Influence of vessel size, age and body mass index on the flow-mediated dilatation (FMD%) of the brachial artery

Schroeder, Stephen; Enderle, Markus D.; Baumbach, Andreas; Ossen, Runald; Herdeg, Christian; Kuettner, Axel; Karsch, Karl R.

doi:10.1016/s0167-5273(00)00381-8

Cited by 61 publications

(65 citation statements)

References 18 publications

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“…The results of this study indicate that baseline artery size is inversely correlated with the FMD response, a finding that essentially confirms various previous reports (3,12,13,26). However, we used a within-subjects approach and simultaneous recording of different-sized arteries in response to the same stimulus.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Heterogeneity in conduit artery function in humans: impact of arterial size

Thijssen¹,

Dawson²,

Black³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

128

120

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To determine whether conduit artery size affects functional responses, we compared the magnitude, time course, and eliciting shear rate stimulus for flow-mediated dilation (FMD) in healthy men (n ϭ 20; 31 Ϯ 7 yr). Upper limb (brachial and radial) and lower limb (common and superficial femoral) FMD responses were simultaneously assessed, whereas popliteal responses were measured in the same subjects during a separate visit. Glyceryl trinitrate (GTN)-mediated responses were similarly examined. Edge detection and wall tracking of highresolution B-mode arterial ultrasound images, combined with synchronized Doppler waveform envelope analysis, were used to calculate conduit artery diameter, blood flow, and shear rate continuously across the cardiac cycle. Baseline artery size correlated inversely with the FMD response (r ϭ Ϫ0.57, P Ͻ 0.001). Within-artery comparisons revealed a significant inverse correlation between artery size and FMD% for the radial (r ϭ Ϫ0.66, P ϭ 0.001), brachial (r ϭ Ϫ0.55, P ϭ 0.01), and popliteal artery (r ϭ Ϫ0.48, P ϭ 0.03), but not for the superficial and common femoral artery. Normalization of FMD responses for differences in eliciting shear rate did not abolish the between-artery relationship for artery function and size (r ϭ Ϫ0.48, P Ͻ 0.001), suggesting that differences between artery function responses were not entirely due to size-related differences in shear rate. This was reinforced by a significant between-artery correlation for GTN responses and baseline artery size (r ϭ Ϫ0.74, P Ͻ 0.001). In summary, systematic differences exist in vascular function responses of conduit arteries that differ in size. This raises the possibility that differences in artery size within or between individuals may influence functional responses. flow-mediated dilation; nitroglycerine; arterial diameter; high-resolution ultrasound; Doppler MEASURES OF ARTERIAL FUNCTION have increasingly been adopted as surrogate markers of cardiovascular risk (31). For example, conduit artery vasodilation to a 5-min ischemic period, commonly referred to as flow-mediated dilation (FMD), reflects bioactivity of endothelium-derived nitric oxide (NO) (14, 17), which possesses myriad antiatherogenic effects (31). Endothelial dysfunction can be considered an early and integral manifestation of vascular disease that predicts cardiovascular events (8,15,16,18,21), whereas improvement in endothelial function impacts significantly on cardiovascular risk (10,11,16).For many years, it has been recognized that baseline artery diameter correlates strongly with the magnitude of the FMD response. It was recently proposed that this relationship might be explained as a consequence of smaller arteries being exposed, by virtue of their size, to a greater shear stress stimulus during reactive hyperemia. In relative terms, this results in enhanced dilator responses compared with arteries of larger dimension (25,27,28). Correcting the FMD response to the magnitude of the shear stress stimulus may eliminate the between-subject variability (23)....

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Section: Discussionsupporting

confidence: 90%

“…To our knowledge, this wellfounded hypothesis has not been systematically examined in humans. In addition, studies on which the relationship between artery size and FMD response are based have primarily been derived from correlations between baseline diameter and FMD responses in cross-sectional studies of single arteries (3,12,13,26). …”

mentioning

confidence: 99%

Heterogeneity in conduit artery function in humans: impact of arterial size

Thijssen¹,

Dawson²,

Black³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

128

120

View full text Add to dashboard Cite

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“…The interpretation that arteries were constricted at that time, maintaining their physiological capability to dilate, was additionally confirmed by the higher NFMD during the morning period. In fact, previous studies have shown that NFMD is inversely correlated with arterial diameter (18).…”

Section: Discussionmentioning

confidence: 96%

Diurnal variation of vascular diameter and reactivity in healthy young men

Bau

Naujorks³

et al. 2008

Braz J Med Biol Res

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The higher incidence of cardiovascular events in the morning is accompanied by an increased vascular tone. However, there are few published studies designed to evaluate the diurnal variation of vascular and endothelial parameters in healthy subjects. In the present investigation, we evaluated the diurnal variation in brachial artery diameter (BAD), flow-mediated dilation (FMD) and endothelium-independent dilation (NFMD) in a homogeneous sample of healthy non-smoker young men. Fifty subjects aged 20.8 ± 0.3 years (range: 18 to 25 years) were investigated by brachial artery ultrasound. Exclusion criteria were female gender and evidence of clinically significant health problems, including obesity. Volunteers were asked to rest and avoid fat meals as well as alcoholic beverages 48 h before and until completion of the evaluations. BAD, FMD and NFMD were measured at 7 am, 5 pm, and 10 pm and tested by repeated measures ANOVA. BAD was smaller at 7 am (mean ± SEM, 3.8 ± 0.1 mm) in comparison with 5 pm (3.9 ± 0.1) and 10 pm (4.0 ± 0.1 mm; P < 0.001). FMD values did not change significantly during the day, while NFMD increased more at 7 am (18.5 ± 1.1%), when compared to 15.5 ± 0.9% at 10 pm and 15.5 ± 0.9% at 5 pm (P = 0.04). The physiological state of vasoconstriction after awakening, with preserved capability to dilate in the morning, should be considered to be part of the healthy cardiovascular adaptation before considering later life risk factors and endothelial dysfunction.

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“…Indeed, there is an inverse relationship between vessel size and the relative FMD. 73,74 Thus a smaller deconditioned SFA may be expected to exhibit enhanced FMD, whereas an enlarged brachial artery may be expected to exhibit a reduced FMD. Unfortunately, the only study directly to test this postulate by examining differences in FMD above and below the lesion in similar-sized arteries reported that SCI individuals exhibit a similar reduction in FMD above and below the injury, suggesting that differences in baseline diameter do not fully explain the differences in FMD.…”

Section: Conduit Arterial Function After Sci Structural Adaptationsmentioning

confidence: 99%

Peripheral vascular function in spinal cord injury: a systematic review

et al. 2012

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Background: During the past 20 years, significant advances in patient care have resulted in individuals with spinal cord injury (SCI) living longer than before. As lifespan increases, cardiovascular complications are emerging as the leading cause of mortality in this population, and individuals with SCI develop cardiovascular disease at younger ages than their able-bodied counterparts. To address this increasing clinical challenge, several recent studies investigated the central cardiovascular adaptations that occur following SCI. However, a somewhat less recognized component of cardiovascular dysfunction in this population is the peripheral vascular adaptations that also occur as a result of SCI. Study design: Literature review.Objective: To present a comprehensive overview of changes in arterial structure and function, which occur after SCI. Setting: Canada. Methods: A systematic literature review was conducted to extract studies that incorporated measures of arterial structure or function after SCI in animals or humans. Results: Individuals with SCI exhibit vascular dysfunction below the lesion that is characterized by a reduction in conduit artery diameter and blood flow, increased shear rate and leg vascular resistance, and adrenoceptor hyper-responsiveness. There is also recent alarming evidence for central arterial stiffening in individuals with SCI. Conclusion: Although physical deconditioning is the primary candidate responsible for the maladaptive remodeling of the peripheral vasculature after SCI, there is emerging evidence that blood pressure oscillations, such as those occurring in the large majority of individuals with SCI, also exacerbates vascular dysfunction in this population.

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Influence of vessel size, age and body mass index on the flow-mediated dilatation (FMD%) of the brachial artery

Cited by 61 publications

References 18 publications

Heterogeneity in conduit artery function in humans: impact of arterial size

Heterogeneity in conduit artery function in humans: impact of arterial size

Diurnal variation of vascular diameter and reactivity in healthy young men

Peripheral vascular function in spinal cord injury: a systematic review

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