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Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
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Transient endothelial dysfunction following flow-mediated dilation assessment.

Roberto Nerla1, Antonio Di Monaco, Alfonso Sestito

  • 1Dipartimento di Medicina Cardiovascolare, Università Cattolica del Sacro Cuore, Rome, Italy.

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|December 15, 2010
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Flow-mediated dilation (FMD) assessment can impair endothelial function. L-arginine administration reversed this impairment, suggesting increased NO synthesis inhibitors contribute to the effect.

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Area of Science:

  • Cardiovascular Research
  • Endothelial Function Assessment
  • Vascular Biology

Background:

  • Flow-mediated dilation (FMD) is a standard method for assessing endothelial function.
  • Concerns exist regarding potential mechanical damage to the arterial endothelium during FMD assessment.
  • Understanding the impact of repeated FMD measurements on endothelial function is crucial.

Purpose of the Study:

  • To investigate the effect of repeated flow-mediated dilation (FMD) assessments on endothelial function.
  • To determine if L-arginine administration can mitigate any impairment in endothelial function caused by FMD assessment.
  • To explore the role of asymmetric dimethyl-arginine (ADMA) in FMD-induced endothelial changes.

Main Methods:

  • Twenty healthy subjects underwent two consecutive FMD measurements on separate days.
  • On day 1, two FMD tests were performed 15 minutes apart.
  • On day 2, subjects received either placebo or intravenous L-arginine before undergoing two consecutive FMD tests; ADMA levels were measured.

Main Results:

  • Repeated FMD assessments significantly reduced FMD on day 1 in all subjects.
  • In the placebo group on day 2, the second FMD measurement was significantly lower than the first.
  • L-arginine administration on day 2 prevented the reduction in FMD, and ADMA levels increased after the first FMD test.

Conclusions:

  • Flow-mediated dilation assessment can induce a significant, temporary impairment of endothelial function.
  • This impairment appears to be mediated by an increase in endogenous nitric oxide synthesis inhibitors.
  • L-arginine administration effectively reverses this FMD-induced endothelial dysfunction, highlighting its therapeutic potential.