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Inflammatory status and endothelial function in asymptomatic and symptomatic peripheral arterial disease

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University ‘Federico II’, Naples, Italy, antoniosilvestro{at}libero.it

Francesco Scopacasa

Department of Laboratory Medicine, University ‘Federico II’, Naples, Italy

Aldo Ruocco

Department of Laboratory Medicine, University ‘Federico II’, Naples, Italy

Gabriella Oliva

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University ‘Federico II’, Naples, Italy

Vittorio Schiano

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University ‘Federico II’, Naples, Italy

Carmela Zincarelli

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University ‘Federico II’, Naples, Italy

Gregorio Brevetti

Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University ‘Federico II’, Naples, Italy

Peripheral arterial disease (PAD) is a predictor of cardiovascular risk. However, it is unknown whether PAD severity influences inflammatory status and endothelial function, which play a major role in atherosclerosis. Accordingly, we measured brachial artery flow-mediated dilation (FMD), and plasma levels of several inflammatory markers in 15 control subjects, and 19 asymptomatic and 19 symptomatic PAD patients. Each symptomatic patient was matched to an asymptomatic patient for age, sex, risk factors, presence of cardiovascular disease, and pharmacological treatments. Asymptomatic patients had similar inflammatory profiles as controls, but lower median FMD (11.7% vs 8.5%, p < 0.01). Compared with asymptomatic patients, symptomatic patients had higher median C-reactive protein (1.5mg=l vs 6.0 mg=l, p < 0.05) and interleukine-6 (1.5 pg=ml vs 3.5 pg=ml, p < 0.05), and lower FMD (8.5% vs 5.1%, p < 0.01). In the 38 PAD patients, the ankle=brachial pressure index correlated positively with FMD (p < 0.01), and negatively with C-reactive protein (p < 0.05), soluble intercellular adhesion molecule-1 (p < 0.05) and soluble vascular cell adhesion molecule-1 (p < 0.05). Thus, in PAD, endothelial function and inflammatory status are related to the severity of the circulatory impairment. This finding may contribute to the explanation of the increasingly poor prognosis with increased PAD severity.

Key Words: adhesion molecules • endothelial dysfunction • inflammation • peripheral arterial disease

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