Endothelial function assessment: flow-mediated dilation and constriction provide different and complementary information on the presence of coronary artery disease

Gori, Tommaso; Muxel, Selina; Damaske, Ana; Radmacher, Marie-Christine; Fasola, Federica; Schaefer, S.; Schulz, Andreas; Jabs, Alexander; Parker, John D.; Münzel, Thomas

doi:10.1093/eurheartj/ehr361

Cited by 83 publications

(78 citation statements)

References 24 publications

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“…In contrast to our findings and those of Spiro et al, Gori found that subjects with coronary heart disease have a low L-FMC measured at radial artery compared with those without coronary heart disease, although the magnitude of L-FMC did not discriminate subjects with different number of diseased vessels 13) . However, looking at the descriptive table, subjects without coronary heart disease had a comparable prevalence of some cardiovascular risk factors and were taking fewer drugs (statins, ACE-inhibitors, nitrates) compared with subjects with coronary disease.…”

Section: Discussioncontrasting

confidence: 99%

“…Some authors have described radial artery vasoconstriction during low flow and suggested that this is an additional marker of endothelial function [11][12][13][14][15][16] . However, the low-flowmediated vasoconstriction (L-FMC) seems to be specific to the radial artery because it has not been consistently described for the brachial artery.…”

Section: Ultrasound Study Proceduresmentioning

confidence: 99%

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Brachial Low-Flow-Mediated Constriction is Associated with Delayed Brachial Flow-Mediated Dilation

Irace

Tripolino

Scavelli

et al. 2016

JAT

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Aim: Flow-mediated vasodilation (FMD) of the brachial artery measures the ability of the artery to dilate after a forearm ischemia lasting for 5 min. During ischemia, and therefore in conditions of low flow, constriction of the brachial artery (L-FMC) has sometimes been reported. The meaning of L-FMC is still unclear. The aims of our study were to establish the prevalence of subjects with L-FMC, to determine whether the magnitude of L-FMC correlates with magnitude of FMD, and to determine whether L-FMC can be used to predict FMD timing. Methods: A total of 179 outpatients were studied, and the brachial artery diameter was measured every minute during the 5 min forearm ischemia. Subjects who had at least one measurement showing a constriction of 1% during ischemia were defined as constrictors. FMD was evaluated at 50 s, 2 min, and 3 min after cuff release. On the basis of time, the subjects in whom maximal dilation had occurred were divided into Early, Late, or No dilators. Conclusions:The present study reveals that almost 40% of the subjects had brachial artery L-FMC and a more pronounced constriction during ischemia correlated with a lower dilation after ischemia. Finally, the prevalence of subjects showing L-FMC was significantly higher among subjects with delayed or no vasodilation, suggesting that L-FMC may be a marker of endothelial dysfunction.

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Section: Discussioncontrasting

confidence: 99%

Section: Ultrasound Study Proceduresmentioning

confidence: 99%

Brachial Low-Flow-Mediated Constriction is Associated with Delayed Brachial Flow-Mediated Dilation

Irace

Tripolino

Scavelli

et al. 2016

JAT

View full text Add to dashboard Cite

show abstract

“…brachial vs. radial arteries. The technique of measuring L-FMC also differs in cuff position; most authors place the pneumatic cuff distal to the side of arterial diameter measurement 29) , while others use the proximal cuff occlusion method 30) . Low-flow-mediated constriction is calculated as the percentage decrease in arterial diameter in the last 30s of cuff occlusion (after 4.5 min of 5 min occlusion) as compared with resting diameter 31) ; however, FMD is determined in the 5 min following cuff deflation.…”

Section: Peripheral Arterial Tonometrymentioning

confidence: 99%

Testing Endothelial Function and its Clinical Relevance

Poredoš¹,

Ježovnik²

2013

JAT

105

109

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Endothelial dysfunction as an integrating index of the risk factor burden and genetic susceptibility is an early marker of atherothrombotic disease. Therefore, tremendous interest exists in its measurement and determination of the clinical utility of the evaluation of endothelial function. Different invasive and non-invasive techniques exist for exploring various aspects of the pathobiology of the endothelium. As endothelial dysfunction is a diffuse-systemic disorder, the peripheral arteries, because of their accessibility, represent the basis for assessment of endothelial dysfunction.

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“…Several studies have focused on the peripheral endothelial function and coronary artery disease [15,16,17]. Kuvin et al [15] found an association between coronary atherosclerosis and impaired endothelium-dependent vasomotion using high-resolution brachial artery ultrasound imaging.…”

Section: Discussionmentioning

confidence: 99%

Clinical SYNTAX Score Can Predict Acute Kidney Injury following On-Pump but Not Off-Pump Coronary Artery Bypass Surgery

et al. 2015

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Background: The complexity of coronary artery disease is usually a neglected factor in risk stratification systems. We aimed to analyze the discriminative ability of the clinical SYNTAX score (CSS) for acute kidney injury (AKI) following on- and off-pump coronary artery surgery. Methods: A total of 193 patients were reviewed in this study. Patients were divided into two groups according to the surgical procedure (group I: off-pump coronary artery bypass grafting, n = 89; group II: on-pump coronary artery bypass grafting, n = 104). Preoperative demographic data, the CSS and postoperative renal functions were evaluated. The postoperative AKI classification was made using the RIFLE (Risk, Injury, Failure, Loss of function, and End-stage renal disease) criteria. Results: Postoperative AKI occurred in 14 of 89 patients (15.7%) in group I and in 29 of 104 patients in group II (27.8%; p = 0.046). The CSS did not vary much between the groups (31.52 ± 13.08 vs. 29.89 ± 15.70; p = 0.638). In group I, the CSS was not different between patients with AKI and those without AKI (30.167 ± 3.93 vs. 31.91± 14.75; p = 0.78). In group II, the CSS was 36.85 ± 18.33 in patients with AKI and 28.02 ± 12.32 in those without, and the difference was significant (p = 0.02). The discriminative ability of the CSS for postoperative AKI using the AUC analysis was 0.500 in group I and 0.840 in group II. Conclusion: The CSSmay be a simple and successful means of risk prediction of postoperative AKI in on-pump coronary artery surgery.

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Endothelial function assessment: flow-mediated dilation and constriction provide different and complementary information on the presence of coronary artery disease

Abstract: Endothelial function assessment provides modest but statistically significant additional information in predicting the presence of CAD.

Cited by 83 publications

References 24 publications

Brachial Low-Flow-Mediated Constriction is Associated with Delayed Brachial Flow-Mediated Dilation

Brachial Low-Flow-Mediated Constriction is Associated with Delayed Brachial Flow-Mediated Dilation

Testing Endothelial Function and its Clinical Relevance

Clinical SYNTAX Score Can Predict Acute Kidney Injury following On-Pump but Not Off-Pump Coronary Artery Bypass Surgery

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