Relación entre el estrés de fricción endotelial y la vasodilatación mediada por flujo en primigestantes saludables

Información del artículo

La vasodilatación mediada por flujo (VMF) es una medida fisiológica que permite estimar de manera no invasiva la función endotelial. De igual forma, se la asocia con algunos factores de riesgo cardiovascular y con eventos cardiovasculares.

El objetivo de este estudio es presentar la primera exploración de la normalización de los datos de la VMF durante la gestación y examinar la relación del estrés de fricción endotelial (EFE) y la normalización de la vasodilatación mediada por flujo (nVMF) en esta población. Se encontró una relación entre la VMF y la nVMF (R2=0,782, p<0,05), pero no entre la VMF y el EFE (R2=0,782, p>0,05), ni entre el EFE y la nVMF (R2=0,013, p>0,05). Futuras investigaciones, cuidadosamente diseñadas, podrían estudiar esta propuesta en diferentes poblaciones. Los autores sugieren que la VMF y la nVMF, alguna vez podrán ser consideradas como herramientas con aplicabilidad clínica para estimar el riesgo cardiovascular.

Palabras clave:

embarazo

función endotelial

estrés de fricción

Flow-mediated vasodilation (FMV) is a physiological measure to non-invasively estimate endothelial function. Similarly, it is associated with some cardiovascular risk factors and cardiovascular events.

The aim of this study is to present the first exploration of the standardization of FMV data during pregnancy and examine the relationship of endothelial friction stress (EFE) and the normalization of flow-mediated vasodilation (nMFV) in this population. A relationship between VMF and nVMF (R2 = 0.782, p <0.05) was found, but not between the VMF and the EFE (R2 = 0.782, p> 0.05) or between the EFE and nVMF (R2 = 0.013, p> 0.05). Future research, carefully designed, could examine this proposal in different populations. We suggest that MFV and nMFV, may ever be seen as tools with clinical applications to estimate cardiovascular risk.

Keywords:

pregnancy

endothelial function

shear stress

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Bibliografía

[1.]

D.S. Celermajer, K.E. Sorensen, V.M. Gooch, D.J. Spiegelhalter, O.I. Miller, I.D. Sullivan, et al.

Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.

Lancet, 340 (1992), pp. 1111-1115

Medline

[2.]

J.A. Vita, J.F. Keaney Jr..

Endothelial function: a barometer for cardiovascular risk?.

Circulation, 106 (2002), pp. 640-642

Medline

[3.]

A.R. Patel, J.T. Kuvin, K.A. Sliney, W.M. Rand, J.C. Chiang, J.E. Udelson, et al.

Genderbased differences in brachial artery flow-mediated vasodilation as an indicator of significant coronary artery disease.

Am J Cardiol, 96 (2005),

[4.]

G. Chequer, B.R. Nascimento, T.P. Navarro, E.B. Falqueto, M.C.N. Alencar, M.C.R. Miranda, et al.

Espessamento médio-intimal da carótida e função endotelial na doença arterial coronariana.

Arq Bras Cardiol, 87 (2006), pp. 84-90

Medline

[5.]

M.C. Corretti, T.J. Anderson, E.J. Benjamin, D. Celermajer, F. Charbonneau, M.A. Creager, et al.

Guidelines for the ultrasound assessment of endothelial-dependent flowmediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force.

J Am Coll Cardiol, 39 (2002), pp. 257-265

Medline

[6.]

J. Yeboah, J.R. Crouse, F.C. Hsu, G.L. Burke, D.M. Herrington.

Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the Cardiovascular Health Study.

Circulation, 115 (2007), pp. 2390-2397

http://dx.doi.org/10.1161/CIRCULATIONAHA.106.678276 | Medline

[7.]

D. Shimbo, C. Grahame-Clarke, Y. Miyake, C. Rodriguez, R. Sciacca, T.M. Di, et al.

The association between endothelial dysfunction and cardiovascular outcomes in a population-based multi-ethnic cohort.

Atherosclerosis, 192 (2007), pp. 197-203

http://dx.doi.org/10.1016/j.atherosclerosis.2006.05.005 | Medline

[8.]

J. Padilla, B.D. Johnson, S.C. Newcomer, D.P. Wilhite, T.D. Mickleborough, A.D. Fly, et al.

Normalization of flow-mediated dilation to shear stress area under the curve eliminates the impact of variable hyperemic stimulus.

Cardiovasc Ultrasound, 6 (2008), pp. 44

http://dx.doi.org/10.1186/1476-7120-6-44 | Medline

[9.]

Y.S. Chatzizisis, A.U. Coskun, M. Jonas, E.R. Edelman, P.H. Stone, C.L. Feldman.

Risk stratification of individual coronary lesions using local endothelial shear stress: a new paradigm for managing coronary artery disease.

Curr Opin Cardiol, 22 (2007), pp. 552-564

http://dx.doi.org/10.1097/HCO.0b013e3282f07548 | Medline

[10.]

Y.S. Chatzizisis, A.U. Coskun, M. Jonas, E.R. Edelman, C.L. Feldman, P.H. Stone.

Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior.

J Am Coll Cardiol, 25 (2007), pp. 2379-2393

[11.]

M.S. Wolin, J.M. Rodenburg, E.J. Messina, G. Kaley.

Similarities in the pharmacological modulation of reactive hyperemia and vasodilation to hydrogen peroxide in rat skeletal muscle arterioles: effects of probes for endothelium-derived mediators.

J Pharmacol Exp Ther, 253 (1990), pp. 508-512

Medline

[12.]

K.E. Pyke, M.E. Tschakovsky.

Peak vs. total reactive hyperemia: which determines the magnitude of flow-mediated dilation?.

J Appl Physiol, 102 (2007), pp. 1510-1519

http://dx.doi.org/10.1152/japplphysiol.01024.2006 | Medline

[13.]

L. Lind, J. Hall.

Johansson K. Evaluation of four different methods to measure endothelium-dependent vasodilation in the human peripheral circulation.

Clin Sci, 102 (2002), pp. 561-567

Medline

[14.]

A.L. Huang, A.E. Silver, E. Shvenke, D.W. Schopfer, E. Jahangir, M.A. Titas, et al.

Predictive value of reactive hyperemia for cardiovascular events in patients with peripheral arterial disease undergoing vascular surgery.

Arterioscler Thromb Vasc Biol, 27 (2007), pp. 2113-2119

http://dx.doi.org/10.1161/ATVBAHA.107.147322 | Medline

[15.]

K.E. Pyke, E.M. Dwyer, M.E. Tschakovsky.

Impact of controlling shear rate on flowmediated dilation responses in the brachial artery of humans.

J Appl Physiol, 97 (2004), pp. 499-508

http://dx.doi.org/10.1152/japplphysiol.01245.2003 | Medline

[16.]

P. López-Jaramillo, E. Terán, S. Moncada.

Calcium supplementation prevent pregnancy-induced hypertension by increasing the production of vascular nitric oxide.

Med Hypoth, 45 (1995), pp. 68-72

[17.]

P. López-Jaramillo, M. Narváez, A. Calle, J. Rivera, P. Jácome, C. Ruano, et al.

Cyclic guanosine 3’, 5’ monophosphate concentrations in preeclampsia: effects of hydralazine.

Br J Obstet Gynaecol, 103 (1996), pp. 33-38

Medline

[18.]

P. López-Jaramillo, W.D. Arenas, R.G. García, M.Y. Rincón, M. López.

The role of the L-arginine-nitric oxide pathway in preeclampsia.

Therap Adv Cardiovas Dis, 2 (2008), pp. 261-275

[19.]

E. Terán, C. Escudero, W. Moya, M. Flórez, P. Vallance, P. López-Jaramillo.

Elevated C-reactive protein and pro-inflammatory cytokines in andean women with preeclampsia.

Int J Gynaecol Obstet, 75 (2001), pp. 243-249

Medline

[20.]

M. Palm, O. Axelsson, L. Wernroth, S. Basu.

F(2)-isoprostanes, tocopherols and normal pregnancy.

Free Radic Res, 43 (2009), pp. 546-552

http://dx.doi.org/10.1080/10715760902902737 | Medline

[21.]

V. Toescu, S.L. Nuttall, U. Martin, M.J. Kendall, F. Dunne.

Oxidative stress and normal pregnancy.

Clin Endocrinol (Oxf), 7 (2002), pp. 609-613

[22.]

S.K. Walsh, F.A. English, E.J. Johns, L.C. Kenny.

Plasma-mediated vascular dysfunction in the reduced uterine perfusion pressure model of preeclampsia: a microvascular characterization.

Hypertension, 54 (2009), pp. 345-351

http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.132191 | Medline

[23.]

P. López-Jaramillo.

Prevention of preeclampsia with calcium supplementation and its relation with the L-arginine: nitric oxide pathway.

Braz J Med Biol Res, 29 (1996), pp. 731-743

Medline

[24.]

A.P. Cockell, L. Poston.

Flow-mediated vasodilatation is enhanced in normal pregnancy but reduced in preeclampsia.

Hypertension, 30 (1997), pp. 247-251

Medline

[25.]

G.A. Knock, A.L. McCarthy, C. Lowy, L. Poston.

Association of gestational diabetes with abnormal maternal vascular endothelial function.

Br J Obstet Gynaecol, 104 (1997), pp. 229-234

Medline

[26.]

[27.]

S. Silva, C. Villamizar, N. Villamizar, F. Silva, C. Luengas, J.P. Casas, et al.

Colombian study to assess the use of noninvasive determination of Endothelium-mediated vasodilation (CANDEV).

II. Does location of the occlusion device affects Diagnostic accuracy?. Endothelium, 12 (2005), pp. 107-111

[28.]

M. Juonala, J.S.A. Viikari, T. Laittinen, J. Marneimi, H. Helenius, T. Ronnemaa, et al.

Interrelations between branchial endothelial function and carotid intima-media thickness in young adults: The Cardiovascular Risk in Young Finns Study.

Circulation, 110 (2004), pp. 2918-2923

http://dx.doi.org/10.1161/01.CIR.0000147540.88559.00 | Medline

[29.]

G. Brevetti, A. Silvestro, V. Schiano, M. Chiariello.

Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive value of flowmediated dilation to ankle-brachial pressure index.

Circulation, 108 (2003), pp. 2093-2098

http://dx.doi.org/10.1161/01.CIR.0000095273.92468.D9 | Medline

[30.]

R.S. Reneman, T. Art, A.P.G. Hoeks.

Wall shear stress—an important determinant of endothelial cell function, and structure in the arterial system in vivo.

J Vasc Res, 43 (2006), pp. 251-269

http://dx.doi.org/10.1159/000091648 | Medline

[31.]

S. Soljanlahti, T. Autti, L. Hyttinen, A.F. Vuorio, P. Keto, K. Lauerman.

Compliance of the aorta in two diseases affecting vascular elasticity Familial hypercholesterolemia and diabetes: an MRI study.

Vas Health Risk Manag, 4 (2008), pp. 1103-1109

[32.]