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Measures of brachial artery distensibility in relation to coronary calcification
Matthew J Budoff1, Ferdinand Flores, Jeffrey Tsai
1Division of Cardiology, Harbor-UCLA Medical Center Research and Education Institute, Torrance, California 90502, USA. budoff@flash.net
Insights
Measures of brachial artery distensibility predict coronary artery calcification (CAC) in healthy adults. Stiffer arteries, indicating reduced distensibility, correlate with higher CAC, suggesting a noninvasive method for assessing atherosclerotic burden.
Area of Science:
- Cardiovascular disease research
- Vascular biology
- Diagnostic imaging
Background:
- Brachial artery distensibility measures are linked to heart disease risk.
- These measures may reflect endothelial function or atherosclerosis but lack direct comparison to subclinical atherosclerosis.
- This study aimed to compare brachial artery distensibility with subclinical atherosclerosis assessed by electron beam tomography (EBT).
Purpose of the Study:
- To compare brachial artery distensibility measurements with subclinical atherosclerosis determined by EBT.
- To evaluate the predictive value of brachial artery measures for coronary artery calcification (CAC).
Main Methods:
- Collected brachial artery pulse waveform data from 201 healthy adults using DynaPulse 2000A.
- Measured arterial distensibility and compared it with coronary artery calcification (CAC) via EBT.
- Obtained laboratory values, risk factors, blood pressure, and heart rate for comparative analysis.
Main Results:
- Brachial artery measures were the strongest predictors of CAC in multivariate analysis.
- In women, brachial artery resistance was the strongest independent predictor of log CAC score (r = 0.373, P =.004).
- In men, brachial artery distensibility was the sole independent predictor of calcium scores (P =.012).
- Individuals in the highest quintile of CAC score exhibited significantly higher mean brachial artery distensibility compared to the lowest quintile (P =.02).
Conclusions:
- Decreased arterial distensibility (stiffer vessels) was observed in individuals with higher coronary artery calcium levels.
- Noninvasive distensibility measures are valuable for assessing subclinical vascular changes associated with arteriosclerosis.
- This noninvasive approach offers a potentially simple and cost-effective method for identifying patients with substantial atherosclerotic burden.
Background:
Brachial artery measures of arterial distensibility have been demonstrated to be independent risk factors for development of heart disease. These measures have been suggested as reflecting the endothelial function or atherosclerotic burden; however, they have not been compared with levels of subclinical atherosclerosis. This study sought to compare measures of brachial artery distensibility to subclinical atherosclerosis as measured by electron beam tomography (EBT).
Methods:
Brachial artery pulse waveform data were collected using the DynaPulse 2000A (Pulse Metric, Inc., San Diego, CA). Distensibility measurements were taken on 201 healthy adults and compared with levels of coronary artery calcification (CAC) as measured by EBT. Laboratory values, risk factors, blood pressure (BP), and heart rate measurements were also obtained. We then compared the results of the brachial artery measurements to measures of standard risk factors and CAC.
Results:
Multivariate analysis was performed, revealing that brachial artery measures were the strongest predictor of CAC. For women, brachial artery (BA) resistance was the strongest independent predictor of log CAC score (r = 0.373, P =.004). For men, BA distensibility was the only independent predictor of calcium scores (P =.012). We then divided the patients into quintiles of calcium score. Patients in the top quintile had a mean BA distensibility that was significantly higher than those of the lowest quintile (P =.02).
Conclusions:
Stiffer vessels with decreased distensibility were seen in subjects with higher levels of coronary artery calcium. Therefore, noninvasive measures of distensibility are useful in measuring subclinical vascular changes related to arteriosclerosis. This noninvasive measure might provide a simple and inexpensive method to identify patients with significant atherosclerotic burden.