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Relationship between brachial flow-mediated dilation and carotid intima-media thickness in patients with coronary
Shigeru Toyoda1, Seiko Tokoi2, Hidehiro Takekawa3,4
1Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Japan - s-toyoda@dokkyomed.ac.jp.
Insights
Flow-mediated vasodilation (FMD) and carotid intima-media thickness (IMT) are markers of atherosclerosis. This study found carotid artery diameter correlated with FMD, but IMT did not significantly correlate with FMD in coronary artery disease patients.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Diagnostic Markers
Background:
- Flow-mediated vasodilation (FMD) of the brachial artery and carotid intima-media thickness (IMT) are established surrogate markers for atherosclerosis.
- Limited data exists on the direct relationship between brachial FMD and carotid IMT in patients with coronary artery disease (CAD).
Purpose of the Study:
- To extensively assess the relationship between brachial FMD and carotid ultrasonography findings in patients with established CAD.
- To determine if these markers have overlapping or distinct clinical significance in atherosclerotic disease pathophysiology.
Main Methods:
- Retrospective analysis of brachial FMD and carotid ultrasonography data from 159 patients with angiographically verified CAD.
- Statistical correlation analysis between mean/maximum IMT, carotid artery diameter, and FMD values.
Main Results:
- Mean carotid IMT showed a trend towards correlation with FMD (P=0.061), but maximum IMT did not (P=0.508).
- Carotid artery diameter was significantly correlated with FMD (P=0.0002).
- Abnormal FMD was associated with higher prevalence of high IMT and larger carotid artery diameter.
Conclusions:
- Brachial FMD and carotid IMT may possess different clinical significance as surrogate markers for atherosclerotic disease.
- Carotid artery diameter appears more closely related to FMD than IMT in this CAD cohort.
Background:
Although flow-mediated vasodilation (FMD) of brachial artery and carotid intima-media thickness (IMT) are important surrogate markers in the process of atherosclerosis, information about relationship between both markers is insufficient. In the present study, we assessed extensively the relationship in patients with coronary artery disease (CAD).
Methods:
The values of brachial FMD and carotid ultrasonography findings in 159 patients (67±8 years, 130 males) with angiographically verified CAD were retrospectively analyzed.
Results:
In all patients, mean carotid IMT tended to be correlated with FMD, although the correlation was not statistically significant (R=-0.149, P=0.061). Maximum IMT was not correlated with the FMD (R=0.053, P=0.508). In addition, carotid artery diameter was significantly correlated with the FMD (R=0.290, P=0.0002). Prevalence of high IMT value (≥1.0 mm) was higher in the abnormal FMD group (4%>; N.=67), compared with the normal FMD group (≥7%; N.=24; P<0.05). Carotid artery diameter was larger in abnormal FMD group, compared with both groups of normal FMD (P<0.01) and borderline FMD (4-7%; N.=68) (P<0.01). In all patients, receiver operating characteristics analysis demonstrated that cut-off value of FMD to predict the prevalence of ischemic stroke was 3.7% (AUC=0.735, P<0.001). The cut-off value of maximum IMT was 1.9 mm, but was not significant (AUC=0.522, P=0.829).
Conclusions:
Brachial FMD and carotid IMT would be different in clinical significance as a surrogate marker for pathophysiology of atherosclerotic disease.
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