Correlation of Brachial Flow Mediated Dilation with Severity of Coronary Artery Disease
Abstract
Background. Endothelial dysfunction precedes the development of morphological changes and contributes to atherosclerotic lesion development and progression. Evaluation using non invasive method such as brachial FMD (flow mediated dilation) has given inconsistent information for extension and coronary atherosclerotic severity regarding endothelial dysfunction. This research will evaluate the correlation between brachial FMD and severity of coronary artery disease (CAD) stenosis.Methods. It was a cross sectional study. Evaluations were performed in 85 patients who had followed elective coronary angiography and fulfilled inclusion criteria in National Cardiovascular Center Harapan Kita since January until October of 2012. Correlation between brachial FMD and severity of CAD stenosis (Gensini score) was evaluated using linear regression analysis.
Results. Brachial FMD had negative correlation with Gensini score (R= -0,227; P= 0,037). Hypertension had negative correlation with brachial FMD (R= -0,235; P= 0,032). Male gender had positive correlation with brachial FMD (R= 0,220; P= 0,040).
Conclusion. There was weak negative correlation between brachial FMD and Gensini score.
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References
Charakida M, Masi S, Luscher TF, Kastelein JJ, Deanfield JE. Assessment of atherosclerosis: the role of flow-mediated dilatation. Eur Heart J 2010;31:2854-61.
Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995;92:1355-74.
Juonala M, Viikari JS, Laitinen T, et al. Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the cardiovascular risk in young Finns study. Circulation 2004;110:2918-23.
Halcox JP, Donald AE, Ellins E, et al. Endothelial function predicts progression of carotid intima-media thickness. Circulation 2009;119:1005-12.
Glowinska-Olszewska B, Tolwinska J, Urban M. Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents. J Pediatr Endocrinol Metab 2007;20:1125-36.
Kobayashi K, Akishita M, Yu W, Hashimoto M, Ohni M, Toba K. Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 2004;173:13-8.
Arrebola-Moreno AL, Laclaustra M, Kaski JC. Noninvasive assessment of endothelial function in clinical practice. Rev Esp Cardiol (Engl Ed) 2012;65:80-90.
Halcox JP, Deanfield JE. Endothelial cell function testing: how does the method help us in evaluating vascular status? Acta Paediatr Suppl 2004;93:48-54.
Gori T, Muxel S, Damaske A, et al. Endothelial function assessment: flow-mediated dilation and constriction provide different and complementary information on the presence of coronary artery disease. Eur Heart J 2012;33:363-71.
Neunteufl T, Katzenschlager R, Hassan A, et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997;129:111-8.
Teragawa H, Ueda K, Matsuda K, et al. Relationship between endothelial function in the coronary and brachial arteries. Clin Cardiol 2005;28:460-6.
Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995;26:1235-41.
Takase B, Hamabe A, Satomura K, et al. Comparable prognostic value of vasodilator response to acetylcholine in brachial and coronary arteries for predicting long-term cardiovascular events in suspected coronary artery disease. Circ J 2006;70:49-56.
Neeland IJ, Patel RS, Eshtehardi P, et al. Coronary angiographic scoring systems: an evaluation of their equivalence and validity. Am Heart J 2012;164:547-52 e1.
Lillpopp L, Tzikas S, Ojeda F, et al. Prognostic information of glycogen phosphorylase isoenzyme BB in patients with suspected acute coronary syndrome. Am J Cardiol 2012;110:1225-30.
Verma S, Buchanan MR, Anderson TJ. Endothelial function testing as a biomarker of vascular disease. Circulation 2003;108:2054-9.
Widlansky ME, Gokce N, Keaney JF, Jr., Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol 2003;42:1149-60.
Taddei S, Virdis A, Ghiadoni L, Salvetti G, Salvetti A. Endothelial dysfunction in hypertension. J Nephrol 2000;13:205-10.
Taddei S, Virdis A, Ghiadoni L, Salvetti A. Vascular effects of endothelin-1 in essential hypertension: relationship with cyclooxygenase-derived endothelium-dependent contracting factors and nitric oxide. J Cardiovasc Pharmacol 2000;35:S37-40.
Forstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J 2012;33:829-37, 37a-37d.
Corretti MC, Plotnick GD, Vogel RA. Correlation of cold pressor and flow-mediated brachial artery diameter responses with the presence of coronary artery disease. Am J Cardiol 1995;75:783-7.
Rohani M, Jogestrand T, Kallner G, Jussila R, Agewall S. Morphological changes rather than flow-mediated dilatation in the brachial artery are better indicators of the extent and severity of coronary artery disease. J Hypertens 2005;23:1397-402.
Frick M, Schwarzacher SP, Alber HF, et al. Morphologic rather than functional or mechanical sonographic parameters of the brachial artery are related to angiographically evident coronary atherosclerosis. J Am Coll Cardiol 2002;40:1825-30.
Spiro JR, Digby JE, Ghimire G, et al. Brachial artery low-flow-mediated constriction is increased early after coronary intervention and reduces during recovery after acute coronary syndrome: characterization of a recently described index of vascular function. Eur Heart J 2011;32:856-66.
Schroeder S, Enderle MD, Ossen R, et al. Noninvasive determination of endothelium-mediated vasodilation as a screening test for coronary artery disease: pilot study to assess the predictive value in comparison with angina pectoris, exercise electrocardiography, and myocardial perfusion imaging. Am Heart J 1999;138:731-9.
Matsushima Y, Takase B, Uehata A, et al. Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity. Int J Cardiol 2007;117:165-72.
Kylintireas I, Shirodaria C, Lee JM, et al. Multimodal cardiovascular magnetic resonance quantifies regional variation in vascular structure and function in patients with coronary artery disease: relationships with coronary disease severity. J Cardiovasc Magn Reson 2011;13:61.
Bots ML, Westerink J, Rabelink TJ, de Koning EJ. Assessment of flow-mediated vasodilatation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response. Eur Heart J 2005;26:363-8.
Atkinson G, Batterham AM, Thijssen DH, Green DJ. A new approach to improve the specificity of flow-mediated dilation for indicating endothelial function in cardiovascular research. J Hypertens 2013;31:287-91.
Donald AE, Charakida M, Falaschetti E, et al. Determinants of vascular phenotype in a large childhood population: the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur Heart J 2010;31:1502-10.
Ghiadoni L, Faita F, Salvetti M, et al. Assessment of flow-mediated dilation reproducibility: a nationwide multicenter study. J Hypertens 2012;30:1399-405.
Donald AE, Halcox JP, Charakida M, et al. Methodological approaches to optimize reproducibility and power in clinical studies of flow-mediated dilation. J Am Coll Cardiol 2008;51:1959-64.
Stary HC, Chandler AB, Dinsmore RE, et al. A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation 1995;92:1355-74.
Juonala M, Viikari JS, Laitinen T, et al. Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the cardiovascular risk in young Finns study. Circulation 2004;110:2918-23.
Halcox JP, Donald AE, Ellins E, et al. Endothelial function predicts progression of carotid intima-media thickness. Circulation 2009;119:1005-12.
Glowinska-Olszewska B, Tolwinska J, Urban M. Relationship between endothelial dysfunction, carotid artery intima media thickness and circulating markers of vascular inflammation in obese hypertensive children and adolescents. J Pediatr Endocrinol Metab 2007;20:1125-36.
Kobayashi K, Akishita M, Yu W, Hashimoto M, Ohni M, Toba K. Interrelationship between non-invasive measurements of atherosclerosis: flow-mediated dilation of brachial artery, carotid intima-media thickness and pulse wave velocity. Atherosclerosis 2004;173:13-8.
Arrebola-Moreno AL, Laclaustra M, Kaski JC. Noninvasive assessment of endothelial function in clinical practice. Rev Esp Cardiol (Engl Ed) 2012;65:80-90.
Halcox JP, Deanfield JE. Endothelial cell function testing: how does the method help us in evaluating vascular status? Acta Paediatr Suppl 2004;93:48-54.
Gori T, Muxel S, Damaske A, et al. Endothelial function assessment: flow-mediated dilation and constriction provide different and complementary information on the presence of coronary artery disease. Eur Heart J 2012;33:363-71.
Neunteufl T, Katzenschlager R, Hassan A, et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997;129:111-8.
Teragawa H, Ueda K, Matsuda K, et al. Relationship between endothelial function in the coronary and brachial arteries. Clin Cardiol 2005;28:460-6.
Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995;26:1235-41.
Takase B, Hamabe A, Satomura K, et al. Comparable prognostic value of vasodilator response to acetylcholine in brachial and coronary arteries for predicting long-term cardiovascular events in suspected coronary artery disease. Circ J 2006;70:49-56.
Neeland IJ, Patel RS, Eshtehardi P, et al. Coronary angiographic scoring systems: an evaluation of their equivalence and validity. Am Heart J 2012;164:547-52 e1.
Lillpopp L, Tzikas S, Ojeda F, et al. Prognostic information of glycogen phosphorylase isoenzyme BB in patients with suspected acute coronary syndrome. Am J Cardiol 2012;110:1225-30.
Verma S, Buchanan MR, Anderson TJ. Endothelial function testing as a biomarker of vascular disease. Circulation 2003;108:2054-9.
Widlansky ME, Gokce N, Keaney JF, Jr., Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol 2003;42:1149-60.
Taddei S, Virdis A, Ghiadoni L, Salvetti G, Salvetti A. Endothelial dysfunction in hypertension. J Nephrol 2000;13:205-10.
Taddei S, Virdis A, Ghiadoni L, Salvetti A. Vascular effects of endothelin-1 in essential hypertension: relationship with cyclooxygenase-derived endothelium-dependent contracting factors and nitric oxide. J Cardiovasc Pharmacol 2000;35:S37-40.
Forstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J 2012;33:829-37, 37a-37d.
Corretti MC, Plotnick GD, Vogel RA. Correlation of cold pressor and flow-mediated brachial artery diameter responses with the presence of coronary artery disease. Am J Cardiol 1995;75:783-7.
Rohani M, Jogestrand T, Kallner G, Jussila R, Agewall S. Morphological changes rather than flow-mediated dilatation in the brachial artery are better indicators of the extent and severity of coronary artery disease. J Hypertens 2005;23:1397-402.
Frick M, Schwarzacher SP, Alber HF, et al. Morphologic rather than functional or mechanical sonographic parameters of the brachial artery are related to angiographically evident coronary atherosclerosis. J Am Coll Cardiol 2002;40:1825-30.
Spiro JR, Digby JE, Ghimire G, et al. Brachial artery low-flow-mediated constriction is increased early after coronary intervention and reduces during recovery after acute coronary syndrome: characterization of a recently described index of vascular function. Eur Heart J 2011;32:856-66.
Schroeder S, Enderle MD, Ossen R, et al. Noninvasive determination of endothelium-mediated vasodilation as a screening test for coronary artery disease: pilot study to assess the predictive value in comparison with angina pectoris, exercise electrocardiography, and myocardial perfusion imaging. Am Heart J 1999;138:731-9.
Matsushima Y, Takase B, Uehata A, et al. Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity. Int J Cardiol 2007;117:165-72.
Kylintireas I, Shirodaria C, Lee JM, et al. Multimodal cardiovascular magnetic resonance quantifies regional variation in vascular structure and function in patients with coronary artery disease: relationships with coronary disease severity. J Cardiovasc Magn Reson 2011;13:61.
Bots ML, Westerink J, Rabelink TJ, de Koning EJ. Assessment of flow-mediated vasodilatation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response. Eur Heart J 2005;26:363-8.
Atkinson G, Batterham AM, Thijssen DH, Green DJ. A new approach to improve the specificity of flow-mediated dilation for indicating endothelial function in cardiovascular research. J Hypertens 2013;31:287-91.
Donald AE, Charakida M, Falaschetti E, et al. Determinants of vascular phenotype in a large childhood population: the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur Heart J 2010;31:1502-10.
Ghiadoni L, Faita F, Salvetti M, et al. Assessment of flow-mediated dilation reproducibility: a nationwide multicenter study. J Hypertens 2012;30:1399-405.
Donald AE, Halcox JP, Charakida M, et al. Methodological approaches to optimize reproducibility and power in clinical studies of flow-mediated dilation. J Am Coll Cardiol 2008;51:1959-64.
Published
2014-03-03
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How to Cite
Mulia, E., Sunu, I., Joesoef, A., & Harimurti, G. (2014). Correlation of Brachial Flow Mediated Dilation with Severity of Coronary Artery Disease. Indonesian Journal of Cardiology, 34(2), 71-8. https://doi.org/10.30701/ijc.v34i2.323
Section
Clinical Research
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