Endothelium-dependent and independent vasodilation in young males with previous myocardial infarction

INTRODUCTION: Flow-mediated vasodilatation of brachial arteries, a non-invasive parameter of endothelial function, is correlated with cardiovascular risk factors. An impairment of flow-mediated vasodilatation in the brachial artery is related to the extent of coronary artery disease. AIMS: The authors examined the relationship between flow-mediated vasodilatation and coronary artery disease morphology in young patients who had myocardial infarction. PATIENTS AND METHODS: 28 young patients (all men) with myocardial infarction (age 22-40, mean age: 35 years). Coronarography revealed one vessel disease in 16 patients (A group) and multivessel disease in 12 patients (B group). The control group was 14 healthy, young patients (age 18-36 years mean age: 30 years) (C group). The authors examined in all subjects flow-mediated, endothelium-dependent vasodilatation following reactive hyperaemia and nitroglycerin induced (NTG), endothelium-independent vasodilatation in the brachial artery with high resolution ultrasound (Acuson 128 X P/10). RESULTS: Patients after myocardial infarction showed impaired flow-mediated vasodilatation compared to those of controls. (p < 0.01). Flow-mediated vasodilatation was lower in multivessel disease compare to one vessel disease. Nitroglycerin induced similar degrees of vasodilatation in the myocardial infarction and control groups. CONCLUSION: Young patients with myocardial infarction may have impaired endothelium-dependent dilatation and the decrease of flow-mediated vasodilatation is related to the angiographic extent of coronary artery disease.