Flow-mediated Dilation (FMD) – Ultrasound Evaluation of Function of Vascular Endothelium in the Population Groups at Risk

Czech version

Authors: M. Mráz ¹; P. Olexa ²; Ľ. Podracká ¹
Authors‘ workplace: I. Klinika detí a dorastu LF UPJŠ a DFN, Košice prednostka prof. MUDr. Ľ. Podracká, CSc. ¹; Kardiologické oddelenie VÚSCH, Košice primár MUDr. M. Studenčan, PhD. ²
Published in: Čes-slov Pediat 2009; 64 (2): 83-88.
Category: Review

Overview

Cardiovascular diseases are the leading cause of morbidity and mortality in developed world. Their principal underlying mechanism is atherosclerosis which starts in the population at risk already in childhood. Endothelial dysfunction is the first manifestation of the adverse influence that various cardiovascular risk factors have on vessel wall.

As the beginning of atherosclerosis, it is reversible. Hence the current effort to minimize the overall population morbidity and mortality is based on detection of endothelial dysfunction in the young with increased cardiovascular risk. Flow-mediated dilation assessed non-invasively by ultrasound appears as a very promising tool in detection of early changes in vascular wall function.

Key words:
endothelial dysfunction, atherosclerosis, flow-mediated dilation

Sources

1. Endemann DH, Schiffrin EL. Endothelial dysfunction. J. Am. Soc. Nephrol. 2004;15: 1983–1992.

2. Verma S, Anderson TJ. Fundamentals of endothelial function for the clinical cardiologist. Circulation 2002;105: 546–552.

3. Bultas J, Karetová D. Hypertenze – význam endoteliálních faktorů. In Hypertension Prague 2002. Praha: Praha Publishing, 2002: 1–95.

4. Taddei S, Ghiadoni L, Virdis A, Versari D, Salvetti A. Clinical significance of the assessment of endothelial function. Review. Ital. Heart J. Suppl. 2004;5(5): 357–365.

5. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340: 1111–1115.

6. Mráz M. Ultrasound detection of endothelial dysfunction: the significance of flow mediated dilatation. Slov. Pediatr. 2004;4: 201–204.

7. Mráz M, Spurný P, Podracká Ľ. Neinvazívna diagnostika včasných štádií aterosklerózy. Ateroskleróza 2004;8(2): 42–44.

8. Mráz M, Spurný P, Pytliak M, Podracká Ľ. Endotelová dysfunkcia. Čes.-slov. Pediat. 2004;59(6): 311–315.

9. Halcox JP, Deanfield JE. Endothelial cell function testing: how does the method help us in evaluating vascular status? Review. Acta Paediatr. Suppl. 2004;93(446): 48–54.

10. Halcox JP, Schenke WH, Zalos G, et al. Prognostic value of coronary vascular endothelial dysfunction. Circulation 2002;106: 653–658.

11. Moens AL, Goovaerts I, Claeys MJ, Vrints CJ. Flow-mediated vasodilation: a diagnostic instrument, or an experimental tool? Review. Chest 2005;127(6): 2254–2263.

12. Miura H, Wachtel RE, Liu Y, et al. Flow-induced dilation of human coronary arterioles: important role of Ca(2+)-activated K(+) channels. Circulation 2001;103(15): 1992–1998.

13. Jarvisalo MJ, Ronnemaa T, Volanen I, et al. Brachial artery dilatation responses in healthy children and adolescents. Am. J. Physiol. Heart Circ. Physiol. 2002;282(1): H87–92.

14. Sorensen KE, Celermajer DS, Spiegelhalter DJ, et al. Non-invasive measurement of human endothelium dependent arterial responses: accuracy and reproducibility. Br. Heart J. 1995;74(3): 247–253.

15. Ferrari AU, Radaelli A, Centola M. Invited review: aging and the cardiovascular system. Review. J. Appl. Physiol. 2003;95(6): 2591–2597.

16. Silber HA, Ouyang P, Bluemke DA, et al. Why is flow-mediated dilation dependent on arterial size? Assessment of the shear stimulus using phase-contrast magnetic resonance imaging. Am. J. Physiol. Heart Circ. Physiol. 2005;288(2): H822–828.

17. Kelm M. Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects. Review. Am. J. Physiol. Heart Circ. Physiol. 2002;282(1): H1–5.

18. Tandon S, Bhargava K, Gusta H, et al. Non-invasive assessment of endothelial function by brachial artery flow mediated vasodilatation and its association with coronary artery disease: an Indian perspective. J. Indian Med. Assoc. 2004;102(5): 243–246, 251–252.

19. Kaku B, Mizuno S, Ohsato K, et al. The correlation between coronary stenosis index and flow-mediated dilation of the brachial artery. Jpn. Circ. J. 1998;62(6): 425–430.

20. Woo KS, Chook P, Chan WB, et al. Type 1 diabetes and arterial dysfunction in asymptomatic Chinese adults. Diabetes Care 2001;24(1): 173.

21. Woo KS, Chook P, Yu CW, et al. Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening. Int. J. Obes. Relat. Metab. Disord. 2004;28(7): 852–857.

22. Woo KS, Sanderson JE, Sun YY, et al. Hyperhomocyst(e)inemia is a risk factor for arterial endothelial dysfunction in humans. Circulation 2000;101(12): E116.

23. Puranik R, Celermajer DS. Smoking and endothelial function. Review. Prog. Cardiovasc. Dis. 2003;45(6): 443–458.

24. Cosentino F, Volpe M. Hypertension, stroke, and endothelium. Review. Curr. Hypertens. Rep. 2005;7(1): 68–71.

25. Thanyasiri P, Celermajer DS, Adams MR. Endothelial dysfunction occurs in peripheral circulation patients with acute and stable coronary artery disease. Am. J. Physiol. Heart Circ. Physiol. 2005;289(2): H513–517.

26. Vanhoutte PM. Ageing and endothelial dysfunction. Eur. Heart J. 2002;4(Suppl A): A8–A17.

27. Herrington DM, Fan L, Drum M, et al. Brachial flow-mediated vasodilator responses in population-based research: methods, reproducibility and effects of age, gender and baseline diameter. J. Cardiovasc. Risk. 2001;8(5): 319–328.

28. Sanada M, Higashi Y, Nakagawa K, et al. Hormone replacement effects on endothelial function measured in the forearm resistance artery in normocholesterolemic and hypercholesterolemic postmenopausal women. J. Clin. Endocrinol. Metab. 2002;87(10): 4634–4641.

29. Sitges M, Heras M, Roig E, et al. Acute and mid-term combined hormone replacement therapy improves endothelial function in post-menopausal women with angina and angiographically normal coronary arteries. Eur. Heart J. 2001;22(22): 2116–2124.

30. Jokela H, Dastidar P, Rontu R, et al. Effects of long-term estrogen replacement therapy versus combined hormone replacement therapy on nitric oxide-dependent vasomotor function. J. Clin. Endocrinol. Metab. 2003;88(9): 4348–4354.

31. Sorensen KE, Dorup I, Hermann AP, Mosekilde L. Combined hormone replacement therapy does not protect women against the age-related decline in endothelium-dependent vasomotor function. Circulation 1998;97: 1234–1238.

32. Williams MR, Westerman RA, Kingwell BA, et al. Variations in endothelial function and arterial compliance during the menstrual cycle. J. Clin. Endocrinol. Metab. 2001;86(11): 5389–5395.

33. VirdisA, Pinto S, Versari D, et al. Effect of oral contraceptives on endothelial function in the peripheral microcirculation of healthy women. J. Hypertens. 2003;21(12): 2275–2280.

34. Ghiadoni L, Donald A., E., Cropley, M., et al. Mental stress induced transient endothelial dysfunction in humans. Circulation 2000;102: 2473–2478.

35. Hijmering ML, Stroes ES, Olijhoek J, et al. Sympathetic activation markedly reduces endothelium-dependent, flow-mediated vasodilation. J. Am. Coll. Cardiol. 2002;39(4): 683–688.

36. Otto ME, Svatikova A, Barretto RB, et al. Early morning attenuation of endothelial function in healthy humans. Circulation 2004;109(21): 2507–2510.

37. Motoyama T, Kawano H, Kugiyama K, et al. Endothelium-dependent vasodilation in the brachial artery is impaired in smokers: effect of vitamin C. Am. J. Physiol. 1997;273: H1644–H1650.

38. Kawano H, Motoyama T, Hirashima O, et al. Hyperglycemia rapidly suppresses flow-mediated endothelium-dependent vasodilation of brachial artery. J. Am. Coll. Cardiol. 1999;34: 146–154.

39. Panza JA, Epstein SE, Quyyumi A. Circadian variation in vascular tone and its relation to alpha-sympathetic vasoconstrictor activity. N. Engl. J. Med. 1991;325: 986–990.

40. Tsai WC, Li YH, Lin CC, et al. Effects of oxidative stress on endothelial function after a high-fat meal. Clin. Sci. (Lond) 2004;106(3): 315–319.

41. Lee IK, Kim HS, Bae JH. Endothelial dysfunction: its relationship with acute hyperglycaemia and hyperlipidemia. Int. J. Clin. Pract. 2002;Suppl(129): 59–64.

42. Sies H, Stahl W, Sevanian A. Nutritional, dietary and postprandial oxidative stress. Review. J. Nutr. 2005;135(5):969–972.

43. Rebolledo OR, Actis Dato SM. Postprandial hyperglycemia and hyperlipidemia-generated glycoxidative stress: its contribution to the pathogenesis of diabetes complications. Review. Eur. Rev. Med. Pharmacol. Sci. 2005;9(4): 191–208.

44. Dickinson S, Brand-Miller J. Glycemic index, postprandial glycemia and cardiovascular disease. Review. Curr. Opin. Lipidol. 2005;16(1): 69–75.

45. 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. Review. Eur. Heart J. 2005;26(4): 363–368. Epub 2004 Dec 1.

46. De Roos NM, Bots ML, Schouten EG, Katan MB. Within-subject variability of flow-mediated vasodilation of the brachial artery in healthy men and women: implications for experimental studies. Ultrasound Med. Biol. 2003;29(3): 401–406.

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Article was published in

Czech-Slovak Pediatrics

2009 Issue 2