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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
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Flow-mediated dilation is associated with cardiovascular events in non-valvular atrial fibrillation patients

Ludovica Perri1, Daniele Pastori1, Pasquale Pignatelli1

  • 1I Clinica Medica, Sapienza University, Rome, Italy.

International Journal of Cardiology
|December 3, 2014
PubMed

Insights

Low flow-mediated dilation (FMD) in atrial fibrillation (AF) patients indicates a higher risk of cardiovascular events (CVE). Impaired artery dilation is linked to atherosclerotic complications in AF.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Clinical Medicine

Background:

  • Atrial fibrillation (AF) is linked to atherosclerotic risk factors and cardiovascular events (CVE).
  • Endothelial dysfunction, a marker of atherosclerosis, independently predicts CVE.
  • This study investigates the association between endothelial dysfunction, measured by flow-mediated dilation (FMD), and CVE in AF patients.

Purpose of the Study:

  • To evaluate the association between endothelial dysfunction (FMD) and cardiovascular events (CVE) in patients with non-valvular atrial fibrillation.
  • To determine if impaired FMD predicts future cardiovascular events in this patient population.

Main Methods:

  • Prospective measurement of FMD in 514 non-valvular AF patients on vitamin K antagonist therapy.
  • Follow-up for a mean of 23.5 months.
  • Composite outcome included stroke/transient ischemic attack (TIA), myocardial infarction (MI), urgent revascularization, and cardiovascular death.

Main Results:

  • A cardiovascular event (CVE) occurred in 8.56% of patients.
  • Patients experiencing a CVE had significantly lower FMD compared to those who did not (3.06% vs 4.67%, p=0.027).
  • Low FMD (below median), older age, smoking, and a history of stroke/TIA were independent predictors of CVE (p<0.023).

Conclusions:

  • Reduced flow-mediated dilation (FMD) is associated with an increased risk of cardiovascular events (CVE) in atrial fibrillation (AF) patients.
  • Impaired artery dilation is a significant predictor of atherosclerotic complications in AF.
  • FMD may serve as a valuable biomarker for risk stratification in AF patients.
Abstract

Keywords:
Atrial fibrillationEndothelial dysfunctionFlow mediated diolationMyocardial infarction

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