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Published on: October 22, 2014
Flow-Mediated Dilatation in the Assessment of Coronary Heart Disease: A Meta-Analysis
Xiaoyong Xiao1, Xian Li2, Xiaohua Xiao3
1Department of Emergency, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China.
Insights
This meta-analysis reveals that patients with coronary heart disease (CHD) exhibit significantly lower flow-mediated dilatation (FMD) compared to controls. Lower FMD is a key indicator of endothelial dysfunction in CHD patients.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Medical Diagnostics
Background:
- Endothelial dysfunction is linked to increased coronary heart disease (CHD) morbidity and mortality.
- Flow-mediated dilatation (FMD) is a primary noninvasive method for assessing vascular endothelial function.
Purpose of the Study:
- To conduct a meta-analysis investigating the association between FMD and CHD.
- To determine if FMD levels differ significantly between individuals with and without CHD.
Main Methods:
- Systematic search of PubMed, Web of Science, Scopus, and Embase databases.
- Meta-analysis of 9 studies involving 943 participants (534 CHD patients, 409 controls) using Stata 14.
- Standardized Mean Difference (SMD) calculated for FMD levels with 95% Confidence Intervals (CI); heterogeneity assessed using I² statistics.
Main Results:
- Patients with CHD demonstrated significantly lower FMD compared to control groups (SMD -0.706%; 95% CI: -0.985, -0.427; P=0.001).
- High statistical heterogeneity was observed across the included studies.
- Funnel plot analysis indicated potential publication bias, though sensitivity analyses found no single influential study.
Conclusions:
- This meta-analysis provides robust evidence that reduced FMD is significantly associated with coronary heart disease.
- FMD serves as a critical indicator of endothelial dysfunction and a potential hallmark in the context of CHD.
Abstract:
Endothelial dysfunction may contribute to the increased morbidity and mortality associated with coronary heart disease (CHD). Flow-mediated dilatation (FMD) is the most popular noninvasive method for vascular endothelial function evaluation. This meta-analysis aimed to investigate the association between FMD and CHD. We searched the publications listed in the PubMed, Web of Science, Scopus, and Embase databases. Stata 14 software was used to analyze the data. Standardized mean difference (SMD) was used to calculate FMD levels, and the effect sizes were expressed with a 95% confidence interval (CI). I2 statistics were used to evaluate statistical heterogeneity. In this meta-analysis, 9 studies enrolled a total number of 943 participants, including 534 (56.63%) patients with CHD and 409 controls (43.37%). We found that patients with CHD showed a significantly lower FMD than the controls (SMD -0.706%; 95% CI: -0.985, -0.427; P=0.001) with high heterogeneity. In addition, funnel plot analysis suggested asymmetry that could be evidence of publication bias. But sensitivity analyses show that there were no influential studies. This meta-analysis provides evidence that patients with CHD show a significantly lower FMD than controls and highlights the literature on FMD as a hallmark in CHD diseases.
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