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Non-invasive ultrasound detection of endothelial dysfunction
O Y Atkov1, T V Balahonova, O A Pogorelova
1Cardiology Research Complex of Ministry of Health of the Russian Federation, Moscow, Russia.
Insights
High-resolution ultrasound reveals endothelial dysfunction in familial hypercholesterolemia, a key risk factor for atherosclerosis. This method effectively detects endothelial dysfunction and monitors hypolipidemic treatment effectiveness.
Area of Science:
- Vascular Biology
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Endothelial dysfunction is an early indicator of atherosclerosis.
- Assessing endothelial function is crucial for identifying cardiovascular disease risk.
- High-resolution ultrasound offers a non-invasive method to evaluate vascular health.
Purpose of the Study:
- To assess endothelial function in individuals at risk for atherosclerosis using high-resolution ultrasound.
- To compare endothelial function between patients with essential hypertension, familial hypercholesterolemia, and healthy controls.
- To evaluate the potential of ultrasound-derived endothelial function parameters as markers for hypolipidemic therapy.
Main Methods:
- Utilized a 7.0 MHz linear array transducer on an ACUSON 128XP/10 system.
- Measured brachial artery diameter at rest, during reactive hyperemia (endothelium-dependent), and after nitroglycerin administration (endothelium-independent).
- Studied three groups: essential hypertension (12), familial hypercholesterolemia (10), and controls (10).
Main Results:
- Flow-mediated dilation was significantly impaired in familial hypercholesterolemia (3.0%) compared to controls (9.5%) and essential hypertension (9.4%).
- Nitroglycerin-induced dilation was not impaired in familial hypercholesterolemia (16.6%) or essential hypertension (14.5%) versus controls (20.5%).
- Ultrasound demonstrated capability in detecting endothelial dysfunction.
Conclusions:
- Endothelial dysfunction is present in familial hypercholesterolemia and is a significant risk factor for atherosclerosis.
- High-resolution ultrasound is effective in identifying endothelial dysfunction.
- Endothelial function parameters can serve as biomarkers to monitor the impact of hypolipidemic treatments.
Abstract:
With high resolution ultrasound we assessed endothelial function in subjects at risk of atherosclerosis. We used ACUSON 128XP/10 system with 7.0 MHz linear array transducer. Three groups of patients (pts) were studied: 12 patients with essential hypertension, ten patients with 2A familial hyperholesterolamia and ten controls without vascular risk factors. We measured the diameter of brachial artery at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilation), and after sublingual 0.01 mg nitroglycerin (causing endothelium-independent dilation). Flow-mediated dilation is not impaired in essential hypertension (9. 4%) compared with controls (9.5%) and impaired in patients with familial hyperholesterolaemia (3.0%). NTG-induced dilation is not impaired in familial hyperholesterolaemia (16.6%) and essential hypertension (14.5%) compared with controls (20.5%). The effect of hypolipidaemic influence (probucol and plasmapheresis) was assessed in a separate study. These results demonstrate the capability of ultrasound in detection of endothelial dysfunction, and suggest that endothelial dysfunction in patients with familial hyperholesterolaemia is one of the risk factors for atherosclerosis. The parameters of endothelial function may be used as markers of hypolipidemic influence on patients with hyperholesterolaemia.