Assessment of atherosclerosis: the role of flow-mediated dilatation

Abstract

Evidence suggests that endothelial dysfunction is on the causal pathway for both atherogenesis and destabilization of established plaques. In this review, the role of flow-mediated dilatation (FMD) as a non-invasive method to assess endothelial function is discussed. Technical modifications and development of analysis software have significantly improved the variability of the method. Following a strict standardized protocol enables reproducible measurements to be achieved and export of the technique from specialized laboratories to population studies and multicentre settings. Endothelial function assessed by FMD has been shown to be affected by cardiovascular risk factors, to be related to structural arterial disease and to cardiovascular outcome, validating its use for studying the pathophysiology of arterial disease. Numerous studies have also demonstrated that it is responsive to physiological and pharmacological interventions. Flow-mediated dilatation provides unique opportunities in drug development programmes to assess an early rapidly responsive signal of risk or benefit, complementing endpoints of structural arterial disease and cardiovascular outcomes that take much longer and are more expensive.

Endothelial dysfunction in human essential hypertension

“…19 This technique is particularly attractive as it is easy to repeat in patients, however there is still some variation between centres regarding image acquisition, for example in the time when measurements are obtained after cuff release so there still needs to be some standardization of the technique, though there have been attempts to do that. 20,21 Recently, FMD has shown good, reproducible results in multi-centre studies when rigorous methodology is used, perhaps suggesting that it will soon be able to be utilised in large prospective population studies as an outcome measure. 22,23 In a seven-centre study by Ghiadoni et al, the authors evaluated 135 adult healthy volunteers to assess reproducibility of FMD using a standardized protocol at 3 timepoints (baseline, 1 hour after baseline and 30 days after).…”

Evidence that periodontal treatment improves biomarkers and CVD outcomes

“…Endothelial dysfunction can predict adverse CVD events and long-term outcomes (Schachinger et al 2000). Flow-mediated dilatation (FMD) represents the most widely used non-invasive ultrasound method to assess endothelial function, it measures endothelium-dependent vasorelaxation of the brachial artery (Charakida et al 2010).…”

Study of Insulin Resistance, Inflammatory Cytokines and Adhesive Molecules in Obese Subjects with Obstructive Sleep Apnea

“…Circulating abnormal levels of inflammatory markers and adhesive molecules have been associated with future cardiovascular risk [19,20]. However, high risk of mortality and cardiovascular morbidity is associated with OSA [21][22][23].…”