ORIGINAL ARTICLES   

International Angiology 2002 June;21(2):180-6

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Increases plasma total nitric oxide among patients with severe chronic venous disease

Howlader M. H., Coleridge Smith P. D.

Department of Surgery, Royal Free and University College Medical School, The Middlesex Hospital, Mortimer Street, London, UK

Background. Skin dam­age in chron­ic ­venous dis­ease (CVD) may be par­tial­ly attrib­ut­able to free rad­i­cal inju­ry includ­ing that of ­nitric oxide (NO). The aim of this study was to meas­ure total plas­ma NO in ­patients with CVD com­pared to con­trol sub­jects.
Methods. Forty-four ­patients with CVD and 13 con­trol sub­jects with no arte­ri­al or ­venous dis­ease were includ­ed in this study. The ­patients under­went ­duplex ultra­so­nog­ra­phy to con­firm the ­extent of the ­venous dis­ease and were ­assigned to the appro­pri­ate CEAP clin­i­cal stage. Exhaustive exclu­sion cri­te­ria were ­applied to pre­vent the influ­ence of die­tary ­intake and other dis­eas­es in total NO pro­duc­tion. Patients were stud­ied after rest­ing ­supine for 10 min­ in room tem­per­a­ture. Blood sam­ples were taken from the long saph­e­nous or a dor­sal foot vein. Plasma was sep­ar­at­ed and fro­zen at -80°C with­in 1 hour of ven­e­sec­tion. Total NO was ­assayed with a color­imet­ric test using the Griess reac­tion (R&D ­systems, UK).
Results. The ­median total ­NO lev­els among ­patients with the C5 was 55 μmol/L (inter­quar­tile range 51 to 64); with C4 was 53 μmol/L (inter­quar­tile range 44 to 58); C2 and C3 was 44 μmol/L (inter­quar­tile range 36 to 50) and with con­trol sub­jects it was 43 μmol/L (inter­quar­tile range 41 to 50). Those with ­healed ­ulcers (C5) ­showed sta­tis­ti­cal­ly ­raised ­NO lev­els com­pared to con­trols (median dif­fer­ence 12 μmol/L [95% con­fi­dence inter­val: 5-22]). Combining the data in the C4 and C5 ­patients ­results in a set of data sig­nif­i­cant­ly dif­fer­ent from con­trol sub­jects (­median dif­fer­ence 9 [95% C.I. 2-15]).
Conclusions. Raised total ­NO is strong­ly asso­ciat­ed with the more ­severe stag­es (lip­o­der­ma­tos­cler­o­sis and ­healed ulcer­a­tion), in ­patients with ­venous dis­ease.