The clinical relevance of the percentage flow mediated dilation index

Hdl Handle:
http://hdl.handle.net/10149/337283
Title:
The clinical relevance of the percentage flow mediated dilation index
Authors:
Atkinson, G. (Greg); Batterham, A. M. (Alan)
Affiliation:
Teesside University. Health and Social Care Institute.
Citation:
Atkinson, G., Batterham, A. M. (2015) 'The clinical relevance of the percentage flow mediated dilation index' Current Hypertension Reports: Forthcoming 2015
Publisher:
Current Medline Group
Journal:
Current Hypertension Reports
Issue Date:
2015
URI:
http://hdl.handle.net/10149/337283
Additional Links:
http://link.springer.com/journal/11906
Abstract:
In 2010, the American College of Cardiology Foundation and American Heart Association could not recommend brachial artery percentage flow-mediated dilation (FMD%) for risk assessment of coronary artery disease (CAD) in asymptomatic adults. We aimed to scrutinise past and recently-published findings regarding FMD% in this same context of clinical utility, and conclude that (1) The question of whether brachial FMD% is a suitable substitute for coronary vasodilation is addressed by method agreement statistics rather than the correlation coefficients that have been reported in past studies. Also, the much-repeated view that brachial FMD% and coronary vasodilation are “closely related” is not entirely justified, even before the influence of baseline lumen diameters on this relationship is accounted for, (2) Along with the specialist training and the considerable time (≥ 1 h) that is required for the FMD% protocol, the error in individual measurements and population reference ranges is too large for clinical decisions to be robust on individual patients, (3) Many interventions that are proposed to change FMD% also change baseline artery diameter, which can bias estimates of any intervention effects on the flow-mediated response per se, and (4) The FMD% index generates spurious correlations between shear rate, artery diameter and endothelial function, which may help to explain the apparent paradoxes of FMD% being higher in obese people and lower in athletes. In conclusion, the clinical relevance of brachial artery flow-mediated dilation is unclear at present. The dependence of the chosen index, FMD%, on initial artery size has contributed to this lack of clarity.
Type:
Article
Language:
en
Keywords:
Allometry; statistical analysis; Measurement error; Clinical utility; Spurious
ISSN:
1522-6417
Rights:
Following 12 month embrago author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo [Accessed: 17/12/2014]

Full metadata record

DC FieldValue Language
dc.contributor.authorAtkinson, G. (Greg)en
dc.contributor.authorBatterham, A. M. (Alan)en
dc.date.accessioned2014-12-17T12:41:16Z-
dc.date.available2014-12-17T12:41:16Z-
dc.date.issued2015-
dc.identifier.citationCurrent Hypertension Reports: Forthcoming 2015en
dc.identifier.issn1522-6417-
dc.identifier.urihttp://hdl.handle.net/10149/337283-
dc.description.abstractIn 2010, the American College of Cardiology Foundation and American Heart Association could not recommend brachial artery percentage flow-mediated dilation (FMD%) for risk assessment of coronary artery disease (CAD) in asymptomatic adults. We aimed to scrutinise past and recently-published findings regarding FMD% in this same context of clinical utility, and conclude that (1) The question of whether brachial FMD% is a suitable substitute for coronary vasodilation is addressed by method agreement statistics rather than the correlation coefficients that have been reported in past studies. Also, the much-repeated view that brachial FMD% and coronary vasodilation are “closely related” is not entirely justified, even before the influence of baseline lumen diameters on this relationship is accounted for, (2) Along with the specialist training and the considerable time (≥ 1 h) that is required for the FMD% protocol, the error in individual measurements and population reference ranges is too large for clinical decisions to be robust on individual patients, (3) Many interventions that are proposed to change FMD% also change baseline artery diameter, which can bias estimates of any intervention effects on the flow-mediated response per se, and (4) The FMD% index generates spurious correlations between shear rate, artery diameter and endothelial function, which may help to explain the apparent paradoxes of FMD% being higher in obese people and lower in athletes. In conclusion, the clinical relevance of brachial artery flow-mediated dilation is unclear at present. The dependence of the chosen index, FMD%, on initial artery size has contributed to this lack of clarity.en
dc.language.isoenen
dc.publisherCurrent Medline Groupen
dc.relation.urlhttp://link.springer.com/journal/11906en
dc.rightsFollowing 12 month embrago author can archive post-print (ie final draft post-refereeing). For full details see http://www.sherpa.ac.uk/romeo [Accessed: 17/12/2014]en
dc.subjectAllometryen
dc.subjectstatistical analysisen
dc.subjectMeasurement erroren
dc.subjectClinical utilityen
dc.subjectSpuriousen
dc.titleThe clinical relevance of the percentage flow mediated dilation indexen
dc.typeArticleen
dc.contributor.departmentTeesside University. Health and Social Care Institute.en
dc.identifier.journalCurrent Hypertension Reportsen
or.citation.harvardAtkinson, G., Batterham, A. M. (2015) 'The clinical relevance of the percentage flow mediated dilation index' Current Hypertension Reports: Forthcoming 2015-
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