Relationship Between Carotid Artery Intima-Media Thickness and Brachial Artery Flow-Mediated Dilation in Middle-Aged Healthy Men

Yan, Raymond T.; Anderson, Todd J.; Charbonneau, François; Title, Lawrence M.; Verma, Subodh; Lonn, Eva

doi:10.1016/j.jacc.2004.12.079

Cited by 135 publications

(153 citation statements)

References 29 publications

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“…Consistent with the findings from previous studies, 1,2,14 our results demonstrated that assessment of vascular function by measuring FMD can serve as a marker for prediction of future cardiovascular events. Furthermore, impaired FMD appears to be more useful in predicting cardiovascular events in patients without CAD than those with CAD.…”

Section: Discussionsupporting

confidence: 92%

“…Indeed, recent studies have failed to demonstrate any significant correlation between FMD and IMT in healthy subjects. 2 Prior studies have demonstrated that impaired FMD 3 and increased IMT 4 are independently associated with an increased risk of cardiovascular events. Nevertheless, recent studies have yielded inconsistent findings on the relative predictive values of FMD and IMT for cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Wang

Lau

et al. 2008

Clinical Cardiology

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Background: Impaired brachial flow-mediated dilation (FMD) and increased carotid intima-media thickness (IMT) are associated with increased risk of cardiovascular events. Methods: We measured brachial FMD and a mean of 12 sites maximum carotid IMT (mmIMT) in 279 patients (mean age 62±12 y; 163 men) admitted for coronary angiography due to chest pain. Hypothesis: There are gender differences in the predictive values of FMD and IMT for cardiovascular events. Results: Univariable analysis showed that impaired FMD (p<0.001), but not increased mmIMT (p = 0.056), significantly predicted spontaneous cardiovascular events. After adjusting for the extent of coronary artery disease (CAD) and other clinical variables, age (heart rate [HR] 1.05, 95% confidence interval [CI]: 1.01-1.09, p = 0.017) and FMD (HR 0.85, 95% CI: 0.75-0.97, p = 0.012) were independent predictors for cardiovascular events. A total of 148 (53%) patients had CAD (≥50% diameter stenosis). Over a median follow-up of 16 mo, 36 (12.9%) patients experienced spontaneous cardiovascular events (cardiovascular death, stroke, acute myocardial infarction [MI], unstable angina pectoris, and congestive heart failure [HF]). Women were more likely than men to develop cardiovascular events in patients without significant CAD (11.9% versus 1.6%, odds ratio [OR] = 8.54, p = 0.033), but not in those patients with CAD (20.4 % versus 17.2%, OR = 1.24, p = 0.66). Moreover, women accounted for 8 (88.9%) events in non-CAD patients. Furthermore, impaired FMD predicted the occurrence of cardiovascular events in both men and women (p<0.05). Conclusion: Brachial FMD, rather than carotid IMT, was an independent predictor for cardiovascular events after adjusting for the extent of CAD. Moreover, impaired brachial endothelial function in women without significant CAD was associated with an increased risk of spontaneous cardiovascular events.Key words: flow-mediated dilation, intima-media thickness, coronary artery disease, cardiovascular events Introduction Noninvasive assessments of brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) have been widely used as surrogate markers for subclinical atherosclerosis. 1 However, these 2 parameters measure different aspects and stages of early atherosclerosis: IMT detects early morphological changes, but FMD provides functional alteration of the arterial wall. Indeed, recent studies have failed to demonstrate any significant correlation between FMD and IMT in healthy subjects. 2 Prior studies have demonstrated that impaired FMD 3 and increased IMT 4 are independently associated with an increased risk of cardiovascular events. Nevertheless, recent studies have yielded inconsistent findings on the relative predictive values of FMD and IMT for cardiovascular events. 5 In the majority of studies, 3 -7 only male subjects were included. The gender difference on the predictive values of IMT and FMD may account for this conflicting result. Currently, there is very limited gender-specific data on the predictiv...

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Wang

Lau

et al. 2008

Clinical Cardiology

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“…Interestingly, no significant difference was determined between control subjects and patients with mild to moderate OSA [30]. In middle-aged healthy men, there was no significant correlation between carotid IMT and brachial artery FMD, suggesting that these two markers may be associated with different stages of atherogenesis [31]. Further investigations are required to confirm the association between OSA and IMT as risk factors for cardiovascular disease.…”

Section: Carotid Imtmentioning

confidence: 86%

Beneficial effects of CPAP treatment on endothelial function in patients with mild to moderate obstructive sleep apnea

Miyata¹,

Noda²,

Yasuda³

et al. 2017

Cardiovasc Disord Med

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Purpose: Obstructive sleep apnea (OSA) is associated with endothelial dysfunction, which may contribute to the onset of atherosclerosis and associated complications. Flow-mediated dilation (FMD) is routinely used as a noninvasive technique to evaluate endothelial function. The aim of the study was to investigate the impact of continuous positive airway pressure (CPAP) treatment on endothelial function in OSA. Methods:A cohort of twenty-five patients with OSA (age 53.8 ± 11.8 years) and 17 age-matched controls (age 48.1 ± 15.1 years) were included in the study. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using a plethysmography. FMD was evaluated using high-resolution ultrasound with a 7.5 MHz linear array transducer. The % FMD index was calculated as (maximum diameter -baseline diameter) / (baseline diameter) × 100. Maximum carotid intimamedia thickness (max IMT) was also determined.Results: % FMD was significantly lower in OSA patients compared to controls (3.3 ± 1.9 vs. 5.0 ± 1.9, P=0.009) while SBP, DBP, and max IMT did not significantly differ between the two groups. In OSA patients showing good CPAP adherence (defined as CPAP usage ≥4 h/night and 70% of nights), % FMD improved from 1.7 to 3.1 in the absence of any significant decrease in SBP or DBP. Conclusion:Although there was no difference in max IMT between OSA patients and control subjects, % FMD was significantly decreased in OSA patients. More particularly, our results suggest that good adherence to CPAP treatment might reverse endothelial dysfunction in these patients.

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“…It is accepted that the value of X10% dilatation was normal and that of o10% dilatation was abnormal, based on the results of a previous studies. 12,13 A normal age-matched group was also constituted with 12 subjects having FMD values obtained in the same laboratory.…”

Section: Sonographic Examinationsmentioning

confidence: 99%

The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction

et al. 2007

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The aim of this study was to investigate the relationship between penile color Doppler sonography (CDS) findings and sonographic endothelial parameters in patients with erectile dysfunction (ED), including intima-media thickness (IMT) of common carotid arteries (CCA) and flow-mediated dilatation (FMD) of brachial artery. Fifty-six ED patients were included in the study. Penile CDS, IMT of CCA and FMD of brachial artery were performed in all patients. According to penile CDS findings, 27 (48%) patients had non-vasculogenic and 29 (52%) patients had vasculogenic ED. Among 29 patients, 17 (30%) patients had cavernous veno-occlusive disease (CVOD) and 12 (22%) patients had arterial/combined insufficiency (AI). Median (interquartile range) FMD values of nonvasculogenic ED, CVOD and AI were 12.50 (6.54)%, 12.82 (7.41)% and 6.25 (7.17)%, respectively. FMD was found to be impaired significantly in AI group when compared to the other groups. FMD values of CVOD group were lower when compared to non-vasculogenic group, but the difference was not statistically significant. IMT values of vasculogenic ED patients were higher than nonvasculogenic ED patients (Po0.05). Although IMT values were higher in AI group when compared to CVOD, the difference was not statistically significant. The combined use of IMT and FMD established the diagnosis of vasculogenic ED with 100% sensitivity and 59.2% specificity. The positive predictive value was 72%, negative predictive value 100% and accuracy 80%. The combined use of brachial artery FMD and carotid arteries IMT measurements may be suggested as an alternative method to evaluate vasculogenic ED.

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Relationship Between Carotid Artery Intima-Media Thickness and Brachial Artery Flow-Mediated Dilation in Middle-Aged Healthy Men

Cited by 135 publications

References 29 publications

Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Gender Differences on Brachial Flow‐mediated Dilation and Carotid Intima‐media Thickness for Prediction of Spontaneous Cardiovascular Events

Beneficial effects of CPAP treatment on endothelial function in patients with mild to moderate obstructive sleep apnea

The combined use of brachial artery flow-mediated dilatation and carotid artery intima-media thickness measurements may be a method to determine vasculogenic erectile dysfunction

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