Global endothelial function assessment using pulse wave analysis in hypercholesterolemia
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Date
7/14/2022
Authors
Nik Ibrahim, Nik Nor izah
Abdul Rahman, Razlina
Azlan, Maryam
Ghulam Rasool, Aida Hanum
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Abstract
To compare global endothelial function assessed by pulse wave analysis (PWA) using the ratio of endothelium dependent vasodilatation (EDV) to endothelium independent vasodilatation (EIV) in patients with hypercholesterolemia and controls. 92 subjects [46 hypercholesterolemics, 46 controls] were studied at standardized conditions. Baseline augmentation index (AIx) was assessed followed by the administration of 0.5 mg sublingual nitroglycerine, an endothelium independent vasodilator. AIx was assessed and the maximum change in AIx after nitroglycerine was recorded as EIV. After a washout period of 30 minutes, 400 µg of inhaled salbutamol, an endothelium dependent vasodilator was administered. AIx was assessed again and the maximum change in AIx after salbutamol was recorded as EDV. Global endothelial function was calculated as EDV:EIV ratio. EDV and EIV in patients with hypercholesterolemia compared to controls were 2.97 ± 3.95 and 6.65 ± 3.80 (p<0.001); and 13.41 ± 4.57 and 15.88 ± 4.78 (p=0.01) respectively. EDV:EIV ratio was significantly reduced in patients with hypercholesterolemia compared to controls; 0.21 ± 0.38 and 0.44 ± 0.24 (p<0.001) respectively. EDV:EIV ratio was significantly reduced in patients with hypercholesterolemia compared to controls. PWA is a potential clinical tool to assess global endothelial function in patients with hypercholesterolemia.
Description
This was a cross-sectional study involving 46 patients with hypercholesterolemia aged ≥35 years with LDL cholesterol ≥4.1 mmol/l being compared against 46 volunteers with normal LDL cholesterol. Source populations were the patients attending outpatient clinic during the study period. The study protocol was approved by the Human Research Ethics Committee of Universiti Sains Malaysia (USM) and all subjects gave written informed consent according to the Declaration of Helsinki.
Pregnant subjects and subjects who were already on statins or any treatment with vasoactive medications such as ACE inhibitors and Angiotensin Receptor Blockers were excluded from the study. Before endothelial function assessment, baseline heart rate and blood pressure (BP) (Omron, England), AIx, and central arterial pressure (CAP) (PWV Limited, Australia) were assessed.
Keywords
Endothelial function,