10 research outputs found
DIFFERENTIAL EFFECTS OF AMBULATORY ISOLATED SYSTOLIC AND ISOLATED DIASTOLIC HYPERTENSION IN CARDIAC ADAPTATIONS IN THE EARLY STAGES OF HYPERTENSION
OBESITY AS A DETERMINANT OF LEFT ATRIAL SIZE IN THE EARLY STAGES OF HYPERTENSION. THE CRUCIAL ROLE OF WAIST CIRCUMFERENCE
OBESITY AS A DETERMINANT OF LEFT ATRIAL SIZE IN THE EARLY STAGES OF HYPERTENSION. THE CRUCIAL ROLE OF WAIST CIRCUMFERENCE
DIFFERENTIAL EFFECTS OF AMBULATORY ISOLATED SYSTOLIC AND ISOLATED DIASTOLIC HYPERTENSION IN CARDIAC ADAPTATIONS IN THE EARLY STAGES OF HYPERTENSION
WAIST CIRCUMFERENCE VERSUS OTHER OBESITY INDICES FOR PREDICTION OF CORONARY ARTERY DISEASE IN ESSENTIAL HYPERTENSION
WAIST CIRCUMFERENCE VERSUS OTHER OBESITY INDICES FOR PREDICTION OF CORONARY ARTERY DISEASE IN ESSENTIAL HYPERTENSION
THE ADVERSE EFFECTS OF NOCTURNAL HYPERTENSION ON ARTERIAL STIFFNESS AND URINARY ALBUMIN EXCRETION IN HYPERTENSION
Long-term endothelial dysfunction after trans-radial catheterization: A meta-analytic approach
Background: Following cardiac catheterization using radial artery (RA)
access, persistent endothelial dysfunction may limit the use of RA as a
conduit during coronary artery bypass graft (CABG) surgery. We reviewed
published literature to investigate the effects of transradial coronary
catheterization on RA endothelial function.
Methods: We searched PubMed from inception to April 2017 for published
studies assessing RA endothelial function late (>= 1 month) after
coronary catheterization. A total of 12 eligible published studies (n =
490 patients) were included in the final quantitative synthesis.
Statistical heterogeneity among studies was assessed by the I-2. A
random effects model was used to calculate the pooled estimate for
standardized mean difference (SMD). Meta-regression analysis was used to
explore predictors of change in RA endothelial function following
catheterization.
Results: In all studies, a significant reduction in endothelium
dependent response was observed post-catheterization (SMD = -0.53, 95%
confidence interval [CI]: -0.93 to -0.13, P = 0.01) and a marginal,
non-significant, reduction in endothelium independent response (SMD =
-0.38, 95%CI: -0.77, 0.01, P < 0.059). In controlled studies, using the
contralateral RA as a control, a significant impairment in endothelial
function was confirmed (SMD = -6.26, 95%CI: -9.71 to -2.81, P <
0.0001), while the change in endothelium-independent response was not
significant (SMD = -4.46, 95%CI: -13.3 to 4.37, P = 0.32). In
meta-regression analysis male gender (z = 2.36, P = 0.018) and
increasing time following catheterization (z = 2.62, P = 0.009) were
associated with less RA endothelial dysfunction.
Conclusions: Transradial catheterization impairs endothelium dependent
vasodilatory properties of the cannulated RA, which do not recover even
several months post-catheterization. Non-recovery of vasomotor function
of cannulated RAs may limit their use as arterial grafts during CABG
surgery