Abstract 460: Intra- and Inter-Day Reproducibility of Low-Flow Mediated Constriction Response in Young Adults

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Michelle M Harbin ◽  
Joseph D Ostrem ◽  
Nicholas G Evanoff ◽  
Aaron S Kelly ◽  
Donald R Dengel
Keyword(s):  
Young Adults ◽  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Low Flow ◽  
Strong Positive Correlation ◽  
Brachial Artery Diameter ◽  
Flow Mediated Vasodilation ◽  
Relative Change ◽  
Cuff Occlusion ◽  
Baseline Diameter

Purpose: When assessing vasomotor endothelial function of the brachial artery by reactive hyperemia, blood flow is stopped and creates a period of low-flow mediated constriction (L-FMC). Little is known about how this parameter influences flow-mediated vasodilation (FMD). The purpose of this study was to better understand this relationship and to determine the intra- and inter-day reproducibility of brachial L-FMC in healthy adults. Methods: Brachial L-FMC and FMD were measured on 26 healthy, young adults (13 males, 13 females; 24.6 ± 2.7 years). Each subject had two assessments conducted on two separate visits, separated by a minimum of seven days. Brachial artery pre-occlusion baseline diameter was imaged during rest and prior to cuff-occlusion. Continuous imaging of the artery was captured during the last 20 seconds of cuff-occlusion to 180 seconds post-cuff release. An L-FMC was considered present if the relative change from pre-occlusion baseline to L-FMC artery diameter was less than -0.1%. Peak FMD was measured as the greatest 10-second average in brachial artery diameter following occlusion compared to pre-occlusion baseline. Results: Overall, there was a strong, positive correlation between increased brachial L-FMC and blunted FMD (visit 1 test 1: r=0.758, p <0.001; visit 1 test 2: r=0.706, p <0.001; visit 2 test 1: r=0.836, p <0.001; visit 2 test 2: 0.857, p <0.001). The reproducibility of intra- and inter-day L-FMC diameter were ICC = 0.627, CV = 54.4% and ICC = 0.734, CV = 43.5%, respectively. Conclusion: The results of the present study suggest that the degree of vasoconstriction to low-flow conditions influences the subsequent maximal dilation during reactive hyperemia. However, L-FMC in young adults is variable as evidenced by the weak inter- and intra-day reproducibility of the measure. Further research is needed to study brachial L-FMC reproducibility among varying subject populations and the implications L-FMC has on the interpretation of FMD results.

Normal pregnancy is associated with enhanced endothelium-dependent flow-mediated vasodilation

1999 ◽  
Vol 276 (3) ◽  
pp. H821-H825 ◽  
Author(s):  
Inge Dørup ◽  
Kristjar Skajaa ◽  
Keld E. Sørensen
Keyword(s):  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Peripheral Resistance ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Brachial Artery Diameter ◽  
Vasomotor Function ◽  
Pregnancy Status ◽  
Dependent Flow ◽  
Flow Mediated Vasodilation

Normal pregnancy is characterized by reduced systemic vascular resistance, which may be mediated by nitric oxide (NO). We compared endothelial vasomotor function in 71 normal pregnant women (13 in first, 29 in middle, and 29 in last trimester) to 37 healthy age-matched controls. With external ultrasound, brachial artery diameter was measured at rest, during reactive hyperemia [with increased flow causing endothelium-dependent dilation (FMD)], and after sublingual nitroglycerin (causing endothelium-independent dilation). Compared with controls, resting flow and brachial artery diameter were significantly higher during the middle and last trimesters. Reactive hyperemia was reduced in all pregnant groups. FMD increased from the first trimester (by 26%), reaching the highest value in the last trimester (to 47% above nonpregnant values). FMD was significantly correlated to pregnancy status (nonpregnant or pregnant) and to vessel size. Nitroglycerin-induced dilation was similar in pregnant and nonpregnant women. A longitudinal study of eight women evaluated in the first, middle, and last trimesters confirmed an increase in FMD throughout pregnancy. The study supports the idea that basal and stimulated NO activity is enhanced in normal pregnancy and may contribute to the decrease in peripheral resistance.

scholarly journals Noninvasive Assessment of Endothelium-Dependent Flow-Mediated Dilation of the Brachial Artery

1997 ◽  
Vol 2 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Akimi Uehata ◽  
Eric H Lieberman ◽  
Marie D Gerhard ◽  
Todd J Anderson ◽  
Peter Ganz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endothelial Function ◽  
Brachial Artery ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Intraobserver Variability ◽  
Flow Mediated Dilation ◽  
Noninvasive Technique ◽  
Brachial Artery Diameter ◽  
Cuff Occlusion

Coronary atherosclerosis is characterized by an early loss of endothelium-dependent vasodilation. However, the methods of assessing coronary endothelial function are invasive and difficult to repeat over time. Recently, a noninvasive ultrasound method has been widely used to measure flow-mediated dilation in the brachial artery as a surrogate test for endothelial function. We seek to further validate this method of measuring vascular function. The brachial artery diameters and blood flow of 20 normal volunteers (10 males and 10 females) were measured using high resolution (7.5 MHz) ultrasound and strain gauge plethysmography. Flow-mediated endothelium-dependent vasodilation was measured in the brachial artery during reactive hyperemia after 5 minutes of cuff occlusion in the upper arm. The brachial artery diameter increased maximally by 9.7 ± 4.3% from baseline at 1 min after cuff release and blood flow increased by 1002 ± 376%. Five min of cuff occlusion was sufficient to achieve 97 ± 6% of maximal brachial artery dilation and degree of dilation was not different whether the cuff was inflated proximally or distally to the image site. The intraobserver variability in measuring brachial diameters was 2.9 % and the variability of the hyperemic response was 1.4%. In young, healthy men and women, the baseline brachial artery diameter was the only factor that was predictive of the flow-mediated vasodilation response. The brachial noninvasive technique has been further validated by the determination of flow-mediated dilation. This method of assessing endothelial function may help to determine the importance of vasodilator dysfunction as a risk factor in the development of atherosclerosis.

Brachial artery dilatation responses in healthy children and adolescents

2002 ◽  
Vol 282 (1) ◽  
pp. H87-H92 ◽  
Author(s):  
Mikko J. Järvisalo ◽  
Tapani Rönnemaa ◽  
Iina Volanen ◽  
Tuuli Kaitosaari ◽  
Katariina Kallio ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Cholesterol Concentration ◽  
Healthy Children ◽  
Brachial Artery Diameter ◽  
Serum Cholesterol Concentration ◽  
Flow Mediated Dilatation ◽  
Artery Flow ◽  
Cuff Occlusion ◽  
Baseline Diameter ◽  
Similar Peak

To characterize brachial artery flow-mediated dilatation (FMD) in children, we monitored arterial diameter changes with ultrasound between 40 and 180 s after a 4.5-min forearm cuff occlusion-induced hyperemia in 105 healthy children (mean age, 11 yr; range, 9–16 yr). The peak FMD was 7.7 ± 4.0% and occurred 79 ± 33 s after cuff release. FMD at 60 s (5.3 ± 4.0%) was significantly lower than the peak FMD ( P < 0.0001). Twenty-three percent of the children ( n = 24) reached peak FMD first after 110 s of postocclusion. Compared with others, these late responders weighed less, had smaller vessel size, and were more often girls, but had similar peak FMD. In multivariate analysis, FMD responses were inversely associated with brachial artery baseline diameter and serum cholesterol concentration. We conclude that the time to reach the peak FMD response in children varies considerably. When studying endothelial function in children with the use of the noninvasive ultrasound method, several brachial artery diameter measurements up to 120 s after cuff release are needed to determine the true FMD peak response.

Abstract 12000: Altered Vascular Elasticity Reflected Vascular Endothelial Dysfunction and Elevated Galectin-3 Using Novel Brachial Artery Vascular Volume Elastic Modulus With Automated Oscillometric Approach

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Keiichiro Yoshinaga ◽  
Yuuki Tomiyama ◽  
Satoshi Fujii ◽  
Saori Nishio ◽  
Noriki Ochi ◽  
...  
Keyword(s):  
Elastic Modulus ◽  
Brachial Artery ◽  
Vascular Function ◽  
Inflammatory Marker ◽  
Reactive Hyperemia ◽  
Vascular Stiffness ◽  
Brachial Artery Diameter ◽  
Novel Approach ◽  
Galectin 3 ◽  
Vascular Elasticity

Introduction: Simple vascular function measurements are desirable for atherosclerosis risk assessments. Recently, we developed a novel modality of automated oscillometric method to measure a brachial artery’s vascular elastic modulus (V E ) and reported that V E is uninfluenced by blood pressure. Galectin-3 (Gal-3) expressed in endothelial cells regulates vascular fibrosis and is a molecular determinant of vascular stiffness. Hypothesis: We aimed to clarify whether V E selectively correlates with marker of vascular stiffness in chronic kidney disease (CKD). Methods: 12 moderate-to-severe CKD pts (mean eGFR 25.9±23.5 mL/min/1.73m 2 ) and 15 controls were studied. Rest V E in brachial artery was measured by new automated oscillometric detector. V E was defined as follows [VE =ΔPressure/ (100XΔarea/Area) mmHg/%]. Using ultrasound, the brachial artery diameter at rest and during reactive hyperemia [flow mediated dilatation (FMD) with endothelial-dependent dilatation] was measured. Gal-3 and interleukin-6 (IL-6), a representative inflammatory marker, were measured by enzyme-linked immune assay. Results: CKD had lower FMD (4.86±3.37 vs 9.05±2.98 %, P=0.003) and had attenuated V E than control (1.08±0.26 vs 0.83±0.17 mmHg/%, P=0.002). CKD had higher IL-6 (0.67±0.29 vs 0.29±0.33 pg/mL, P=0.003) and higher Gal-3 (20.0±12.4 vs. 5.84±2.83 pg/mL, P<0.001). V E was negatively correlated with %FMD (r=-0.46, P=0.015) and correlated with Gal-3 (r=0.40, P=0.036) but not in IL-6 (r=0.21, P=0.28). Conclusions: Attenuated vascular elasticity detected by this novel approach closely correlated with increase in Gal-3 and reduced FMD in CKD. This may indicate that the attenuated vascular elasticity selectively reflects vascular fibrosis as evidenced by Gal-3 and subsequent endothelial responses to vascular stiffness. Thus, this oscillometric measurement may be useful for detecting vascular fibrosis information and dysfunction in endothelium level.

Endothelial and left ventricular diastolic function in young adults exposed to tobacco

2019 ◽  
Vol 97 (10) ◽  
pp. 1006-1011
Author(s):  
Ayelen Rodriguez-Portelles ◽  
Delfin Rodriguez-Leyva
Keyword(s):  
Young Adults ◽  
Flow Velocity ◽  
Diastolic Function ◽  
Cigarette Smoke ◽  
Brachial Artery ◽  
Left Ventricular Diastolic Function ◽  
Left Ventricular ◽  
Acute Exposure ◽  
Brachial Artery Diameter ◽  
Arterial Dilation

Smoking is associated with endothelial and left ventricular diastolic disfunction. We aimed to determine the endothelial and diastolic function in young adults exposed to tobacco smoke and the effects of acute exposure to it. Smokers were considered as cases and non-smokers as controls. Brachial artery diameter, brachial artery flow velocity, and echocardiographic variables were measured. Mean age of the participants was 21 years. Smokers showed significant endothelial dysfunction compared with non-smokers. Arterial dilation mediated by the endothelium was significantly higher in non-smokers than in smokers (p = 0.005). Non-endothelium-mediated arterial dilation was significantly impaired in smokers compared with non-smokers (p = 0.02). After reactive hyperaemia, there was a significant increase in blood flow in non-smokers (61%) compared with that in smokers (29%). Acute cigarette exposure showed a trend towards left ventricle diastolic disfunction in smokers. Left atrium diameter was significantly higher in smokers than in non-smokers. After acute exposure to cigarette smoke, arterial dilation and brachial flow velocity were lower than those achieved in the abstinence phase (p = 0.005). We concluded that endothelium-dependent arterial dilation is impaired in young smokers and it worsens even after acute exposure to cigarette smoke.

Influence of prostaglandins and endothelial-derived hyperpolarizing factors on brachial and popliteal endothelial-dependent function in young adults

2021 ◽  
Vol 130 (1) ◽  
pp. 17-25
Author(s):  
Jennifer L. Petterson ◽  
Myles W. O’Brien ◽  
Jarrett A. Johns ◽  
Jack Chiasson ◽  
Derek S. Kimmerly
Keyword(s):  
Blood Flow ◽  
Young Adults ◽  
Shear Rate ◽  
Brachial Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Low Flow ◽  
Flow Mediated Dilation ◽  
Artery Blood Flow ◽  
Dependent Function

We compared changes in upper- and lower-limb artery endothelial-dependent vasodilatory and vasoconstrictor responses between control, prostaglandin inhibition, and endothelial-derived hyperpolarizing factor inhibition conditions. Neither prostaglandins nor endothelial-derived hyperpolarizing factor influenced flow-mediated dilation responses in either the brachial or popliteal artery. In contrast, endothelial-derived hyperpolarizing factor, but not prostaglandins, reduced resting brachial artery blood flow and shear rate and resting popliteal artery diameter, as well as low-flow-mediated constriction responses in both the popliteal and brachial arteries.

Impact of controlling shear rate on flow-mediated dilation responses in the brachial artery of humans

2004 ◽  
Vol 97 (2) ◽  
pp. 499-508 ◽  
Author(s):  
Kyra E. Pyke ◽  
Erin M. Dwyer ◽  
Michael E. Tschakovsky
Keyword(s):  
Shear Stress ◽  
Shear Rate ◽  
Brachial Artery ◽  
Reactive Hyperemia ◽  
Flow Mediated Dilation ◽  
Response Peak ◽  
Dependent Flow ◽  
Flow Mediated Vasodilation ◽  
The Impact ◽  
Forearm Occlusion

The reactive hyperemia test (RHtest) evokes a transient increase in shear stress as a stimulus for endothelial-dependent flow-mediated vasodilation (EDFMD). We developed a noninvasive method to create controlled elevations in brachial artery (BA) shear rate (SR, estimate of shear stress), controlled hyperemia test (CHtest), and assessed the impact of this vs. the RHtest approach on EDFMD. Eight healthy subjects participated in two trials of each test on 3 separate days. For the CHtest, SR was step increased from 8 to 50 s−1, created by controlled release of BA compression during forearm heating. For the RHtest, transient increases in SR were achieved after 5 min of forearm occlusion. BA diameter and blood flow velocity (ultrasound) were measured upstream of compression and occlusion sites. Both tests elicited significant dilation (RHtest: 6.33 ± 3.12%; CHtest: 3.00 ± 1.05%). The CHtest resulted in 1) reduced between-subject SR and EDFMD variability vs. the RHtest [SR coefficient of variation (CV): 4.9% vs. 36.6%; EDFMD CV: 36.16% vs. 51.80%] and 2) virtual elimination of the impact of BA diameter on the peak EDFMD response (peak EDFMD vs. baseline diameter for RHtest, r2 = 0.64, P < 0.01, vs. CHtest, r2 = 0.14, P < 0.01). Normalization of the RHtest EDFMD response to the magnitude of the SR stimulus eliminated test differences in between-subject response variability. Reductions in trial-to-trial and day-to-day SR variability with the CHtest did not reduce EDFMD variability. Between-subject SR variability contributes to EDFMD variability with the RHtest. SR controls with the CHtest or RHtest response normalization are essential for examining EDFMD between groups differing in baseline arterial diameter.

Abnormal brachial artery flow-mediated vasodilation in young adults with major depression

2001 ◽  
Vol 88 (2) ◽  
pp. 196-198 ◽  
Author(s):  
Sanjay Rajagopalan ◽  
Robert Brook ◽  
Melvyn Rubenfire ◽  
Elaine Pitt ◽  
Elizabeth Young ◽  
...  
Keyword(s):  
Young Adults ◽  
Major Depression ◽  
Brachial Artery ◽  
Artery Flow ◽  
Flow Mediated Vasodilation

Low flow-mediated constriction occurs in the radial but not the brachial artery in healthy pregnant and nonpregnant women

2010 ◽  
Vol 108 (5) ◽  
pp. 1097-1105 ◽  
Author(s):  
Tracey L. Weissgerber ◽  
Gregory A. L. Davies ◽  
Michael E. Tschakovsky
Keyword(s):  
Shear Rate ◽  
Pregnant Women ◽  
Radial Artery ◽  
Brachial Artery ◽  
Vascular Function ◽  
Low Flow ◽  
Flow Mediated Dilation ◽  
Brachial Artery Diameter ◽  
Function Test ◽  
Positive Correlations

Radial artery diameter decreases when a wrist cuff is inflated to stop blood flow to distal tissue. This phenomenon, referred to as low flow-mediated vasoconstriction (L-FMC), was proposed as a vascular function test. Recommendations that L-FMC be measured concurrently with flow-mediated dilation (FMD) were based on radial artery data. However, cardiovascular disease prediction studies traditionally measure brachial artery FMD. Therefore, studies should determine whether L-FMC occurs in the brachial artery. The hypothesis that reduced shear causes L-FMC has not been tested. Brachial and radial artery L-FMC and FMD were assessed in active nonpregnant ( n = 17), inactive nonpregnant ( n = 10), active pregnant ( n = 15, 34.1 ± 1.2 wk gestation), and inactive pregnant ( n = 8, 34.2 ± 2.2 wk gestation) women. Radial artery diameter decreased significantly during occlusion in all groups (nonpregnant, −4.4 ± 4.2%; pregnant, −6.4 ± 3.2%). Brachial artery diameter did not change in active and inactive nonpregnant, and inactive pregnant women; however, the small decrease in active pregnant women was significant. Occlusion decreased shear rate in both arteries, yet L-FMC only occurred in the radial artery. Radial artery L-FMC was not correlated with the reduction in shear rate. L-FMC occurs in the radial but not the brachial artery and is not related to changes in shear rate. Positive correlations between L-FMC (negative values) and FMD (positive values) suggest that radial artery FMD may be reduced among women who experience greater L-FMC. Studies should clarify the underlying stimulus and mechanisms regulating L-FMC, and test the hypothesis that endothelial dysfunction is manifested as enhanced brachial artery L-FMC, but attenuated radial artery L-FMC.

scholarly journals Gender differences in vascular function and insulin sensitivity in young adults

2010 ◽  
Vol 120 (4) ◽  
pp. 153-160 ◽  
Author(s):  
Donald R. Dengel ◽  
David R. Jacobs ◽  
Julia Steinberger ◽  
Antoinette M. Moran ◽  
Alan R. Sinaiko
Keyword(s):  
Gender Differences ◽  
Young Adults ◽  
Insulin Sensitivity ◽  
Brachial Artery ◽  
Vascular Function ◽  
Adult Population ◽  
Density Lipoprotein ◽  
Cross Sectional ◽  
Brachial Artery Diameter ◽  
Significant Difference

To examine influence of insulin resistance and other clinical risk factors for the MetS (metabolic syndrome) on vascular structure and function in young adults. This cross-sectional study was conducted in a cohort of young adults (mean age 22 years) and their siblings participating in a longitudinal study of cardiovascular risk (n=370). Insulin sensitivity was determined by euglycaemic insulin clamp. EDD (endothelium-dependent dilation) was determined by flow-mediated dilation using high-resolution ultrasound imaging of the brachial artery. EID (endothelium-independent dilation) was determined by NTG (nitroglycerine)-mediated dilation. The diameter and cIMT (intima–media thickness) of the carotid artery were also measured. There was no significant difference between males and females for age or body mass index. However, males had significantly higher glucose and triacylglycerol (triglyceride) levels, while the females had significantly higher HDL-C (high-density lipoprotein-cholesterol) and insulin sensitivity (13.00±0.33 compared with 10.71±0.31 mg·kg−1 of lean body mass·min−1, P<0.0001). Although peak EDD was significantly lower (6.28±0.26 compared with 8.50±0.28%, P<0.0001) in males than females, this difference was largely explained by adjustment for brachial artery diameter (P=0.15). Peak EID also was significantly lower in males than females (20.26±0.44 compared with 28.64±0.47%, P<0.0001), a difference that remained significantly lower after adjustment for brachial artery diameter. Males had a significantly greater cIMT compared with females (females 0.420±0.004 compared with males 0.444±0.004 mm, P=0.01), but when adjusted for carotid diameter, there was no significant difference (P=0.163). Although there were gender differences in vascular function and structure in the young adult population examined in this study, many of the differences were eliminated simply by adjusting for artery diameter. However, the lower EID observed in males could not be explained by artery diameter. Future studies need to continue to examine influence of gender on EID and other measures of vascular function.

Sign in / Sign up

Export Citation Format

Share Document