Endothelial dysfunction associated with left ventricular diastolic dysfunction in patients with coronary heart disease

Objective: We sought to assess the correlation between endothelial vasodila tion and left ventricular diastolic function. Background: Previous studies have demonstrated that similar neurohumoral factors are involved in myocard ial and vascular endothelial impairment. The degree of endothelial dysfunct ion is related to the clinical severity of the heart failure. However, it i s not clear whether endothelial dysfunction develops with the progression o f left ventricular diastolic dysfunction. We hypothesize that the endotheli al dysfunction is associated with left ventricular diastolic dysfunction. M ethods: Using high-resolution ultrasound, we measured the dilator response of the brachial artery to hyperemia (endothelium-dependent vasodilation) an d to 0.5 mg nitroglycerin (endothelium-independent vasodilation), and measu red peak velocities of the early wave (Evmax) and the atrial wave (Avmax) i n 40 coronary heart disease (CHD) patients and 20 normal subjects, We analy zed the relationship between the Evmax/Avmax ratio and endothelium-dependen t vasodilation. Results: The results showed that endothelium-dependent and endothelium-independent vasodilation as well as the Evmax/Avmax ratio were lower in the CHD group than those in the control group (4.29%+/-1.42%, 17.5 8%+/-2.99%, 0.81+/-0.24 vs. 9.62%+/-2.34%, 24.18%+/-3.15%, 1.07+/-0.29, res pectively, P<0.01). The Evmax/Avmax ratio was related to endothelium-depend ent vasodilation (r=0.45, P<0.01). Conclusions: Our results showed that the development of endothelial dysfunction was associated with the progression of myocardial diastolic dysfunction, which suggests that the same mechanis ms may be involved in the impairment of endothelium and myocardium, (C) 200 0 Elsevier Science Ireland Ltd. All rights reserved.