Related Experiment Video
Updated: May 4, 2026
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Microvascular function predicts cardiovascular events in primary prevention: long-term results from the Firefighters
Todd J Anderson1, Francois Charbonneau, Lawrence M Title
1Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, 1403-29th St. NW, Calgary, AB, Canada. todd.anderson@albertahealthservices.ca
Insights
Hyperemic velocity, a marker of microvascular function, predicts cardiovascular events in healthy men. This finding improves risk stratification beyond traditional factors and carotid intima-media thickness.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Biomarkers
Background:
- Atherosclerosis biomarkers can refine clinical decisions for individuals at risk of cardiovascular disease.
- Assessing endothelial function and vascular markers aids in risk stratification for apparently healthy men.
Purpose of the Study:
- To determine the prognostic significance of endothelial function and other vascular markers in apparently healthy men.
- To evaluate if microvascular function markers improve cardiovascular risk prediction.
Main Methods:
- 1574 apparently healthy men were studied, measuring flow-mediated dilation, hyperemic velocity, carotid intima-media thickness, and C-reactive protein.
- Cox proportional hazard models assessed relationships between vascular markers, Framingham risk score, and cardiovascular events.
- Follow-up averaged 7.2 years for a composite cardiovascular endpoint.
Main Results:
- Hyperemic velocity (HR, 0.70) and carotid intima-media thickness (HR, 1.45) were significant predictors of cardiovascular events.
- Flow-mediated dilation and C-reactive protein were not associated with events.
- Adding hyperemic velocity to the Framingham risk score significantly improved risk reclassification in intermediate-risk men.
Conclusions:
- Hyperemic velocity, a marker of microvascular function, is a significant predictor of adverse cardiovascular outcomes in men.
- This marker's prognostic value is additive to traditional risk factors and carotid intima-media thickness.
- Hyperemic velocity offers a novel tool for improving cardiovascular risk stratification in lower-risk healthy men.
Background:
Biomarkers of atherosclerosis may refine clinical decision making in individuals at risk of cardiovascular disease. The purpose of the study was to determine the prognostic significance of endothelial function and other vascular markers in apparently healthy men.
Methods And Results:
The cohort consisted of 1574 men (age, 49.4 years) free of vascular disease. Measurements included flow-mediated dilation and its microvascular stimulus, hyperemic velocity, carotid intima-media thickness, and C-reactive protein. Cox proportional hazard models evaluated the relationship between vascular markers, Framingham risk score, and time to a first composite cardiovascular end point of vascular death, revascularization, myocardial infarction, angina, and stroke. Subjects had low median Framingham risk score (7.9%). Cardiovascular events occurred in 71 subjects (111 events) over a mean follow-up of 7.2±1.7 years. Flow-mediated dilation was not associated with subsequent cardiovascular events (hazard ratio, 0.92; P=0.54). Both hyperemic velocity (hazard ratio, 0.70; 95% confidence interval, 0.54 to 0.90; P=0.006) and carotid intima-media thickness (hazard ratio, 1.45; confidence interval, 1.15 to 1.83; P=0.002) but not C-reactive protein (P=0.35) were related to events in a multivariable analysis that included Framingham risk score (per unit SD). Furthermore, the addition of hyperemic velocity to Framingham risk score resulted in a net clinical reclassification improvement of 28.7% (P<0.001) after 5 years of follow-up in the intermediate-risk group. Overall net reclassification improvement for hyperemic velocity was 6.9% (P=0.24).
Conclusions:
In men, hyperemic velocity, the stimulus for flow-mediated dilation, but not flow-mediated dilation itself was a significant risk marker for adverse cardiovascular outcomes. The prognostic value was additive to traditional risk factors and carotid intima-media thickness. Hyperemic velocity, a newly described marker of microvascular function, is a novel tool that may improve risk stratification of lower-risk healthy men.
More Related Videos
10:11Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
06:04Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024