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Related Experiment Video

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Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
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DOES FLOW-MEDIATED DILATION NORMALIZATION FOR BASE-SCALED SHEAR RATE IMPROVE ITS VALUE IN CORONARY ARTERY DISEASE

Andrzej Nowicki1, Barbara Gambin1, Wojciech Secomski1

  • 1Department of Ultrasound, Institute of the Fundamental Technological Research of the Polish Academy of Sciences, Warsaw, Poland.

Ultrasound in Medicine & Biology
|July 1, 2020
PubMed
Summary

A new method for normalizing flow-mediated dilation (FMD) improves coronary artery disease (CAD) detection. This enhanced FMD/BSSR analysis offers 100% sensitivity and specificity in differentiating healthy individuals from CAD patients.

Keywords:
Coronary artery diseaseFlow-mediated vasodilationPulsed DopplerRadial arteryShear rateUltrasonography

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Area of Science:

  • Vascular biology
  • Cardiovascular diagnostics
  • Biomedical engineering

Background:

  • Flow-mediated dilation (FMD) is a key indicator of endothelial function.
  • Current FMD normalization methods may limit diagnostic accuracy for coronary artery disease (CAD).
  • A novel normalization parameter, basal shear rate (BSSR), is proposed.

Purpose of the Study:

  • To introduce and validate a new normalization method for FMD in the radial artery using BSSR.
  • To assess the efficacy of the FMD/BSSR normalization in differentiating healthy subjects from patients with stable CAD.

Main Methods:

  • A new FMD normalization algorithm incorporating BSSR (ratio of basal shear rate to post-occlusive shear rate) was developed.
  • The algorithm's in vivo performance was evaluated in healthy volunteers (Group I) and patients with stable CAD (Group II).
  • Normalized FMD values (FMD/SR and FMD/BSSR) were compared between groups, and diagnostic performance metrics were calculated.

Main Results:

  • The FMD/BSSR normalization revealed a ~50% greater difference between healthy subjects and CAD patients compared to FMD/SR.
  • FMD/SR values were (3.19 ± 1.4)•10-4 in healthy subjects and (1.02 ± 0.76)•10-4 in CAD patients.
  • FMD/BSSR values were 28 ± 9.40 in healthy subjects and 6.01 ± 3.74 in CAD patients.
  • Prediction of CAD using FMD/SR had 83.3% sensitivity and 84.6% specificity.
  • Prediction of CAD using FMD/BSSR achieved 100% sensitivity and 100% specificity.

Conclusions:

  • The novel FMD/BSSR normalization algorithm significantly enhances the differentiation between healthy individuals and patients with stable CAD.
  • This improved diagnostic accuracy suggests the FMD/BSSR method is a valuable tool for cardiovascular risk assessment.