Abstract
The functional changes of endothelium can be detected by ultrasound (US) parameter flow-mediated vasodilation (FMD). The carotid intima-media thickness (IMT) reflects the structural changes of arterial wall. The combination of previous mentioned methods with the inflammatory markers may provide more complex information concerning the changes of arterial wall as every method allows alone. Significantly reduced, FMD has been found in subjects with coronary artery disease (CAD) compared to the control group (C group) (CAD group: 96.47 ± 13.4%, C group: 108.27 ± 7.1%). Endothelium-independent vasodilation (EID) was also significantly reduced. Mean diameters of the brachial artery at rest, the common carotid artery (CCA) and the internal carotid artery (ICA) were significantly larger in subjects with CAD. The mean carotid IMT of the near and the far wall was significantly higher. There were observed elevated levels of soluble receptor RI of tumor necrosis factor-a (sTNF-RI) in these subjects, too. A significant has been found correlation between soluble receptor RII of tumor necrosis factor-α (sTNF-RII) and carotid IMT of the near wall, and the slight correlation between sTNF-RI and the diameter of brachial artery at rest. According to the multivariate analysis, a relationship was determined between sTNF-RII, diameter of CCA and carotid IMT of the near wall. Conclusions: We have found significant reduced FMD and activation of sTNF-RI in patients with CAD in mild stage of CHF. The relationships between mean diameter of CCA, carotid IMT of the near wall and sTNF-RII may be explained via the arterial remodeling.
Keywords: Endothelial dysfunction, flow-mediated vasodilation, carotid intima-media thickness, soluble receptors RI and RII of tumor necrosis factor-alpha, arterial remodeling