Low-Flow Mediated Constriction is Endothelium-Dependent Effects of Exercise Training After Radial Artery Catheterization

Background-Radial artery catheterization is associated with endothelial denudation and impaired vasodilator function, while postcatheterization exercise training may enhance artery function. The impact of catheterization and subsequent exercise training on low-flow mediated vasoconstriction (L-FMC) has not previously been studied. The aim of this study was to examine whether radial artery L-FMC is impaired by catheterization and consequent endothelial denudation. A further aim was to examine the effect of local handgrip exercise training on radial artery L-FMC and flow-mediated dilation (FMD) after transradial catheterization. Methods and Results-Thirty-two subjects undergoing transradial catheterization underwent assessment of L-FMC and FMD in the catheterized and contralateral radial artery before, and the day after, catheterization. A further 18 patients were recruited and randomly assigned to either a 6-week handgrip exercise training program (N=9) or a nonexercise control period (N=9). L-FMC was attenuated 1 day postcatheterization in the catheterized arm (-2.07 +/- 0.84 to 0.35 +/- 0.83), but unchanged in the noncatheterized arm (-0.93 +/- 0.86 to -0.90 +/- 0.92; P<0.05). In the training study, both FMD and L-FMC of the catheterized arm were preserved in the exercise group 7 weeks after catheterization (FMD-pre, 6.84 +/- 0.79; FMD-post, 6.85 +/- 1.16; L-FMC-pre, -2.14 +/- 1.42; L-FMC-post, -3.58 +/- 1.04%), but reduced in the control group (FMD-pre, 8.27 +/- 1.52; FMD-post, 4.66 +/- 0.70; P=0.06; L-FMC-pre, -3.26 +/- 1.19; L-FMC-post, -1.34 +/- 1.27%; P<0.05). Conclusions-Catheterization, and associated endothelial denudation, decreases L-FMC in the radial artery, suggesting that it is endothelium-dependent. Moreover, we demonstrate for the first time that exercise training has beneficial impacts on radial artery vasodilator and constrictor function. (Circ Cardiovasc Interv. 2012;5:713-719.)