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Updated: Aug 24, 2025
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Flow-Mediated Dilation, a Marker of Endothelial Cell Dysfunction, in Patients with Pulmonary Hypertension
Ahmad Mirdamadi1, Mohammad Shirzad2, Raana Abrishamkar2
1Department of Cardiology, Najafabad Branch, Islamic Azad University, Najafabad, Isfahan, Iran.
Insights
Flow-mediated dilation (FMD) indicates endothelial cell dysfunction in pulmonary hypertension (PH). FMD and 6-minute walk tests are objective prognostic markers for PH, while pro-BNP aids in diagnosing right ventricular dysfunction.
Area of Science:
- Cardiovascular Medicine
- Pulmonary Medicine
- Vascular Biology
Background:
- Endothelial cell dysfunction (ECD) is linked to cardiovascular diseases.
- The role of ECD in pulmonary hypertension (PH) pathogenesis is not well understood.
- Flow-mediated dilation (FMD) is a key indicator of ECD.
Purpose of the Study:
- To investigate the relationship between FMD and PH.
- To assess FMD as a potential marker in PH patients.
Main Methods:
- Cross-sectional study of 40 PH patients.
- Brachial artery FMD measurement.
- Evaluation of echocardiography, 6-minute walk test (6MWT), and pro-brain natriuretic peptide (pro-BNP).
Main Results:
- Significant direct correlation between left ventricular ejection fraction and FMD.
- Significant inverse relationship between pro-BNP and FMD.
- Significant direct correlation between right ventricular (RV) function and FMD.
- RV dilation correlated with pro-BNP.
- Inverse relationship between pro-BNP and 6MWT.
Conclusions:
- Endothelial function, assessed by FMD, is relevant in PH.
- FMD and 6MWT serve as objective prognostic markers in PH.
- Pro-BNP is a noninvasive indicator for diagnosing RV systolic dysfunction.
Background:
Flow-mediated dilation (FMD) is considered a marker of endothelial cell dysfunction (ECD) and has been mostly evaluated in coronary artery disease. The role of ECD in the pathogenesis of pulmonary hypertension (PH) is not well-known. This study sought to evaluate the relationship between FMD and PH.
Materials And Methods:
In this cross-sectional study, the FMD of the brachial artery was measured in 40 confirmed PH patients. Meanwhile, echocardiographic findings, the 6-minute walk test (6MWT), and serum pro-brain natriuretic peptide (pro-BNP) level were evaluated. Overall, 20 patients accomplished all evaluations, and their data were analyzed using SPSS software (version 23).
Results:
There was an inverse relationship between pro-BNP and 6MWT (r<0, P<0.05). A significant direct relationship was observed between left ventricular ejection fraction and FMD (P=0.031). Right ventricular (RV) dilation was significantly correlated with pro-BNP (P=0.046). There was a significant direct correlation between RV function and FMD and a significant inverse relationship between pro-BNP and FMD (P=0.05). The independent t-test showed no relationship between FMD and syncope (P=0.75).
Conclusion:
Endothelial cell function, which can be evaluated by FMD, was involved in patients with PH. The FMD and 6MWT were helpful as objective prognostic markers in PH. Furthermore, pro-BNP was a noninvasive indicator in the diagnosis of RV systolic dysfunction.
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