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. 2023 Mar 27;12(7):2534.
doi: 10.3390/jcm12072534.

Endothelial Function Is Preserved in Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy

Yu Hashimoto  1 , Takayuki Yamaji  1 , Toshiro Kitagawa  1 , Yukiko Nakano  2 , Masato Kajikawa  2 , Kenichi Yoshimura  3 , Kazuaki Chayama  4 , Chikara Goto  5 , Syunsuke Tanigawa  6 , Aya Mizobuchi  6 , Takahiro Harada  6 , Farina Mohamad Yusoff  6 , Shinji Kishimoto  6 , Tatsuya Maruhashi  6 , Asuka Fujita  6   7 , Toshio Uchiki  6   7 , Ayumu Nakashima  8 , Yukihito Higashi  2   6
Affiliations

Endothelial Function Is Preserved in Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy

Yu Hashimoto et al. J Clin Med. .

Abstract

Heart failure (HF) is associated with endothelial dysfunction. Vascular function per se plays an important role in cardiac function, whether it is a cause or consequence. However, there is no information on vascular function in patients with wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). The purpose of this study was to evaluate vascular function in patients with ATTRwt-CM. We measured flow-mediated vasodilation (FMD) as an index of endothelial function and nitroglycerine-induced vasodilation (NID) as an index of vascular smooth muscle function and brachial artery intima-media thickness (bIMT) and brachial-ankle pulse wave velocity (baPWV) as indices of arterial stiffness in 22 patients with ATTRwt-CM and in 22 one-by-one matched control patients using vascular function confounding factors. FMD was significantly greater in patients with ATTRwt-CM than in the controls (5.4 ± 3.4% versus 3.5 ± 2.4%, p = 0.038) and the N-terminal pro-brain natriuretic peptide (NT-proBNP) level was significantly greater in patients with ATTRwt-CM than in the controls (2202 ± 1478 versus 470 ± 677 pg/mL, p < 0.001). There were no significant differences in NID, bIMT or baPWV between the two groups. There was a significant relationship between NT-proBNP and FMD in patients with ATTRwt-CM (r = 0.485, p = 0.022). NT-proBNP showed no significant relationships with NID, bIMT or baPWV. Conclusions: Endothelial function was preserved in patients with ATTRwt-CM. Patients with ATTRwt-CM may have compensatory effects with respect to endothelial function through elevation of BNP.

Keywords: N-terminal pro-brain natriuretic peptide; endothelial function; flow-mediated vasodilation; wild-type transthyretin amyloidosis cardiomyopathy.

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Conflict of interest statement

The authors declared that they do not have anything to disclose regarding conflicts of interest with respect to this manuscript.

Figures

Figure 1
Figure 1
Comparison of flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation (NID), brachial intima-media thickness (bIMT) and brachial-ankle pulse wave velocity (baPWV) between controls and wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM). Bar graphs show FMD (A) and NID (B), bIMT (C) and baPWV (D) in controls and patients with ATTRwt-CM.
Figure 2
Figure 2
Association between N-terminal pro-brain natriuretic peptide (NT-proBNP) and flow mediated vasodilation (FMD). Scatter plots show the relationship of NT-proBNP with FMD (A) and nitroglycerine-induced vasodilation (B), brachial intima-media thickness (C) and brachial-ankle pulse wave velocity (D) in patients with wild-type transthyretin amyloid cardiomyopathy.
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