Associations between parameters of flow-mediated vasodilatation obtained by continuous measurement approaches and the presence of coronary artery disease and the severity of coronary atherosclerosis

• Published in: Clinical and experimental hypertension (1993) Vol. 38; no. 5; pp. 443 - 450
• Main Authors: Hitaka, Yuka, Miura, Shin-ichiro, Koyoshi, Rie, Suematsu, Yasunori, Miyase, Yuiko, Norimatsu, Kenji, Adachi, Sen, Shiga, Yuhei, Morito, Natsumi, Nishikawa, Hiroaki, Saku, Keijiro
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03.07.2016
• Subjects: Aged; Brachial Artery - diagnostic imaging; Brachial Artery - physiopathology; Continuous measurement approaches; Coronary Angiography - methods; coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - physiopathology; coronary atherosclerosis; Diabetes Mellitus - physiopathology; Dyslipidemias - physiopathology; Female; flow-mediated vasodilatation; Gensini score; Humans; Hypertension - diagnostic imaging; Hypertension - physiopathology; Male; Retrospective Studies; Sensitivity and Specificity; Vasodilation - physiology; coronary artery disease; flow-mediated vasodilatation; Gensini score; coronary atherosclerosis; Continuous measurement approaches
• ISSN: 1064-1963; 1525-6006
• DOI: 10.3109/10641963.2016.1163365

We investigated the associations between the parameters of flow-mediated vasodilatation (FMD) obtained by continuous measurement approaches and the presence of coronary artery disease (CAD) and the severity of coronary atherosclerosis. The subjects consisted of 282 consecutive patients who underwent coronary angiography (CAG) and in whom we could measure FMD. Using continuous measurement approaches, we measured FMD as the magnitude of the percentage change from brachial artery diameter from baseline to peak (bFMD), the maximum FMD rate calculated as the maximal slope of dilation (FMD-MDR), and the integrated FMD response calculated as the area under the dilation curve during the 60- and 120 s dilation periods (FMD-AUC 60 and FMD-AUC 120 ). We divided the patients into two groups, the CAD group and the non-CAD group, and defined the severity of coronary atherosclerosis according to the Gensini score. The CAD group showed significantly lower %FMD, FMD-MDR, FMD-AUC 60 , and FMD-AUC 120 . Gender, smoking, dyslipidemia (DL), and diabetes mellitus (DM), in addition to FMD-AUC 120 , were identified as significant independent variables that predicted the presence of CAD by a multivariate logistic regression. In addition, a multiple regression analysis indicated that gender, DL, and hypertension, in addition to FMD-AUC 120 , were predictors of the Gensini score. Finally, we defined the cutoff value of FMD-AUC 120 for the prediction of CAD in all patients as 11.1 (sensitivity 0.582, specificity 0.652) by a receiver-operating characteristic (ROC) curve analysis. In conclusion, FMD-AUC 120 as assessed by continuous measurement approaches may be a superior marker for evaluating the presence of CAD and the severity of coronary atherosclerosis.