Abstract
Background and hypothesis: Brachial artery flow‐mediated dilation (FMD), a noninvasive, widely used clinical index of endothelial function and magnitude of FMD, has been reported to be closely related to many coronary risk factors and coronary atherosclerosis. However, there has been no study that examines the diurnal change of FMD. We designed this study to reveal the diurnal variation of FMD in healthy volunteers.
Methods: We examined FMD in response to reactive hyperemia by high resolution ultrasound in 13 healthy young men (age 25–32) at four different times over the course of a day.
Results: Mean measures of brachial artery FMD was 4.0% at 8:00, 5.3% at 12:00, 9.7% at 17:00, and 6.9% at 21:00 hours. Flow‐mediated dilation at 8:00 and at 12:00 hours was significantly lower than that at 17:00 (p <0.05).
Conclusions: These results show that endothelial function has diurnal variation and is significantly attenuated in the morning. Morning attenuation of endothelial function should be recognized in clinical research and may play an important role in the circadian variation of the occurrence of acute cardiovascular events.
Keywords: endothelial function, diurnal variation, brachial artery
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References
- 1. Ridker PM, Manson JE, Buring JE, Muller JE, Hennekens CH: Circadian variation of acute myocardial infarction and the effect of low‐dose aspirin in a randomized trial of physicians. Circulation 1990; 82: 897–902 [DOI] [PubMed] [Google Scholar]
- 2. Rosing DR, Brakman P, Redwood DR, Goldstein RE, Beiser GD, Astrup T, Epstein SE: Blood fibrinolytic activity in man. Circ Res 1970; 27: 171–184 [DOI] [PubMed] [Google Scholar]
- 3. Willich SN, Linderer T, Wegscheider K, Leizorovicz A, Alamercery I, Schroder R, and the ISAM study group : Increased morning incidence of myocardial infarction in the ISAM study: Absence with prior beta adrenergic blockade. Circulation 1989; 80: 853–858 [DOI] [PubMed] [Google Scholar]
- 4. Linsell CR, Lightman SL, Mullen PE, Brown MJ, Causon RC: Circadian rhythms of epinephrine and norepinephrine in man. J Clin Endocrinol Metab 1985; 60: 1210–1215 [DOI] [PubMed] [Google Scholar]
- 5. Gimbrone MA Jr: Vascular endothelium: An integrator of pathophysiologic stimuli in atherosclerosis. Am J Cardiol 1995; 75: 67B–70B [DOI] [PubMed] [Google Scholar]
- 6. Zeiher AM, Drexler H, Wollschlager H, Just H: Modulation of coronary vasomotor tone in humans. Circulation 1991; 83: 391–401 [DOI] [PubMed] [Google Scholar]
- 7. Levine GN, Frei B, Koulouris SN, Gerhard MD, Keaney JF, Vita JA: Ascorbic acid reverses endothelial vasomotor dysfunction in patients with coronary artery disease. Circulation 1996; 93: 1107–1113 [DOI] [PubMed] [Google Scholar]
- 8. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JE: Non‐invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340: 1111–1115. [DOI] [PubMed] [Google Scholar]
- 9. Corretti MC, Plotnick GD, Vogel RA: Technical aspects of evaluating brachial artery vasodilation using high‐frequency ultrasound. Am J Physiol 1995; 268: H1397–1404 [DOI] [PubMed] [Google Scholar]
- 10. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE: Endothelium‐dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 1994; 24: 1468–1474 [DOI] [PubMed] [Google Scholar]
- 11. Adams MR, Forsyth CJ, Jessup W, Robinson J, Celermajer DS: Oral L‐arginine inhibits platelet aggregation but does not enhance endothelium‐dependent dilation in healthy young men. J Am Coll Cardiol 1995; 26: 1054–1061 [DOI] [PubMed] [Google Scholar]
- 12. Celermajer DS, Adams MR, Clarkson P, Robinson J, McCredie R, Donald A, Deanfield JE: Passive smoking and impaired endothelium‐dependent arterial dilatation in healthy young adults. N Engl J Med 1996; 334: 150–154 [DOI] [PubMed] [Google Scholar]
- 13. Lieberman EH, Gerhard MD, Uehata A, Walsh BW, Selwyn AP, Ganz P, Yeung AC, Creager MA: Estrogen improves endothelium‐dependent, flow‐mediated vasodilation in postmenopausal women. Ann Intern Med 1994; 121: 936–941 [DOI] [PubMed] [Google Scholar]
- 14. Uehata A, Lieberman EH, Gerhard MD, Anderson TJ, Ganz P, Polak JF, Creager MA, Yeung AC: Noninvasive assessment of endothelium‐dependent flow‐mediated dilation of the brachial artery. Vascular Med 1997; 2: 87–92 [DOI] [PubMed] [Google Scholar]
- 15. Celermajer DS, Sorensen KE, Georgakopoulos D, Bull C, Thomas O, Robinson J, Deanfield JE: Cigarette smoking is associated with dose‐related and potentially reversible impairment of endothelium‐dependent dilation in healthy young adults. Circulation 1993; 88: 2149–2155 [DOI] [PubMed] [Google Scholar]
- 16. Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D, Lieberman EH, Ganz P, Creager MA, Yeung AC, Selwyn AP: Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26: 1235–1241 [DOI] [PubMed] [Google Scholar]
- 17. Quyyumi AA, Panza JA, Diodati JG, Lakatos E, Epstein SE: Circadian variation in ischemic threshold: A mechanism underlying the circadian variation in ischemic events. Circulation 1992; 86: 22–28 [DOI] [PubMed] [Google Scholar]
- 18. Anderson TJ, Gerhard MD, Meredith IT, Charbonneau F, Delagrange D, Creager MA, Selwyn AP, Ganz P: Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol 1995; 75: 71B–74B [DOI] [PubMed] [Google Scholar]
- 19. Panza JA, Epstein SE, Quyyumi AA: Circadian variation in vascular tone and its relation to α‐sympathetic vasoconstrictor activity. N Engl J Med 1991; 325: 986–990 [DOI] [PubMed] [Google Scholar]
- 20. Sinzinger H, Rauscha F, O'Grady J, Fitscha P: Prostaglandin I2 and the nitric oxide donor molsidomine have synergistic effects on thromboresistance in man. Br J Clin Pharmacol 1992; 33: 289–292 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21. Salomaa V, Riley W, Kark JD, Nardo C, Folsom AR: Non‐insulin‐dependent diabetes mellitus and fasting glucose and insulin concentrations are associated with arterial stiffness indexes. The ARIC study. Circulation 1995; 91: 1432–1443 [DOI] [PubMed] [Google Scholar]
