{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:20:40Z","timestamp":1790774440244,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,1,30]]},"abstract":"\n Background<\/jats:title>\n \n Endothelial dysfunction is a key factor in the development of atherosclerosis. Commonly, endothelial function is determined in the brachial artery, whereas patients with peripheral artery disease (\n PAD<\/jats:styled-content>\n ) present with lower limb atherosclerosis. We hypothesized that in\n PAD,<\/jats:styled-content>\n a segmental or local association exists between endothelial dysfunction and atherosclerotic structural changes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We used ultrasound to study endothelial function as flow\u2010mediated vasodilation, intima media thickness, and local stiffness of the superficial femoral artery (\n SFA<\/jats:styled-content>\n ) and brachial artery (\n BA<\/jats:styled-content>\n ).\n PAD<\/jats:styled-content>\n patients with symptomatic\n SFA<\/jats:styled-content>\n or below\u2010the\u2010knee disease were compared with age\u2010matched patients without\n PAD<\/jats:styled-content>\n and young healthy controls.\n PAD<\/jats:styled-content>\n patients with\n SFA<\/jats:styled-content>\n or below\u2010the\u2010knee disease exhibited endothelial dysfunction of the proximal\n SFA<\/jats:styled-content>\n (flow\u2010mediated vasodilation: 3.9\u00b10.6%, 3.7\u00b10.6%) compared with healthy controls (7.4\u00b11.0%) and patients without\n PAD<\/jats:styled-content>\n (5.4\u00b10.6%). Brachial artery flow\u2010mediated vasodilation values were not different in\n PAD<\/jats:styled-content>\n patients with\n SFA<\/jats:styled-content>\n or below\u2010the\u2010knee disease compared with patients without\n PAD<\/jats:styled-content>\n , but they were significantly lower than those of healthy controls. Endothelial dysfunction correlated with increased intima media thickness or plaque thickness at the site of flow\u2010mediated vasodilation measurement across vascular sites. In\n PAD<\/jats:styled-content>\n patients with\n SFA<\/jats:styled-content>\n disease,\n SFA<\/jats:styled-content>\n flow\u2010mediated vasodilation was further impaired within and distal to stenosis (prestenosis 3.9\u00b10.6%, intrastenosis 2.3\u00b10.7%, poststenosis 2.5\u00b10.6%) and recovered within 24\u00a0hours after\n SFA<\/jats:styled-content>\n balloon angioplasty to prestenotic values but not to the brachial artery or\n SFA<\/jats:styled-content>\n values in patients without\n PAD<\/jats:styled-content>\n or controls.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n A close association exists between local endothelial function and atherosclerotic structural remodeling, suggesting that in\n PAD<\/jats:styled-content>\n , local and segmental factors\u2014in addition to systemic factors\u2014influence local endothelial function. Our data point toward a pathophysiological role for lower extremity endothelial dysfunction in\n PAD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.114.001472","type":"journal-article","created":{"date-parts":[[2015,2,4]],"date-time":"2015-02-04T04:14:38Z","timestamp":1423023278000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Local Association Between Endothelial Dysfunction and Intimal Hyperplasia: Relevance in Peripheral Artery Disease"],"prefix":"10.1161","volume":"4","author":[{"given":"Yvonne","family":"Heinen","sequence":"first","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Stegemann","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Sansone","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kolja","family":"Benedens","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabea","family":"Wagstaff","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Balzer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tienush","family":"Rassaf","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Lauer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Kelm","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Heiss","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty University Duesseldorf, Duesseldorf, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.8.884"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00984-9"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06351-6"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr211"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2008.09.013"},{"key":"e_1_3_4_7_2","article-title":"Central role of eNOS in the maintenance of endothelial homeostasis","author":"Heiss C","year":"2014","unstructured":"Heiss C, Rodriguez\u2010Mateos A, Kelm M. 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