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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Impaired flow-mediated vasodilatation is associated with increased left ventricular mass in a multiethnic population.
Takuya Hasegawa1, Bernadette Boden-Albala, Kazuo Eguchi
1Division of Cardiology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Insights
Impaired flow-mediated vasodilatation (FMD), a marker of endothelial dysfunction, is linked to increased left ventricular (LV) mass. This finding suggests endothelial dysfunction may contribute to LV hypertrophy, a cardiovascular risk factor.
Area of Science:
- Cardiovascular Science
- Vascular Biology
- Clinical Research
Background:
- Increased left ventricular (LV) mass and endothelial dysfunction are established cardiovascular risk factors.
- The relationship between endothelial dysfunction and LV mass remains unclear.
Purpose of the Study:
- To investigate the association between impaired flow-mediated vasodilatation (FMD) and increased LV mass.
- To test the hypothesis that endothelial dysfunction is linked to LV mass in a multiethnic cohort.
Main Methods:
- Utilized two-dimensional echocardiography and high-resolution ultrasonography for FMD assessment in 867 stroke-free participants from the Northern Manhattan Study (NOMAS).
- Calculated LV mass and defined LV hypertrophy based on sex-specific indexed values.
- Employed multivariable regression models to analyze the association between FMD and LV mass.
Main Results:
- A significant inverse association was found between FMD and LV mass (beta = -1.21 +/- 0.56, P = 0.03) after adjusting for multiple cardiovascular risk factors.
- This association remained significant even after further adjustments for blood pressure components.
- Each 1% decrease in FMD correlated with an 8% increased risk of LV hypertrophy (OR 1.08, 95% CI 1.03-1.13, P < 0.01).
Conclusions:
- Impaired FMD is independently associated with increased LV mass.
- Endothelial dysfunction may represent a potential risk factor for the development of LV hypertrophy.
Background:
Increased left ventricular (LV) mass and endothelial dysfunction are important risk factors for cardiovascular mortality and morbidity. However, it is not clear whether endothelial dysfunction is associated with increased LV mass. We tested the hypothesis that impaired flow-mediated vasodilatation (FMD) is associated with increased LV mass in a population-based multiethnic cohort.
Methods:
As a part of the Northern Manhattan Study (NOMAS), we performed two-dimensional echocardiography and FMD assessment during reactive hyperemia by high-resolution ultrasonography in 867 stroke-free community participants. LV mass was calculated according to an established method. LV hypertrophy was defined as the 90th percentile of sex-specific LV mass indexed for body surface area among normal subjects. Multivariable models were used to test the association of FMD with LV mass.
Results:
In multiple linear regression analysis adjusting for age, sex, body mass index, systolic blood pressure, antihypertensive medications, low-density lipoprotein cholesterol, diabetes, smoking, hematocrit, and race-ethnicity, FMD was inversely associated with LV mass (beta = -1.21 +/- 0.56, P = 0.03). The association persisted after further adjustment for any component of blood pressure (systolic, mean, and pulse pressure). In univariate logistic regression analysis, each 1% decrease in FMD was associated with an 8% higher risk of LV hypertrophy (odds ratio 1.08, 95% confidence interval 1.03-1.13 per each FMD point P < 0.01).
Conclusions:
Impaired FMD is associated with LV mass, independent of other factors associated with increased LV mass. Endothelial dysfunction might be a potential risk factor for LV hypertrophy.
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