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Updated: May 26, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Assessment of endothelial function by brachial artery flow mediated dilatation in microvascular disease
Otikunta Adikesava Naidu1, Durgaprasad Rajasekhar, S A A Latheef
1Department of Cardiology, Osmania General Hospital and Osmania Medical College, Hyderabad, Andhra Pradesh, India. yakheen@gmail.com
Insights
Cardiac Syndrome X (CSX) patients exhibit impaired endothelial function, indicated by reduced flow-mediated dilation. Higher blood pressure and BMI are linked to this endothelial dysfunction in CSX.
Area of Science:
- Cardiology
- Vascular Biology
- Diagnostic Medicine
Background:
- Cardiac Syndrome X (CSX) presents a significant diagnostic and therapeutic challenge.
- Understanding CSX pathophysiology is crucial for managing coronary microcirculation disorders.
Purpose of the Study:
- To investigate endothelial function in CSX patients using flow-mediated dilation (FMD).
- To identify potential risk factors associated with endothelial dysfunction in CSX.
Main Methods:
- High-resolution ultrasound measured brachial artery FMD (endothelium-dependent and independent) in 30 CSX patients and 30 controls.
- Nitroglycerin response assessed independent vasodilation.
Main Results:
- CSX patients showed significantly decreased FMD compared to controls (9.42±7.20 vs 21.11±9.16, p<0.01).
- Endothelial dysfunction prevalence was higher in CSX patients (76% vs 16%, p<0.01).
- FMD was significantly associated with systolic blood pressure (OR 1.122) and body mass index (OR 1.248).
Conclusions:
- Endothelial dysfunction is impaired in patients with Cardiac Syndrome X.
- Elevated systolic blood pressure and body mass index are risk factors for endothelial dysfunction in CSX.
Background:
Cardiac syndrome X is an important therapeutic and diagnostic challenge to physician. Study of Csx patients may help to understand the pathophysiology of coronary microcirculation and to gain an insight on the management of these group patients.
Methods:
We measured the flow mediated dilation of the brachial artery both endothelium dependent and independent vasodilatation by high resolution ultrasound in 30 cardiac syndrome X patients and matched with 30 healthy control subjects.
Results:
Significantly decreased flow mediated dilatation was observed in patients when compared to control (9.42±7.20 vs 21.11±9.16 p<0.01) but no significant difference was observed between groups in response to nitroglycerin (25.39±6.82 vs 28.87±8.69). Receiver operator characteristic analysis showed that value of <11.11 had sensitivity of 80%, specificity 86.67%, positive predictive value 76.66%, negative predictive value 83.33%. In total, 46% of subjects had endothelial dysfunction and of them, CSX subjects had higher prevalence (76% vs 16% p<0.01) than control subjects. Higher mean values of body mass index, systolic blood pressure and diastolic blood pressure was observed in subjects with FMD<11.11 than >11.11(p<0.01). In logistic regression analysis, FMD was significantly associated with systolic blood pressure (Odds ratio 1.122 95% CI 1.053-1.196 p<0.01) and body mass index (Odds 1.248 95%CI 0.995-1.56 p<0.05).
Conclusions:
The study suggests impairment of endothelial function in cardiac syndrome X patients. Increased Systolic blood pressure and body mass index may increase the risk of impairment of endothelial function in this group of patients.
