Related Experiment Videos
The correlation between coronary stenosis index and flow-mediated dilation of the brachial artery
Insights
Flow-mediated dilation (FMD) of the brachial artery is a key indicator of cardiovascular health. This study found that impaired FMD is strongly linked to the severity of coronary artery disease (CAD).
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide.
- Flow-mediated dilation (FMD) is a non-invasive measure of endothelial function.
- The relationship between brachial artery FMD and the extent of CAD requires further elucidation.
Purpose of the Study:
- To investigate the association between brachial artery FMD and the severity of CAD.
- To determine if FMD can serve as an independent predictor of CAD extent.
Main Methods:
- 121 patients undergoing coronary arteriography were studied.
- High-resolution ultrasonography was used to measure brachial artery FMD and nitroglycerin-induced dilation.
- Coronary stenosis index (CSI) was calculated to assess CAD extent and severity.
Main Results:
- Adjusted FMD showed a significant inverse correlation with CSI (rs=-0.63, p<0.0001).
- Adjusted FMD was an independent predictor of CSI.
- FMD values progressively decreased with increasing CAD severity: 10.2% (no CAD), 7.7% (single-vessel), 5.2% (double-vessel), and 2.0% (triple-vessel).
Conclusions:
- Impaired brachial artery FMD is closely associated with the extent and severity of coronary artery disease.
- Brachial artery FMD is a valuable independent predictor of CAD severity.
- Reduced FMD reflects worsening coronary atherosclerosis.
Abstract:
We examined the relationship between flow-mediated dilation (FMD) of the brachial artery and the extent and severity of coronary artery disease (CAD). Using high-resolution ultrasonography, we measured FMD and nitroglycerin-induced brachial artery dilation. We studied 121 patients (77 men, 44 women; mean age 64+/-11 years, range 25-79 years) who underwent coronary arteriography. The extent and severity of CAD were assessed by the coronary stenosis index (CSI). The adjusted FMD correlated inversely with CSI (rs=-0.63, p<0.0001). Multivariate analysis demonstrated that the adjusted FMD was an independent predictor of CSI. The adjusted FMD was 10.2+/-4.8% in patients without CAD (n=32), 7.7+/-6.0% in patients with single-vessel disease (n=31), 5.2+/-5.5% in patients with double-vessel disease (n=29), and 2.0+/-3.9% in patients with triple-vessel disease (n=29). The adjusted FMD was significantly lower in the double- (p<0.01) and triple-vessel (p<0.0001) disease groups than in patients without CAD. The adjusted FMD was significantly lower in the triple-vessel disease group than in the single-vessel disease group (p<0.001). Based on our results, as coronary atherosclerosis becomes more severe, the adjusted brachial artery FMD becomes more severely impaired.