Relationships between Brachial Artery Flow Mediated Dilation and Carotid Artery Intima-Media Thickness in Patients with Suspected Coronary Artery Disease.

Abstract

SUMMARYThe correlation of peripheral endothelial dysfunction and intima-media thickness (IMT) in patients with suspected coronary artery disease (CAD) has been unclear. Inflammation and thrombosis may play a role at early stages of atherosclerosis. Thus, early atherosclerosis was noninvasively examined morphologically by IMT of carotid arteries, and functionally by flow mediated dilation (FMD) of brachial arteries in patients who were suspected of CAD and had undergone coronary angiography. Plasma antigen levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6, representative atherogenic cytokines, tissue factor (TF) and tissue factor pathway inhibitor (TFPI), markers of coagulation, and plasma activity level of plasminogen activator inhibitor type-1 (PAI-1), a marker of defective fibrinolysis, were measured. Patients with coronary atherosclerosis in one or more vessels with lesion ≥50% had significantly reduced FMD compared with those with angiographically normal coronary arteries. Carotid artery IMT increased significantly only in patients with advanced coronary atherosclerosis in one or more vessels with lesion ≥90%. Plasma antigen levels of IL-6 were significantly increased in patients with reduced FMD (<5%) compared to those in patients with FMD between 10 and 15%. Plasma antigen levels of TF, total and free TFPI, and PAI-1 activity tended to increase with a reduction in FMD. Thus, (1) FMD was reduced at early stages of CAD while IMT was increased in advanced CAD, and (2) inflammation and thrombosis may play a role in the early stages of the atherosclerotic process. (Jpn Heart J 2002; 43: 117-125)

Brachial artery vasoreactivity is associated with cross-sectional and longitudinal anatomical measures of atherosclerosis in postmenopausal women with coronary artery disease

“…The majority of studies to date that have examined the relationship between BFMD and anatomical measures of atherosclerosis have tended to focus on men or populations without clinical CVD. Correlations between BFMD and IMT reported by these studies ranged from r = −0.21 to −0.41 [13,[15][16][17], which are of greater magnitude than we observed (r = −0.12). Our findings in women with mild to moderate CAD provide support that the relationship between BFMD and anatomical measures of atherosclerosis holds true in women and among those with CAD, albeit at a lower magnitude than previously reported.…”

“…While QCA and CIMT are associated with prevalent CVD and have strong prognostic value for incident CVD independent of risk profiles [1,3,[6][7][8][9], the diagnostic and prognostic importance of BFMD for CVD is less certain [10]. Although some studies have shown BFMD to be predictive of future coronary events [11,12], only a handful of studies have reported an inverse association between BFMD and CIMT [13][14][15][16][17][18]. The majority of these studies were small, cross-sectional evaluations of men with pre-existing coronary artery disease (CAD) [13,[15][16][17].…”

“…Although some studies have shown BFMD to be predictive of future coronary events [11,12], only a handful of studies have reported an inverse association between BFMD and CIMT [13][14][15][16][17][18]. The majority of these studies were small, cross-sectional evaluations of men with pre-existing coronary artery disease (CAD) [13,[15][16][17]. Furthermore, associations between BFMD and other recognized measures of atherosclerosis have not been well established.…”

Could there be an association between chronic brucellosis and endothelial damage?

“…Endothelium-dependent vasodilatation is realized through vasodilator agents such as NO. Abnormal NO activity is linked to atherosclerosis and vasculopathy [20]. The changes in NO levels may be determined through the measurement of the nitrite/nitrate levels in the plasma or indirectly through a non-invasive technique such as FMD measurement [21].…”

Evaluation of the effects of chronic biomass fuel smoke exposure on peripheral endothelial functions: an observational study

“…Carotid intima-media thickness (CIMT), flow associated dilatation (FAD %) and nitric oxide sensitivity of the smooth muscle cell of the brachial artery to nitroglycerine (GTN %) are legitimate markers of early atherosclerosis (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). CIMT is a surrogate marker for generalized atherosclerosis and imparts prognostic information independent of traditional cardiovascular risk factors.…”