studies have shown that endothelial denudation abolishes vasodilation in response to increased shear stress. Interestingly, shear-mediated dilation has been reported to be reduced, but not abolished, in coronary artery disease (CAD) patients following catheterization. However, it is not known whether this resulted from a priori endothelial dysfunction in this diseased population. In this study, we evaluated shear-mediated dilation following catheterization in healthy young men.
Methods:
Twenty-six (age: 24.4 ± 3.8 years, BMI: 24.3 ± 2.8 kg m-2, VO2peak: 50.5 ± 8.8 ml/kg/min) healthy males underwent unilateral transradial catheterization. Shear-mediated dilation of both radial arteries was measured using flow-mediated dilation (FMD) pre-, and 7 days post-catheterization.
Results:
FMD was reduced in the catheterized arm [9.3 ± 4.1% to 4.3 ± 4.1% (P < 0.001)] post-catheterization, whereas no change was observed in the control arm [8.4 ± 3.8% to 7.3 ± 3.8% (P = 0.168)]. FMD was completely abolished in the catheterized arm in five participants. Baseline diameter (P = 0.001) and peak diameter during FMD (P = 0.035) were increased in the catheterized arm 7 days post-catheterization (baseline: 2.3 ± 0.3 to 2.6 ± 0.2 mm, P < 0.001, peak: 2.5 ± 0.3 to 2.7 ± 0.3 mm, P = 0.001), with no change in the control arm (baseline: 2.3 ± 0.3 to 2.3 ± 0.3 mm, P = 0.288, peak: 2.5 ± 0.3 to 2.5 ± 0.3 mm, P = 0.608).
Conclusion:
This is the first study in young healthy individuals with intact a priori endothelial function to provide evidence of impaired shear-mediated dilation following catheterization. When combined with earlier studies in CAD patients, our data suggest the catheterization impairs artery function in humans.
