The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease
Impaired endothelial function has been shown to limit exercise in coronary artery disease (CAD) patients and has been implicated in myocardial ischemia. However, the association of endothelial function and ischemia on peak exercise oxygen consumption (VO2) has not been previously reported. A total o...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | International Journal of Vascular Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/274381 |
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| author | Simon L. Bacon Andrew Sherwood Alan Hinderliter Annik Plourde Lee Pierson James A. Blumenthal |
| author_facet | Simon L. Bacon Andrew Sherwood Alan Hinderliter Annik Plourde Lee Pierson James A. Blumenthal |
| author_sort | Simon L. Bacon |
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| description | Impaired endothelial function has been shown to limit exercise in coronary artery disease (CAD) patients and has been implicated in myocardial ischemia. However, the association of endothelial function and ischemia on peak exercise oxygen consumption (VO2) has not been previously reported. A total of 116 CAD patients underwent standard exercise stress testing, during which VO2 was measured. On a separate day, endothelial-dependent and -independent function were assessed by ultrasound using flow-mediated arterial vasodilation (FMD) and sublingual glyceryl trinitrate administration (GTNMD) of the brachial artery. Patients with exercise-induced myocardial ischemia had lower FMD than nonischemic patients (3.64±0.57 versus 4.98±0.36, P=.050), but there was no difference in GTNMD (14.11±0.99 versus 15.47±0.63, P=.249). Analyses revealed that both FMD (P=.006) and GTNMD (P=.019) were related to peak VO2. However, neither the presence of ischemia (P=.860) nor the interaction of ischemia with FMD (P=.382) and GTNMD (P=.151) was related to peak VO2. These data suggest that poor endothelial function, potentially via impaired NO production and smooth muscle dysfunction, may be an important determinant of exercise capacity in patients with CAD, independent of myocardial ischemia. |
| format | Article |
| id | doaj-art-14b495a0eb8d4ffcbb0edd469aa8d238 |
| institution | Kabale University |
| issn | 2090-2824 2090-2832 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | International Journal of Vascular Medicine |
| spelling | doaj-art-14b495a0eb8d4ffcbb0edd469aa8d2382025-02-03T01:31:19ZengWileyInternational Journal of Vascular Medicine2090-28242090-28322012-01-01201210.1155/2012/274381274381The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery DiseaseSimon L. Bacon0Andrew Sherwood1Alan Hinderliter2Annik Plourde3Lee Pierson4James A. Blumenthal5Montreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, A University of Montreal Affiliated Hospital, Montréal, QC, H4J 1C5, CanadaDepartment of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC 27708, USADepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USAMontreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, A University of Montreal Affiliated Hospital, Montréal, QC, H4J 1C5, CanadaDepartment of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USADepartment of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC 27708, USAImpaired endothelial function has been shown to limit exercise in coronary artery disease (CAD) patients and has been implicated in myocardial ischemia. However, the association of endothelial function and ischemia on peak exercise oxygen consumption (VO2) has not been previously reported. A total of 116 CAD patients underwent standard exercise stress testing, during which VO2 was measured. On a separate day, endothelial-dependent and -independent function were assessed by ultrasound using flow-mediated arterial vasodilation (FMD) and sublingual glyceryl trinitrate administration (GTNMD) of the brachial artery. Patients with exercise-induced myocardial ischemia had lower FMD than nonischemic patients (3.64±0.57 versus 4.98±0.36, P=.050), but there was no difference in GTNMD (14.11±0.99 versus 15.47±0.63, P=.249). Analyses revealed that both FMD (P=.006) and GTNMD (P=.019) were related to peak VO2. However, neither the presence of ischemia (P=.860) nor the interaction of ischemia with FMD (P=.382) and GTNMD (P=.151) was related to peak VO2. These data suggest that poor endothelial function, potentially via impaired NO production and smooth muscle dysfunction, may be an important determinant of exercise capacity in patients with CAD, independent of myocardial ischemia.http://dx.doi.org/10.1155/2012/274381 |
| spellingShingle | Simon L. Bacon Andrew Sherwood Alan Hinderliter Annik Plourde Lee Pierson James A. Blumenthal The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease International Journal of Vascular Medicine |
| title | The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease |
| title_full | The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease |
| title_fullStr | The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease |
| title_full_unstemmed | The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease |
| title_short | The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease |
| title_sort | influence of endothelial function and myocardial ischemia on peak oxygen consumption in patients with coronary artery disease |
| url | http://dx.doi.org/10.1155/2012/274381 |
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