Adjusting flow-mediated dilation for shear stress stimulus allows demonstration of endothelial dysfunction in a population with moderate cardiovascular risk

Jaume Padilla, Blair D. Johnson, Sean C. Newcomer, Daniel P. Wilhite, Timothy D. Mickleborough, Alyce D. Fly, Kieren J. Mather, Janet P. Wallace

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Background/Aims: Although normalization of brachial artery flow-mediated dilation (FMD) to individual shear stress (FMD:shear stress ratio) has been proposed to improve this measure of endothelial function, the clinical utility of FMD normalization has not yet been demonstrated. We tested (1) whether following conventional 5-min forearm occlusion, the FMD:shear stress ratio would discriminate a population with moderate cardiovascular risk (MR) from a low-risk (LR) population, and (2) whether the dose-response profile relating shear stress to FMD would be different between the 2 populations. Methods: Five different magnitudes of reactive hyperemia-induced shear stress were applied to 20 MR and 20 LR subjects by manipulating forearm cuff occlusion duration. Brachial artery diameters and velocities were measured via high-resolution ultrasound. To quantify the hyperemic stimulus, shear stress area under the curve was individually calculated for the duration of time-to-peak dilation. Results: Following 5-min of forearm occlusion, FMD:shear stress ratio (p = 0.041), but not FMD (p = 0.286), discriminated MR from LR. The slope of the shear stress-FMD regression line was lower in MR compared to the LR (p <0.001). Conclusion: The FMD:shear stress ratio distinguished reduced endothelial function in a population with MR. The dose-response profile of the shear stress-FMD relationship appears to differ between populations of distinct cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)592-600
Number of pages9
JournalJournal of Vascular Research
Volume46
Issue number6
DOIs
StatePublished - Oct 1 2009

Keywords

  • Blood flow
  • Cardiovascular risk
  • Endothelial function
  • Hemodynamics
  • Human arteries
  • Ischemia
  • Reactive hyperemia
  • Shear stress

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Padilla, J., Johnson, B. D., Newcomer, S. C., Wilhite, D. P., Mickleborough, T. D., Fly, A. D., Mather, K. J., & Wallace, J. P. (2009). Adjusting flow-mediated dilation for shear stress stimulus allows demonstration of endothelial dysfunction in a population with moderate cardiovascular risk. Journal of Vascular Research, 46(6), 592-600. https://doi.org/10.1159/000226227