Peripheral artery endothelial function responses to altered shear stress patterns in humans

Endothelial function is influenced by both the direction and the magnitude of shear stress. Acute improvements in endothelial function have mostly been attributed to increased anterograde shear, whereas results from many interventional models in humans suggest that enhancing shear stress in an oscillatory manner (anterograde and retrograde) might be optimal. Here, we determined the acute brachial artery shear stress (SS) and flow-mediated dilatation (FMD) responses to three shear-altering interventions [passive heat stress (HEAT), mechanical forearm compression (CUFF) and handgrip exercise (HGEX)] and examined the relationship between changes in oscillatory shear index (OSI) and changes in FMD. During separate visits, 10 young healthy men (22 +/- 3years old) underwent 10 min of HEAT, CUFF or HGEX in their left forearm. Anterograde and retrograde SS, Reynolds number, OSI and FMD were assessed at rest and during/after each intervention. Anterograde SS increased during all interventions in a stepwise manner (P<0.05 between interventions), with the change in HGEX (37.7 +/- 12.2 dyn cm(-2), P<0.05)>CUFF (25.1 +/- 11.9 dyn cm(-2), P<0.05)>HEAT (14.5 +/- 7.9 dyn cm(-2), P<0.05). Retrograde SS increased during CUFF (-19.6 +/- 4.3dyn cm(-2), P<0.05). Anterograde blood flow was turbulent (i.e. Reynolds number >=vertical bar 2000 vertical bar) during all interventions (P<0.05). The relative FMD improved after all interventions (P=0.01), and there was no relationship between OSI and FMD. We elicited changes in SS profiles including increased anterograde SS (HEAT and HGEX) and both increased anterograde and retrograde SS (CUFF); regardless of the SS pattern, FMD improved to the same extent. These findings suggest that the presence of anterograde and/or turbulent SS might be the key to optimizing endothelial function in acute assessment protocols.