Delayed flow-mediated vasodilation and carotid atherosclerosis
Concetta Irace1, Claudio Carallo, Antonio Loprete
1Dipartimento di Medicina Sperimentale e Clinica G. Salvatore, Magna Graecia University, Catanzaro, Italy. irace@unicz.it
Insights
Flow-mediated dilation (FMD) patterns reveal varying degrees of carotid atherosclerosis. Delayed or absent FMD indicates more significant plaque buildup and intima-media thickness, highlighting FMD timing as a predictor of cardiovascular disease.
Area of Science:
- Cardiovascular physiology
- Vascular function assessment
- Atherosclerosis research
Background:
- Previous research identified distinct temporal patterns of post-ischemic flow-mediated dilation (FMD): early, late, and absent.
- These patterns were observed when comparing FMD measurements at 50 seconds versus 2 minutes post-cuff release.
Purpose of the Study:
- To investigate the association between these distinct temporal FMD patterns and the degree of carotid atherosclerosis.
- To determine if FMD timing is an independent predictor of carotid artery disease.
Main Methods:
- 124 subjects underwent FMD measurements at 50 seconds, 2 minutes, and 3 minutes post-forearm ischemia.
- Common carotid artery intima-media thickness (IMT) was measured.
- Carotid arteries were assessed for the presence and number of atherosclerotic plaques.
Main Results:
- Subjects were categorized into Early FMD (n=57), Late FMD (n=34), and Absent FMD (n=33) groups.
- Carotid plaque number and IMT increased progressively from Early FMD to Late FMD to Absent FMD.
- These differences remained significant after adjusting for age, sex, and cardiovascular risk factors (P < 0.03).
Conclusions:
- Temporal FMD patterns are significantly associated with the degree of carotid atherosclerosis.
- Late FMD indicates greater atherosclerosis than Early FMD.
- Absent FMD is associated with the most severe carotid atherosclerosis, suggesting FMD timing is a valuable indicator of vascular health.
Background:
In a previous study, we identified temporally distinct postischaemic flow-mediated dilation (FMD) patterns comparing the standard clinical measurement time of 50s postcuff release with measurement at 2 min. The comparison revealed a cohort with the highest FMD at 50s (Early FMD), another cohort with the highest FMD at 2 min (Late FMD) and a third cohort with no FMD (Absent FMD). The aim of this study was to examine whether these temporally distinct FMD patterns associated with different degrees of carotid atherosclerosis.
Materials And Methods:
One hundred and twenty-four free-living white subjects, participating in a cardio-vascular disease prevention campaign, were enrolled. FMD was measured at 50s, 2 min and 3 min after forearm ischaemia. The intima-media thickness (IMT) of the common carotid artery was measured, and the artery was evaluated for the presence and number of carotid plaques.
Results:
Fifty-seven subjects had Early FMD, 34 had Late FMD and 33 had Absent FMD. The three groups were comparable for age, sex and cardiovascular risk factors. The number of plaques in the carotid arteries, and IMT, increased progressively from Early, to Late, and to Absent FMD (P < 0·03), indicating that the FMD pattern is an independent predictive variable for IMT and carotid atherosclerosis.
Conclusions:
The present study demonstrates that temporal patterns associated with the degree of atherosclerosis of the carotid arteries. Patients with delayed vasodilation (Late FMD) had a higher degree of atherosclerosis than those with early vasodilation (Early FMD), and subjects with no postischaemic vasodilation (Absent FMD) had the most atherosclerosis.
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