In 1995, the University of Virginia started measuring common/mean carotid intimal
medial thickness (IMT) and post–ischemia-induced flow-mediated dilation (FMD) as measures
of subclinical arteriosclerosis. These tests were performed in patients with intermediate
cardiovascular risk based on standard risk factors. IMT is a direct measure of carotid
arteriosclerosis and an indirect measure of generalized atherosclerosis.
1
O’Leary et al
2
found that increased common carotid IMT predicted myocardial infarctions in elderly
patients. FMD is a measure of nitric oxide release from the forearm arterial endothelium.
3
,
4
In patients with a healthy endothelium, forearm ischemia induces greater nitric oxide
release, and therefore, greater brachial artery dilation. Endothelial dysfunction
is one the first abnormalities found in arteriosclerosis,
- Corretti M.C.
- Anderson T.J.
- Benjamin E.J.
- Celermajer D.
- Charbonneau F.
- Creager M.A.
- Deanfield J.
- Drexler H.
- Gerhard-Herman M.
- Herrington D.
- et al.
Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation
of the brachial artery a report of the International Brachial Artery Reactivity Task Force.
J Am Coll Cardiol. 2002; 39: 257-265
5
dyslipidemia,
6
and type 2 diabetes.
7
,
8
Since 1995, 968 patients had FMD and IMT measured at the University of Virginia.
It is known that age is a predictor of IMT
9
; FMD is less well characterized. Celermajer et al
5
studied brachial and superficial femoral artery dilation and found an inverse relation
between arterial diameter and percent artery dilation. We sought to more carefully
characterize brachial artery FMD in addition to IMT. Therefore, we evaluated our cohort
of patients to determine how to best interpret FMD and IMT results based on patient
characteristics.To read this article in full you will need to make a payment
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References
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- Noninvasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.Lancet. 1992; 340: 1111-1115
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Article info
Publication history
Accepted:
February 28,
2003
Received in revised form:
February 28,
2003
Received:
December 10,
2002
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.