Acute application of a transdermal nitroglycerin patch protects against prolonged forearm ischemia-induced microvascular dysfunction

Rogerio N. Soares, David N. Proctor, Gustavo V. de Oliveira, Thiago Silveira Alvares, Juan M. Murias

Research output: Contribution to journalArticle

Abstract

Introduction: Prolonged limb blood flow occlusion (ie, tourniquet application during limb surgery) causes transient microvascular dysfunction. We examined the ability of a local nitric oxide donor (transdermal nitroglycerin) administered during prolonged cuff forearm occlusion to protect against microvascular dysfunction and to alter brachial artery dilation. Methods: Ten healthy men (28 ± 8 years) participated in the study. During the control visit, they completed three vascular occlusion tests in the right arm termed, PRE (5-min occlusion), POSTimmediate (20-min occlusion), and POST30min (5-min occlusion). During the nitroglycerin visit, subjects completed the same vascular occlusion tests, but with a nitroglycerin patch placed over the contralateral forearm during the 20-min occlusion test. Micro- and macrovascular function were assessed using the near-infrared spectroscopy-derived reperfusion upslope (reperfusion slope, %.s−1) and flow-mediated dilation (%FMD), respectively. Results: The reperfusion slope (1.44 ± 0.72%.s-1) and the %FMD (15.0 ± 2.8%) of the POSTimmediate test of the nitroglycerin condition were significantly (P <.05) higher than the reperfusion slope (1.01 ± 0.37%.s−1) and %FMD (6.77 ± 1.8%) during the POSTimmediate test of the control visit. Conclusion: Transdermal nitroglycerin protects against ischemia-induced microvascular dysfunction and causes marked dilation of the brachial artery %FMD.

Original languageEnglish (US)
JournalMicrocirculation
DOIs
StateAccepted/In press - Jan 1 2019

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Transdermal Patch
Nitroglycerin
Forearm
Ischemia
Reperfusion
Dilatation
Brachial Artery
Blood Vessels
Extremities
Tourniquets
Near-Infrared Spectroscopy
Nitric Oxide Donors
Arm

All Science Journal Classification (ASJC) codes

  • Physiology
  • Molecular Biology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

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title = "Acute application of a transdermal nitroglycerin patch protects against prolonged forearm ischemia-induced microvascular dysfunction",
abstract = "Introduction: Prolonged limb blood flow occlusion (ie, tourniquet application during limb surgery) causes transient microvascular dysfunction. We examined the ability of a local nitric oxide donor (transdermal nitroglycerin) administered during prolonged cuff forearm occlusion to protect against microvascular dysfunction and to alter brachial artery dilation. Methods: Ten healthy men (28 ± 8 years) participated in the study. During the control visit, they completed three vascular occlusion tests in the right arm termed, PRE (5-min occlusion), POSTimmediate (20-min occlusion), and POST30min (5-min occlusion). During the nitroglycerin visit, subjects completed the same vascular occlusion tests, but with a nitroglycerin patch placed over the contralateral forearm during the 20-min occlusion test. Micro- and macrovascular function were assessed using the near-infrared spectroscopy-derived reperfusion upslope (reperfusion slope, {\%}.s−1) and flow-mediated dilation ({\%}FMD), respectively. Results: The reperfusion slope (1.44 ± 0.72{\%}.s-1) and the {\%}FMD (15.0 ± 2.8{\%}) of the POSTimmediate test of the nitroglycerin condition were significantly (P <.05) higher than the reperfusion slope (1.01 ± 0.37{\%}.s−1) and {\%}FMD (6.77 ± 1.8{\%}) during the POSTimmediate test of the control visit. Conclusion: Transdermal nitroglycerin protects against ischemia-induced microvascular dysfunction and causes marked dilation of the brachial artery {\%}FMD.",
author = "Soares, {Rogerio N.} and Proctor, {David N.} and {de Oliveira}, {Gustavo V.} and Alvares, {Thiago Silveira} and Murias, {Juan M.}",
year = "2019",
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day = "1",
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Acute application of a transdermal nitroglycerin patch protects against prolonged forearm ischemia-induced microvascular dysfunction. / Soares, Rogerio N.; Proctor, David N.; de Oliveira, Gustavo V.; Alvares, Thiago Silveira; Murias, Juan M.

In: Microcirculation, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Acute application of a transdermal nitroglycerin patch protects against prolonged forearm ischemia-induced microvascular dysfunction

AU - Soares, Rogerio N.

AU - Proctor, David N.

AU - de Oliveira, Gustavo V.

AU - Alvares, Thiago Silveira

AU - Murias, Juan M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Introduction: Prolonged limb blood flow occlusion (ie, tourniquet application during limb surgery) causes transient microvascular dysfunction. We examined the ability of a local nitric oxide donor (transdermal nitroglycerin) administered during prolonged cuff forearm occlusion to protect against microvascular dysfunction and to alter brachial artery dilation. Methods: Ten healthy men (28 ± 8 years) participated in the study. During the control visit, they completed three vascular occlusion tests in the right arm termed, PRE (5-min occlusion), POSTimmediate (20-min occlusion), and POST30min (5-min occlusion). During the nitroglycerin visit, subjects completed the same vascular occlusion tests, but with a nitroglycerin patch placed over the contralateral forearm during the 20-min occlusion test. Micro- and macrovascular function were assessed using the near-infrared spectroscopy-derived reperfusion upslope (reperfusion slope, %.s−1) and flow-mediated dilation (%FMD), respectively. Results: The reperfusion slope (1.44 ± 0.72%.s-1) and the %FMD (15.0 ± 2.8%) of the POSTimmediate test of the nitroglycerin condition were significantly (P <.05) higher than the reperfusion slope (1.01 ± 0.37%.s−1) and %FMD (6.77 ± 1.8%) during the POSTimmediate test of the control visit. Conclusion: Transdermal nitroglycerin protects against ischemia-induced microvascular dysfunction and causes marked dilation of the brachial artery %FMD.

AB - Introduction: Prolonged limb blood flow occlusion (ie, tourniquet application during limb surgery) causes transient microvascular dysfunction. We examined the ability of a local nitric oxide donor (transdermal nitroglycerin) administered during prolonged cuff forearm occlusion to protect against microvascular dysfunction and to alter brachial artery dilation. Methods: Ten healthy men (28 ± 8 years) participated in the study. During the control visit, they completed three vascular occlusion tests in the right arm termed, PRE (5-min occlusion), POSTimmediate (20-min occlusion), and POST30min (5-min occlusion). During the nitroglycerin visit, subjects completed the same vascular occlusion tests, but with a nitroglycerin patch placed over the contralateral forearm during the 20-min occlusion test. Micro- and macrovascular function were assessed using the near-infrared spectroscopy-derived reperfusion upslope (reperfusion slope, %.s−1) and flow-mediated dilation (%FMD), respectively. Results: The reperfusion slope (1.44 ± 0.72%.s-1) and the %FMD (15.0 ± 2.8%) of the POSTimmediate test of the nitroglycerin condition were significantly (P <.05) higher than the reperfusion slope (1.01 ± 0.37%.s−1) and %FMD (6.77 ± 1.8%) during the POSTimmediate test of the control visit. Conclusion: Transdermal nitroglycerin protects against ischemia-induced microvascular dysfunction and causes marked dilation of the brachial artery %FMD.

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