Assessment of Endothelial Function by Means of Flow-Mediated Changes Using Pulse Wave Velocity

Eduardo J. Rusak, MD; Claudio A. Bellido, MD; Oscar R. Iavicoli, MD;Sonia T. Vazquez, MD; Mariano Duarte, MD; Jorge Lerman, MDEndothelial dysfunction is a leading cause ofearly development of cardiovascular diseases.Endothelial function can be assessed using ultra-sound methods to watch the arterial flow-medi-ated dilation. It is also possible to find changes inpulse wave velocity (PWV) after induced ischemiarelated to the vessel diameter changes. Pre- andpost-induced ischemia carotid-radial PWV wasrecorded in 226 hypertensive patients (150women [63.5 12.4 years old] and 76 men[63.2 11.8 years old] and 55 healthy patients(38 women [63.1 12.6 years old] and 17 men[54.8 12.8 years old]). The authors considerednormal endothelial function a PWV reduction of5% from baseline. To assess nondependent endo-thelial dilation the authors performed carotid-radial PWV after sublingual administration of5 mg of isosorbide dinitrate in a group ofpatients with abnormal flow-mediated dilation.A significant PWV reduction of 9.8% in normalpatients and only 1.2% among hypertensivepatients (P<.0005) was found. After sublingualisosorbide dinitrate intake the authors observed agreater fall in PWV (14%) than that observed inhealthy people after induced ischemia. Carotid-radial PWV after induced ischemia decreased sig-nificantly in normal participants. No significantchanges were observed in hypertensive patients.These results may offer a reliable tool to assessendothelial function in medium-size arteries.J Clin Hypertens (Greenwich). 2010;12:495–501.