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Updated: Sep 20, 2025
Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test
Published on: April 27, 2016
Evaluation of Endothelial Dysfunction in COVID-19 With Flow-Mediated Dilatation
Asli Kurtar Mansiroglu1, Hande Seymen1, Isa Sincer1
1Abant Izzet Baysal University Hospital, Departamento de Cardiologia, Bolu - Turquia.
Insights
COVID-19 patients show impaired endothelial function, measured by flow-mediated dilatation (FMD), during early recovery. This suggests inflammation from COVID-19 negatively impacts blood vessel health, even after initial infection resolution.
Area of Science:
- Cardiovascular Research
- Infectious Diseases
- Medical Inflammation Studies
Background:
- Inflammation is a key factor in numerous diseases, including COVID-19.
- Endothelial function plays a critical role in cardiovascular health and disease pathogenesis.
Purpose of the Study:
- To evaluate the impact of inflammation on endothelial function in patients recently recovered from COVID-19.
- To assess endothelial function using flow-mediated dilatation (FMD) in COVID-19 survivors.
Main Methods:
- A comparative study involving 80 COVID-19 patients (diagnosed within six months) and 81 healthy controls.
- Transthoracic echocardiography and flow-mediated dilatation (FMD) measurements were performed on all participants.
- Statistical significance was set at p < 0.05.
Main Results:
- No significant differences in echocardiographic parameters were observed between groups.
- Flow-mediated dilatation (FMD) was significantly lower in the COVID-19 group compared to controls (p=0.01).
- Multivariate analysis confirmed FMD was significantly different between the control and COVID-19 groups (p=0.04), indicating endothelial dysfunction.
Conclusions:
- COVID-19 is associated with endothelial dysfunction in the early recovery phase, as indicated by reduced FMD.
- The findings highlight a potential long-term cardiovascular implication of COVID-19 infection.
Background:
Inflammation is known to play a crucial role in many diseases, including COVID-19.
Objective:
Using flow-mediated dilatation (FMD), we aimed to assess the effects of inflammation on endothelial function in COVID-19 patients.
Methods:
This study was conducted with a total of 161 subjects, of whom 80 were diagnosed with COVID-19 within the last six months (comprising 48 women and 32 men with a mean age of 32.10 ± 5.87 years) and 81 were healthy controls (comprising 45 women and 36 men with a mean age of 30.51 ± 7.33 years). We analyzed the findings of transthoracic echocardiography and FMD in all subjects. All results were considered statistically significant at the level of p < 0.05.
Results:
The echocardiography and FMD of the COVID-19 group were performed 35 days (range: 25-178) after diagnosis. There was no statistically significant difference in echocardiographic parameters. Differently, FMD (%) was significantly higher in the control group (9.52 ± 5.98 vs. 12.01 ± 6.18, p=0.01). In multivariate analysis with the forward stepwise model, FMD was significantly different in the control group compared to the COVID-19 group (1.086 (1.026 - 1.149), p=0.04). A Spearman's correlation test indicated that FMD (r=0.27, p=0.006) had a weak positive correlation with the presence of COVID-19.
Conclusion:
Our findings point to COVID-19-induced endothelial dysfunction, as assessed by FMD, in the early recovery phase.
