Evidence of a weak correlation between peripheral endothelial function measures and carotid intima-media thickness
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Updated: May 18, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Sarina Schaefer1, Selina Muxel, Federica Fasola
1Department of Medicine, University Medical Center Mainz, Mainz, Germany.
Insights
Resting endothelial function, measured by radial artery flow-mediated constriction (L-FMC), correlates with subclinical carotid atherosclerosis (IMT). However, this link is weaker than the strong association between age and IMT.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Diagnostic Imaging
Background:
- Endothelial function is linked to coronary atherosclerosis.
- The relationship between endothelial function and carotid intima-media thickness (IMT) requires further investigation.
Purpose of the Study:
- To assess the correlation between endothelial function and carotid intima-media thickness.
- To explore factors influencing IMT in patients undergoing coronary angiography.
Main Methods:
- Assessed endothelial function using radial artery flow-mediated constriction (L-FMC) and dilation (FMD) in 513 patients.
- Measured intima-media thickness (IMT) of both carotid arteries.
- Correlated endothelial function measures with IMT and clinical factors.
Main Results:
- IMT was higher in patients with diabetes, males, BMI >30, and those over 65.
- Age showed a strong positive correlation with IMT (p < 0.0001).
- Resting L-FMC, but not FMD, weakly correlated with IMT (p = 0.008).
Conclusions:
- Resting endothelial function (L-FMC) correlates with subclinical carotid atherosclerosis (IMT).
- This correlation is weaker than the association between age and IMT.
- Age and certain clinical factors are stronger predictors of IMT than endothelial function.
Abstract:
Previous studies from our and other laboratories have demonstrated the existence of a clear relationship between different measures of endothelial function and the extent of coronary atherosclerosis. The relationship between endothelial function and carotid intima-media thickness has not been extensively investigated. Endothelial function using radial artery flow-mediated constriction (L-FMC) and dilation (FMD) was assessed in 513 consecutive patients undergoing diagnostic coronary angiography. Intima-media thickness of both carotid arteries was also measured. IMT was greater in patients with diabetes, males, those with body mass index >30, and in those older than 65 years (all p < 0.05). There was a strong correlation between age and IMT (p < 0.0001). Hypercholesterolemia and a family history for cardiovascular disease had no impact on IMT. In contrast, the relationship between either L-FMC or FMD and IMT was weak at best (p = 0.008 for the relationship between L-FMC and IMT, p = 0.13 for the relationship between FMD and IMT). There was a positive correlation between IMT and resting radial artery diameter (p = 0.008). IMT increased with the extent of coronary artery disease, but this trend did not reach statistical significance (p = 0.07). Resting (L-FMC), but not recruitable (FMD) endothelial function correlates with the extent of subclinical carotid atherosclerosis. This correlation is however weaker in comparison to that with age.
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