The Correlation Between Coronary Stenosis Index and Flow-Mediated Dilation of the Brachial Artery

Abstract

We examined the relationship between flow-mediated dilation (FMD) of the brachial artery and the extent and severity of coronary artery disease (CAD). Using high-resolution ultrasonography, we measured FMD and nitroglycerin-induced brachial artery dilation. We studied 121 patients (77 men, 44 women; mean age 64+/-11 years, range 25-79 years) who underwent coronary arteriography. The extent and severity of CAD were assessed by the coronary stenosis index (CSI). The adjusted FMD correlated inversely with CSI (rs=-0.63, p<0.0001). Multivariate analysis demonstrated that the adjusted FMD was an independent predictor of CSI. The adjusted FMD was 10.2+/-4.8% in patients without CAD (n=32), 7.7+/-6.0% in patients with single-vessel disease (n=31), 5.2+/-5.5% in patients with double-vessel disease (n=29), and 2.0+/-3.9% in patients with triple-vessel disease (n=29). The adjusted FMD was significantly lower in the double- (p<0.01) and triple-vessel (p<0.0001) disease groups than in patients without CAD. The adjusted FMD was significantly lower in the triple-vessel disease group than in the single-vessel disease group (p<0.001). Based on our results, as coronary atherosclerosis becomes more severe, the adjusted brachial artery FMD becomes more severely impaired.

Assessment of Arterial Stiffness Index as a Clinical Parameter for Atherosclerotic Coronary Artery Disease

“…Furthermore, the severity of atherosclerosis in the coronary bed was found to be correlated positively with the ASI on the brachial artery, which agreed well with previous stduies. 13,14 Recently, a new clinical testing device, the CardioVision ® MS-2000, was developed to simultaneously measure the arterial BP, PP, and ASI. [5][6][7][8] The changes in the stiffness of the large arteries, such as the aorta and its major branches, largely account for the changes in the systolic and diastolic BP and PP.…”

“…35 But functional aspects of generalized artery status of muscular artery such as stiffness and endothelial function are known to correlate to clinical CAD. 13,14 These biological and mechanical differences could explain that ASI-H had higher sensitivity, but lower specificity to discriminate patients with CAD than those of PWV.…”

Effects of acute and chronic low-volume high-intensity interval exercise on cardiovascular health in patients with coronary artery disease

“…Therefore, it is not surprising that atherosclerosis and endothelial dysfunction are often found to coexist. Compared to individuals with smooth coronary arteries, individuals with evidence of coronary atherosclerosis demonstrated impaired flow-mediated responses in the coronary (Cox et al 1989) and brachial (Kaku et al 1998;Lieberman et al 1996) arteries. Additionally, there is evidence of impaired NO production and decreased eNOS protein expression in atherosclerotic human arteries (Oemar et al 1998).…”

“…Similar to cardiorespiratory fitness, we did not observe a difference in the magnitude of improvement between the END and HIT groups, lending further support to the notion that positive training adaptations are obtainable with a lower volume of exercise. Patient with CAD are characterized as having endothelial dysfunction (Kaku et al 1998;Lieberman et al 1996); therefore, improved endothelial function would be desired in this population.…”

Self-vasodilating Ability at the Spastic Site of Patients with Vasospastic Angina

“…21) At baseline, the cor- onary artery is more spastic at the vasospastic site of patients with VSA. In human coronary 23,24) and brachial arteries 25,26) nitroglycerin-induced vasodilation (endothelium-independent vasodilation) was not enhanced, even at sites in which endothelium-dependent dilation was impaired. Thus, if endothelial dysfunction is the principle mechanism of coronary artery spasm, the supersensitive dilator response to nitrates at the spastic site was not compatible with past reports.…”