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Updated: Jul 5, 2025
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Association between Brachial Flow-Mediated Dilation and Calcium Score in Patients with Symptomatic CAD
Faezeh Tabesh1, Mozhgan Amooali1, Reihaneh Zavar1
1Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Vascular endothelial dysfunction, measured by flow-mediated dilation (FMD), is strongly linked to coronary atherosclerosis severity. High calcium scores on CT angiography indicate a higher likelihood of abnormal FMD, suggesting increased cardiovascular risk.
Area of Science:
- Cardiovascular Imaging
- Vascular Biology
- Preventive Cardiology
Background:
- Endothelial function is crucial for protecting blood vessels from atherosclerosis.
- Non-invasive detection of endothelial dysfunction (e.g., flow-mediated dilation) and its correlation with coronary artery calcification (calcium score) remain areas of investigation.
- Coronary computed tomography (CT) angiography provides calcium scores to assess atherosclerosis burden.
Purpose of the Study:
- To investigate the association between endothelial function, assessed by flow-mediated dilation (FMD), and coronary artery calcification, measured by calcium score.
- To determine if FMD can serve as a non-invasive marker for endothelial dysfunction in patients with coronary artery disease (CAD).
Main Methods:
- A cross-sectional study included 124 patients with known CAD and positive calcium scores.
- Flow-mediated dilation (FMD) was measured, with values below 7.1% considered abnormal.
- Correlation between calcium score (cutoff >100 for high score) and FMD was analyzed using linear regression.
Main Results:
- A significant association (P < 0.001) was found between calcium score and FMD.
- Only 18.1% of patients with low calcium scores had abnormal FMD.
- A high prevalence (95.1%) of abnormal FMD was observed in patients with high calcium scores.
Conclusions:
- Findings strongly support an association between FMD, a marker of endothelial dysfunction, and the intensity of coronary atherosclerosis.
- Calcium score on coronary CT angiography is a valuable indicator of vascular endothelial dysfunction.
Background:
Endothelial function plays an important role in the protection of vessels from atherosclerosis. Detection of endothelial dysfunction by non-invasive methods (flow-mediated dilation) and its association with other imaging modalities (calcium score in coronary computed tomography [CT] angiography) is still controversial. In this study, we aim to investigate the association between endothelial function evaluated by flow-mediated dilation (FMD) and calcium score evaluated by coronary CT.
Methods:
In this cross-sectional study, 124 patients with known coronary artery disease (CAD, positive calcium score) were enrolled. FMD as an indicator of endothelial function was evaluated in these participants. FMD less than 7.1%was considered abnormal. Correlation between calcium score and severity of calcification(calcium score above 100 considered as the cutoff point of the high score) and glow-mediated dilation was obtained using the linear regression model.
Results:
The association between calcium score and FMD was strongly significant (P < 0.001). Among individuals with low calcium scores, only 15 (18.1%) had abnormal FMD findings, but the majority of individuals with high calcium scores (95.1%) had abnormal FMD findings.
Conclusions:
Our findings provide strong evidence of association between FMD, a marker of vascular endothelial dysfunction, and intensity of coronary atherosclerosis, as assessed by the calcium score on the CCTA.
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