Intima media thickness, pulse wave velocity, and flow mediated dilation

Abstract

The identification of vascular alterations at the sub-clinical, asymptomatic stages are potentially useful for screening, prevention and improvement of cardiovascular risk stratification beyond classical risk factors.Increased intima-media thickness of the common carotid artery is a well-known marker of early atherosclerosis, which significantly correlates with the development of cardiovascular diseases. More recently, other vascular parameters evaluating both structural and functional arterial proprieties of peripheral arteries have been introduced, for cardiovascular risk stratification and as surrogate endpoints in clinical trials. Increased arterial stiffness, which can be detected by applanation tonometry as carotid-femoral pulse wave velocity, has been shown to predict future cardiovascular events and to significantly improve risk stratification.Finally, earlier vascular abnormalities such as endothelial dysfunction in the peripheral arteries, detected as reduced flow-mediated dilation of the brachial artery, are useful in the research setting and as surrogate endpoints in clinical trials and have also been suggested for their possible clinical use in the future.This manuscript will briefly review clinical evidence supporting the use of these different vascular markers for cardiovascular risk stratification, focusing on the correct methodology, which is a crucial issue to address in order to promote their use in future for routine clinical practice.

Novel Paradigms of Salt and Hypertension

“…Endothelial dysfunction (ED) has been shown to be predictive of subsequent cardiovascular events and death. [38][39][40] Recent studies clearly showed that continuous administration of a high salt (300-350 mmol Na + /d or 6.9-8.0 g Na + /d) diet for 1 week impaired forearm endothelium-dependent vasodilation 41 and cutaneous microvascular function 42 independent of BP and serum sodium concentration. High salt intake has been shown to generate oxidative stress, reducing bioavailable NO and endothelium-dependent dilation in humans, 42 mice, 43 and rats.…”

Carotid intima-media thickness and arterial stiffness as early markers of atherosclerosis in pediatric celiac disease

“…Pulse wave velocity (PWV) is the main index for estimating arterial elasticity. This reliable, repeatable and noninvasive method is easy to practice and useful in detecting increased stiffness at the early stage 7 . Pulse wave velocity can be measured by applanation tonometry, oscillometry or vascular ultrasound on several arterial sites 8 .…”

Ubiquinol Ameliorates Endothelial Dysfunction in Subjects with Mild-to-Moderate Dyslipidemia: A Randomized Clinical Trial

“…EF was assessed by measuring the FMD of the brachial artery, a reliable and accurate non-invasive ultrasound technique [37]. Baseline FMD was below 6% in approximately 75% of the 78 subjects screened for the study, reflecting a condition of moderate ED in our population.…”