Abstract 13467: Confounding Factors for Flow-Mediated Vasodilation: FMD-Japan Study
Background: Endothelial dysfunction is the initial step in the pathogenesis of atherosclerosis, resulting in cardiovascular outcomes. Recently, measurement of flow-mediated vasodilation (FMD) has been widely used to assess endothelial function in humans. The purpose of this study was to determine the relationships between FMD and cardiovascular risk factors, and evaluate confounding factors for measurement of FMD in a large general population.
Methods and Results: A high-resolution ultrasonography, an automated edge tracking system, and an arm holding device were used to measure brachial artery diameter in response to reactive hyperemia (FMD, cuff inflated to 50 mmHg above systolic blood pressure for 5 min) in 5314 subjects (46±13 yr; 4131 men and 1183 women), including subjects with cardiovascular risk factor, such as hypertension, diabetes mellitus, and dyslipidemia, and patients with cardiovascular diseases, enrolled in FMD-Japan registry. Univariate regression analysis revealed that FMD correlated with age (r=-0.26, P<0.001), body mass index (BMI) (r=-0.14, P<0.001), systolic blood pressure (r=-0.18, P<0.001), diastolic blood pressure (r=-0.13, P<0.001), total cholesterol (r=-0.06, P<0.001), triglycerides (r=-0.06, P<0.001), high-density lipoprotein cholesterol (r=0.06, P<0.001), low-density lipoprotein cholesterol (r=-0.04, P=0.01), glucose level (r=-0.14, P<0.001), HbA1c (r=-0.14, P<0.001), and baseline brachial artery diameter (r=-0.42, P<0.001) as well as Framingham risk score, a cumulative cardiovascular risk index for heart attack (r=-0.29, P<0.001). Multivariate analysis revealed that age, sex, BMI, systolic blood pressure, diastolic blood pressure, diabetes mellitus, smoking, and baseline brachial artery diameter were independent predictors of FMD
Conclusions: These findings suggest that FMD may be a marker of the grade of atherosclerosis and may be used as a surrogate marker of cardiovascular outcomes. Age, sex, BMI, blood pressure, diabetes mellitus, smoking, and baseline brachial artery diameter are potential factors that might confound for measurement of FMD.
- © 2012 by American Heart Association, Inc.