Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter?

Hdl Handle:
http://hdl.handle.net/10149/218256
Title:
Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter?
Authors:
Green, D. J. (Daniel); Jones, H. (Helen); Thijssen, D. H. J. (Dick); Cable, N. T. (Tim); Atkinson, G. (Greg)
Affiliation:
Liverpool John Moores University. Research Institute for Sport and Exercise Sciences.
Citation:
Green, D.J., Jones, H., Thijssen, D., Cable, N.T., & Atkinson, G. (2011) 'Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter?', Hypertension, 57(3), pp.363-369.
Publisher:
Lippincott, Williams & Wilkins; American Heart Association
Journal:
Hypertension
Issue Date:
Mar-2011
URI:
http://hdl.handle.net/10149/218256
DOI:
10.1161/HYPERTENSIONAHA.110.167015
PubMed ID:
21263128
Additional Links:
http://hyper.ahajournals.org/content/57/3/363.abstract
Abstract:
Endothelial dysfunction is an early atherosclerotic event that precedes clinical symptoms and may also render established plaque vulnerable to rupture. Noninvasive assessment of endothelial function is commonly undertaken using the flow-mediated dilation (FMD) technique. Some studies indicate that FMD possesses independent prognostic value to predict future cardiovascular events that may exceed that associated with traditional risk factor assessment. It has been assumed that this association is related to the proposal that FMD provides an index of endothelium-derived nitric oxide (NO) function. Interestingly, placement of the occlusion cuff during the FMD procedure alters the shear stress stimulus and NO dependency of the resulting dilation: cuff placement distal to the imaged artery leads to a largely NO-mediated response, whereas proximal cuff placement leads to dilation which is less NO dependent. We used this physiological observation and the knowledge that prognostic studies have used both approaches to examine whether the prognostic capacity of FMD is related to its role as a putative index of NO function. In a meta-analysis of 14 studies (>8300 subjects), we found that FMD derived using a proximal cuff was at least as predictive as that derived using distal cuff placement, despite the latter being more NO dependent. This suggests that, whilst FMD is strongly predictive of future cardiovascular events, this may not solely be related to its assumed NO dependency. Although this finding should be confirmed with more and larger studies, we suggest that any direct measure of vascular (endothelial) function may provide independent prognostic information in humans.
Type:
Article
Language:
en
Keywords:
blood flow velocity; cardiovascular diseases; nitric oxide; vasodilation; cuff placement; flow-mediated dilation; predictive value
ISSN:
1524-4563
Rights:
Subject to restrictions author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 12/04/2012].
Citation Count:
17 [Scopus, 12/04/2012]

Full metadata record

DC FieldValue Language
dc.contributor.authorGreen, D. J. (Daniel)en_GB
dc.contributor.authorJones, H. (Helen)en_GB
dc.contributor.authorThijssen, D. H. J. (Dick)en_GB
dc.contributor.authorCable, N. T. (Tim)en_GB
dc.contributor.authorAtkinson, G. (Greg)en_GB
dc.date.accessioned2012-04-12T09:58:27Z-
dc.date.available2012-04-12T09:58:27Z-
dc.date.issued2011-03-
dc.identifier.citationHypertension; 57 (3): 363-9en_GB
dc.identifier.issn1524-4563-
dc.identifier.pmid21263128-
dc.identifier.doi10.1161/HYPERTENSIONAHA.110.167015-
dc.identifier.urihttp://hdl.handle.net/10149/218256-
dc.description.abstractEndothelial dysfunction is an early atherosclerotic event that precedes clinical symptoms and may also render established plaque vulnerable to rupture. Noninvasive assessment of endothelial function is commonly undertaken using the flow-mediated dilation (FMD) technique. Some studies indicate that FMD possesses independent prognostic value to predict future cardiovascular events that may exceed that associated with traditional risk factor assessment. It has been assumed that this association is related to the proposal that FMD provides an index of endothelium-derived nitric oxide (NO) function. Interestingly, placement of the occlusion cuff during the FMD procedure alters the shear stress stimulus and NO dependency of the resulting dilation: cuff placement distal to the imaged artery leads to a largely NO-mediated response, whereas proximal cuff placement leads to dilation which is less NO dependent. We used this physiological observation and the knowledge that prognostic studies have used both approaches to examine whether the prognostic capacity of FMD is related to its role as a putative index of NO function. In a meta-analysis of 14 studies (>8300 subjects), we found that FMD derived using a proximal cuff was at least as predictive as that derived using distal cuff placement, despite the latter being more NO dependent. This suggests that, whilst FMD is strongly predictive of future cardiovascular events, this may not solely be related to its assumed NO dependency. Although this finding should be confirmed with more and larger studies, we suggest that any direct measure of vascular (endothelial) function may provide independent prognostic information in humans.en_GB
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkinsen_GB
dc.publisherAmerican Heart Associationen_GB
dc.relation.urlhttp://hyper.ahajournals.org/content/57/3/363.abstract-
dc.rightsSubject to restrictions author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 12/04/2012].en_GB
dc.subjectblood flow velocityen_GB
dc.subjectcardiovascular diseasesen_GB
dc.subjectnitric oxideen_GB
dc.subjectvasodilationen_GB
dc.subjectcuff placementen_GB
dc.subjectflow-mediated dilationen_GB
dc.subjectpredictive valueen_GB
dc.titleFlow-mediated dilation and cardiovascular event prediction: does nitric oxide matter?en
dc.typeArticleen
dc.contributor.departmentLiverpool John Moores University. Research Institute for Sport and Exercise Sciences.en_GB
dc.identifier.journalHypertensionen_GB
ref.citationcount17 [Scopus, 12/04/2012]en_GB
or.citation.harvardGreen, D.J., Jones, H., Thijssen, D., Cable, N.T., & Atkinson, G. (2011) 'Flow-mediated dilation and cardiovascular event prediction: does nitric oxide matter?', Hypertension, 57(3), pp.363-369.en_GB
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