Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Clinical Significance of Flow-Mediated Dilation, Brachial Intima-Media Thickness and Pulse Wave Velocity in Patients With and Without Coronary Artery Disease
Rie KoyoshiShin-ichiro MiuraNaoko KumagaiYuhei ShigaRyoko MitsutakeKeijiro Saku
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2012 Volume 76 Issue 6 Pages 1469-1475

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Abstract

Background: Little is known about the interrelationships among brachial flow-mediated vasodilatation (bFMD), brachial-ankle pulse wave velocity (baPWV) and brachial intima-media thickness (bIMT) in patients with and without coronary artery disease (CAD). Methods and Results: Two-hundred consecutive patients with stable angina pectoris (SAP) were enrolled as the CAD group and 50 age-, sex- and body mass index-matched patients without CAD were selected as the non-CAD group. bFMD, diastolic blood pressure (DBP) and high-density lipoprotein cholesterol (HDL-C) in the CAD group were significantly lower. The CAD group showed significantly higher levels of hemoglobin A1c (HbA1c) and low-density lipoprotein cholesterol (LDL-C), but not baPWV. CAD was independently associated with bFMD, DBP, HbA1c and HDL-C. bFMD and HDL-C significantly decreased and LDL-C increased as the number of diseased vessels with significant stenosis increased. The number of diseased vessels was independently associated with bFMD and HDL-C. In addition, bFMD, bIMT, the time constant of the shear rate and the time constant of the flow rate as assessed by a new program, Trend Plus®, were associated with the presence of CAD. Among these parameters, the presence of CAD was independently associated with bIMT as well as bFMD. Conclusions: bFMD was a better predictor of the severity of CAD than either baPWV or coronary risk factors in patients with SAP. In addition, bIMT may be a critical predictor of CAD. (Circ J 2012; 76: 1469-1475)

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© 2012 THE JAPANESE CIRCULATION SOCIETY
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