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Updated: Oct 17, 2025
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With
Britt Engan1, Mette Engan2,3, Gottfried Greve1,2
1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
Insights
Young adults born very preterm or with extremely low birthweight show impaired endothelial function, indicating a higher risk for cardiovascular disease. This study assessed vascular endothelial function using flow-mediated dilatation (FMD) in these individuals compared to term-born controls.
Area of Science:
- Cardiovascular Science
- Neonatalogy
- Vascular Biology
Background:
- Preterm birth and low birthweight are linked to increased cardiovascular disease risk in adulthood.
- Endothelial dysfunction is an early indicator of atherosclerotic cardiovascular disease.
- Previous research on endothelial function in very preterm or extremely low birthweight individuals yielded conflicting results.
Purpose of the Study:
- To assess cardiovascular disease risk by evaluating vascular endothelial function.
- Compared young adults born very preterm (<29 weeks gestation) or with extremely low birthweight (<1,000 g) to term-born controls.
Main Methods:
- Included 50 young adults born very preterm/extremely low birthweight and 49 term-born controls.
- Assessed endothelial function via ultrasound-measured flow-mediated dilatation (FMD) of the brachial artery.
- Measured arterial diameter at baseline, post-occlusion, and post-nitroglycerine administration.
Main Results:
- Young adults born very preterm/extremely low birthweight exhibited significantly lower FMD (0.17 mm) compared to controls (0.24 mm) (p=0.01).
- Percentage increase in FMD was lower in the preterm/low birthweight group (5.4%) versus controls (7.6%) (p=0.02).
- FMD relative to nitroglycerine-induced dilatation was significantly reduced in the preterm/low birthweight group (20% vs. 31%, p=0.001).
Conclusions:
- Young adults born very preterm or with extremely low birthweight demonstrate impaired endothelial function (lower FMD).
- This suggests an elevated risk of developing cardiovascular disease later in life.
- Findings highlight the importance of long-term cardiovascular monitoring for this population.
Abstract:
Background: Preterm birth and low birthweight have been associated with increased risk of cardiovascular disease in young adults. Endothelial dysfunction is established as an early marker for development of atherosclerotic cardiovascular disease. Previous studies of endothelial function in young adults born very preterm or with extremely low birthweight have, however, shown diverging results. Objective: We aimed to evaluate the risk of cardiovascular disease as measured by vascular endothelial function in young adults born very preterm (<29 weeks of gestation) or with extremely low birthweight (<1,000 g), compared with term-born controls. Methods: This study included 50 young adults born very preterm or with extremely low birthweight and 49 term-born controls born in Norway in the periods 1982-1985, 1991-1992, and 1999-2000 at mean age 28 (±6) years. The endothelial function was assessed by ultrasound measured flow-mediated dilatation (FMD) of the right brachial artery. The arterial diameter was measured at baseline, after release of 5 min of occlusion, and after sublingual administration of nitroglycerine. FMD was reported as absolute and percentage diameter change from baseline and relative to nitroglycerine-induced dilatation. Results: The participants were mainly normal weight non-smokers, without hypertension, diabetes, or established cardiovascular disease. The cases and controls had mean blood pressure 112/71 (SD 12/9) and 112/69 (SD 11/8) mmHg, body mass index 24.0 (SD 4.2) and 24.4 (SD 4.5) kg/m2, and HbA1c 32.7 (SD 2.5) and 33.0 (SD 2.6) mmol/mol, respectively. For both groups, 4 (8%) were smokers. Mean FMD for the adults born very preterm or with extremely low birthweight was 0.17 mm (95% CI 0.14, 0.21) vs. 0.24 mm (95% CI 0.20, 0.28) for the controls (p = 0.01), corresponding to a percentage increase of 5.4% (95% CI 4.2, 6.6) and 7.6% (95% CI 6.2, 8.9), respectively (p = 0.02). The FMD relative to maximal nitroglycerine-induced dilatation was 20% and 31%, respectively (p = 0.001). Conclusions: Young adults born very preterm or with extremely low birthweight have significantly lower FMD compared with the term-born controls suggesting an increased risk of cardiovascular disease.
