Relation of inflammation to vascular function in patients with coronary heart disease

Endothelium plays a pivotal role in the regulation of vascular relaxation. Inflammation may in turn induce endothelial dysfunction and thus increase t he risk of atherothrombosis. We investigated 31 men with angiographically v erified coronary heart disease, aged 57.7 +/- 5.3 years, in regard to endot helium-dependent, acetylcholine-induced, and to endothelium-independent, so dium nitroprusside-induced vasodilatation in the forearm vasculature by str ain-gauge plethysmography. Logistic regression analysis served to determine the relation between forearm vascular function and the inflammatory factor s measured, concentration of C-reactive protein, subtypes of peripheral blo od T-lymphocytes, and other factors potentially affecting endothelial funct ion (lipoprotein and glucose levels). Concentration of C-reactive protein w as an independent determinant of endothelium-dependent vascular function (P < 0.001 for low dose acetylcholine, P = 0.01 for high dose acetylcholine). Other determinants of endothelium-dependent vascular dysfunction were CD8- lymphocytes expressing ICAM-1 (P=0.001), antibodies to oxidized low-density lipoprotein (P < 0.001), and body weight (P = 0.007). The present data sho wed an association between inflammatory risk factors linked to atherothromb osis and endothelial dysfunction in coronary heart disease patients. It is possible that endothelial dysfunction in coronary heart disease patients is related to the chronic inflammation or infection coexisting with atheroscl erosis. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.