@article{3077659, title = "The importance of endothelial dysfunction in resistance artery remodelling and cardiovascular risk", author = "Masi, S. and Georgiopoulos, G. and Chiriacò, M. and Grassi, G. and Seravalle, G. and Savoia, C. and Volpe, M. and Taddei, S. and Rizzoni, D. and Virdis, A. and on behalf of the Study Group on Micro- and Macro-circulation of the Italian Society of Hypertension (SIIA)", journal = "Cardiovascular Research", year = "2020", volume = "116", number = "2", pages = "429-437", publisher = "Oxford University Press", issn = "0008-6363, 1755-3245", doi = "10.1093/cvr/cvz096", keywords = "nitric oxide; nitric oxide, adult; artery resistance; Article; cardiovascular risk; disease severity; endothelial dysfunction; endothelium; European Heart Score; female; human; major clinical study; male; middle aged; myography; priority journal; scoring system; vascular remodeling; abdominal fat; aged; cardiovascular disease; clinical trial; Italy; metabolism; microvasculature; multicenter study; pathophysiology; prognosis; risk assessment; risk factor; subcutaneous fat; vascular endothelium; vascular resistance; vascularization; vasodilatation, Abdominal Fat; Adult; Aged; Cardiovascular Diseases; Endothelium, Vascular; Female; Humans; Italy; Male; Microvessels; Middle Aged; Nitric Oxide; Prognosis; Risk Assessment; Risk Factors; Subcutaneous Fat; Vascular Remodeling; Vascular Resistance; Vasodilation", abstract = "Aims The relationship between resistance artery remodelling and endothelial function remains unknown. In this study, we assessed (i) the capacity of endothelial function and nitric oxide (NO) availability to provide more information on the severity of resistance artery remodelling than common cardiovascular risk factors in subjects at low or high cardiovascular risk; and (ii) differences between patterns of resistance artery remodelling associated with deficit of NO availability and with exposure to cardiovascular risk factors. Methods and results All analyses were conducted on the microvascular data set of the Italian Society for Arterial Hypertension (SIIA) that includes 356 patients with measures of small resistance arteries remodelling acquired with pressure or wire myography. Information on endothelial function and NO availability were also available in 116 patients. The European Heart Score (HS) was used to define the total cardiovascular risk of each patient. Endothelial function was inversely related with the severity of the resistance artery remodelling, and this association remained significant after adjustment for the HS. By contrast, the HS lost its significant association with the media-to-lumen (M/L) ratio and the media cross-sectional area after adjustment for endothelial function. The strength of these associations was similar in subjects at high and low cardiovascular risk. The addition of endothelial function and NO availability to the HS significantly improved the identification of subjects at more and less severe resistance artery remodelling. A severe deficit of NO availability was associated with hypertrophic remodelling, while a higher HS was more clearly associated with eutrophic remodelling. Conclusion Resistance artery endothelial function and NO availability might represent important factors involved in resistance artery remodelling, independently from cardiovascular risk factor exposure. © The Author(s) 2019." }