Key result
Transradial catheterization is linked to a ~54% reduction in FMD at 7 days post-procedure.
Why the study?
It was unknown whether reduced shear-mediated dilation observed after catheterization in coronary artery disease patients resulted from a priori endothelial dysfunction.
Does unilateral transradial catheterization reduce shear-mediated dilation in healthy young men?
Observational (n=26)
Single-blind
No
Does unilateral transradial catheterization reduce shear-mediated dilation in healthy young men?
Absolute Event Rate: 4.3% vs 9.3%
p-value: p=<0.001
Transradial catheterization impairs shear-mediated arterial dilation in healthy young men with intact baseline endothelial function.
Transradial access was associated with reduced endothelial function in healthy vessels; leaves open clinical relevance and recovery in patients.
PURPOSE: Animal studies have shown that endothelial denudation abolishes vasodilation in response to increased shear stress. Interestingly, shear-mediated dilation has been reported to be reduced, but not abolished, in coronary artery disease (CAD) patients following catheterization. However, it is not known whether this resulted from a priori endothelial dysfunction in this diseased population. In this study, we evaluated shear-mediated dilation following catheterization in healthy young men. METHODS: : 50.5 ± 8.8 ml/kg/min) healthy males underwent unilateral transradial catheterization. Shear-mediated dilation of both radial arteries was measured using flow-mediated dilation (FMD) pre-, and 7 days post-catheterization. RESULTS: FMD was reduced in the catheterized arm [9.3 ± 4.1% to 4.3 ± 4.1% (P < 0.001)] post-catheterization, whereas no change was observed in the control arm [8.4 ± 3.8% to 7.3 ± 3.8% (P = 0.168)]. FMD was completely abolished in the catheterized arm in five participants. Baseline diameter (P = 0.001) and peak diameter during FMD (P = 0.035) were increased in the catheterized arm 7 days post-catheterization (baseline: 2.3 ± 0.3 to 2.6 ± 0.2 mm, P < 0.001, peak: 2.5 ± 0.3 to 2.7 ± 0.3 mm, P = 0.001), with no change in the control arm (baseline: 2.3 ± 0.3 to 2.3 ± 0.3 mm, P = 0.288, peak: 2.5 ± 0.3 to 2.5 ± 0.3 mm, P = 0.608). CONCLUSION: This is the first study in young healthy individuals with intact a priori endothelial function to provide evidence of impaired shear-mediated dilation following catheterization. When combined with earlier studies in CAD patients, our data suggest the catheterization impairs artery function in humans.
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Tryfonos et al. (2020) conducted an observational in Healthy (n=26). Transradial catheterization vs. Contralateral non-catheterized arm (internal control) was evaluated on Flow-mediated dilation (FMD) in the catheterized arm pre- to 7 days post-catheterization (p=<0.001). Transradial catheterization significantly reduced flow-mediated dilation from 9.3% to 4.3% at 7 days post-procedure in healthy young men.
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