Global endothelial function assessment using pulse wave analysis in hypercholesterolemia

Ibrahim, Nik Nor Izah Nik; Rahman, Razlina Abdul; Azlan, Maryam; Rasool, Aida Hanum Ghulam

doi:10.1590/s2175-97902022e191010

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Brazilian Journal of Pharmaceutical Sciences

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Article • Braz. J. Pharm. Sci. 58 • 2022 • https://doi.org/10.1590/s2175-97902022e191010 copy

Global endothelial function assessment using pulse wave analysis in hypercholesterolemia

Authorship SCIMAGO INSTITUTIONS RANKINGS

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.

Keywords:
Endothelial function; Endothelium dependent vasodilatation; Endothelium independent vasodilatation; Augmentation index; SphygmoCor

	Hypercholesterolaemia (n=46)	Control (n=46)	P value
Male/female, n/n	18/28	16/30	0.67^b
Age, y	48.02±8.72	45.57±7.01	0.14^a
BMI, kg/m²	26.40±3.94	26.50±5.00	0.92^a
LDL, mmol/l	4.74±0.65	3.30±0.50	<0.001^a
Cholesterol, mmol/l	7.00±0.76	5.39±0.56	<0.001^a
Peripheral SBP, mmHg	125.28±15.34	120.60±13.36	0.11^a
Peripheral DBP, mmHg	76.17±11.13	74.57±9.96	0.86^a
Central SBP, mmHg	106.53±15.96	102.99±10.75	0.16^a
Central DBP, mmHg	90.49±12.18	89.19±10.23	0.59^a
AIx, %	27.28±7.23	26.78±8.52	0.76^a
EDV, %	2.97±3.95	6.65±3.80	<0.001^a
EIV, %	13.41±4.57	15.88±4.78	0.01^a
EDV:EIV ratio	0.21±0.30	0.44±0.24	<0.001^a
Smoking, n	3	7	0.18^b
Hypertension, n	6	2	0.04^b
Diabetes mellitus, n	3	1	0.31^b

	Hypercholesterolemia (n=46)	Normal (n=46)	Mean difference (95% CI)	P value
EDV:EIV ratio	^a 0.21 (0.30)	^a0.44 (0.24)	0.24 (0.09,0.39)	<0.001^b
	-0.06 (-0.34,0.22)	0.38 (0.16,0.60)	0.44 (0.06,0.82)^c	<0.001^d

Universidade de São Paulo, Faculdade de Ciências Farmacêuticas Av. Prof. Lineu Prestes, n. 580, 05508-000 S. Paulo/SP Brasil, Tel.: (55 11) 3091-3824 - São Paulo - SP - Brazil
E-mail: bjps@usp.br

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[1] *Correspondence: Nik Nor Izah Nik Ibrahim. Department of Pharmacology. School of Medical Sciences. Universiti Sains Malaysia. 16150 Kubang Kerian. Kelantan, Malaysia. ORCID ID: https://orcid.org/0000-0002-9817-1574. Phone: 609-767 6141. Fax: 609-765 3370. E-mail: izah@usm.my.