OBJECTIVE

To assess the endothelial function in patients with benign and progressive course of peripheral arterial disease (PAD) of the lower extremities.

MATERIAL AND METHODS

The study involved 106 people who were divided into 3 groups. The first group (n=48) consisted of patients with a progressive course of PAD and critical limb ischemia (CLI) within 5 years. The second group (n=48) included patients with a benign course of PAD for a long time (over 5 years) without CLI. The control group (n=10) consisted of healthy volunteers of similar age without atherosclerosis. Endothelial function was assessed considering the level of nitric oxide metabolites and endothelin-1 as key mediators released by endothelial cells.

RESULTS

Nitric oxide level was significantly lower in group 1 compared to group 2 (76.14±39.54 and 151.10±24.24 μmol/L, respectively, p<0.0001). Significant differences were obtained in comparison of the study groups with the control group (p<0.0001 compared to group 1 and p=0.0277 compared to group 2). The level of endothelin-1 was significantly higher in group 1 (2.18±0.54 ng/ml) compared to group 2 (1.54±0.28 ng/ml) (p<0.0001). Endothelin-1 level was significantly lower in healthy volunteers (1.22±0.38 ng/ml) compared to group 1 (p<0.0001) and group 2 (p=0.0026).

CONCLUSION

Progressive course of PAD was associated with significant decrease in the level of nitric oxide metabolites and increase in endothelin-1 level. Nitric oxide metabolites and endothelin-1 may be used as prognostic markers in prediction of PAD course.