Colombian Study to Assess the Use of Noninvasive Determination of the Endothelium-Mediated Vasodilation (CANDEV) II. Does Location of the Occlusion Device Affects the Accuracy of the Diagnosis?

Abstract

Endothelial dysfunction (ED), which is often evaluated by flow-mediated vasodilation (FMV) in the brachial artery, has been postulated as a predictor of cardiac events. Although the upper and forearm location of the occlusion device have been used for FMV evaluation, currently there is no consensus whether they provide the same information. The main goal of this study was to evaluate if both techniques have the same accuracy to differentiate subjects with and without cardiovascular risk factors (CRFs). A cross-sectional study in 124 subjects was performed. The volunteers were divided in two groups: 62 subjects (20 women and 42 men) with at least one CRF and 62 (20 women and 42 men) healthy subjects without CRFs. FMV measurements using the cuff in the upper arm and forearm with intervals of 30 min were taken. In all subjects, %FMV with the cuff located in the upper arm was 10.13 +/- 4.5 and 9.8 +/- 4.1 with the cuff located below the elbow. In healthy subjects without CRFs the %FMV in the upper arm was 12.19 +/- 4.0 versus 12.31 +/- 3.4 in the upper forearm, in CRF subjects it was 8.08 +/- 4.0 vs 7.29 +/- 3.2., respectively. FMV was not affected by the location of the cuff in maintaining the test ability and accuracy to differentiate subjects with and without CRFs.

Aged Garlic Extract Improves Adiponectin Levels in Subjects with Metabolic Syndrome: A Double-Blind, Placebo-Controlled, Randomized, Crossover Study

“…The FMV was performed using a high-resolution Doppler ultrasound, measuring the changes in diameter of the brachial artery in response to increased blood flow (reactive hyperemia). This method was previously standardized in our population [21, 22]. …”

A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn

“…Endothelium-dependent vasodilatation will be measured with the technique introduced by Silva et al [30], using the guidelines reported by Corretti et al [31] The diameter of the brachial artery will be assessed using a high-resolution ultrasound device (Siemens SG-60, USA), equipped with a 7.5 MHz linear array transducer and an integrated electrocardiography package. The ultrasound procedures will be performed with the subject resting quietly in supine position for at least 10 min.…”

“…The change in diameter caused by the increased flow will be calculated as the percentage change relative to the baseline measurement (FMD%). The dilating brachial artery response due to shear stress has been shown to have good accuracy and reproducibility [30,31]. Images will be recorded on DVD player, for subsequent measurements by two observers blinded to the study, finally, both measurements will be averaged.…”

Clinical trial to assess the effect of physical exercise on endothelial function and insulin resistance in pregnant women

“…The change in diameter caused by the increased flow will be calculated as the percentage change relative to the baseline measurement (FMD%). The dilator brachial artery response due to shear stress has been shown to have a good accuracy and reproducibility [24,36,37]. Images will be recorded on DVD player, and the measurements will be done by two observers blinded to the study and then both measurements will be averaged.…”