Advertisement

Adjusting for brachial artery diameter in the analysis of flow-mediated dilatation: Pitfalls of a landmark paper?

      Since the publication of the landmark paper by Celermajer et al. on the use of brachial artery ultrasound to measure flow-mediated dilatation (FMD) some 20 years ago [
      • Celermajer D.S.
      • Sorensen K.E.
      • Gooch V.M.
      • et al.
      Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.
      ], researchers have enthusiastically adopted the non-invasive technique as a way to assess endothelial function (EF). Impaired EF is an indicator of pre-clinical cardiovascular risk [
      • Celermajer D.S.
      • Sorensen K.E.
      • Gooch V.M.
      • et al.
      Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.
      ] and predictor of future CV events [
      • Yeboah J.
      • Folsom A.R.
      • Burke G.L.
      • et al.
      Predictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: the multi-ethnic study of atherosclerosis.
      ]. Although the method is now well established, several alternative approaches are often applied to the analysis of FMD. In a previous issue of Atherosclerosis, Atkinson & Batterham argue that the most commonly used approach, and that suggested by the originator of the technique himself, may induce important biases that could alter our research conclusions [
      • Atkinson G.
      • Batterham A.M.
      Allometric scaling of diameter change in the original flow-mediated dilation protocol.
      ].

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Celermajer D.S.
        • Sorensen K.E.
        • Gooch V.M.
        • et al.
        Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis.
        Lancet. 1992; 340: 1111-1115
        • Yeboah J.
        • Folsom A.R.
        • Burke G.L.
        • et al.
        Predictive value of brachial flow-mediated dilation for incident cardiovascular events in a population-based study: the multi-ethnic study of atherosclerosis.
        Circulation. 2009; 120: 502-509
        • Atkinson G.
        • Batterham A.M.
        Allometric scaling of diameter change in the original flow-mediated dilation protocol.
        Atherosclerosis. 2013; 226: 425-427
        • Packard G.C.
        • Boardman T.J.
        The use of percentages and size specific indices to normalsie physiological data for variation in body size: wasted time, wasted effort?.
        Comparative Biochemistry and Physiology Part A. 1999; 122: 37-44
        • Green D.J.
        • Swart A.
        • Exterkate A.
        • et al.
        Impact of age, sex and exercise on brachial and popliteal artery remodelling in humans.
        Atherosclerosis. 2010; 210: 525-530
        • Ward M.R.
        • Pasterkamp G.
        • Yeung A.C.
        • Borst C.
        Arterial remodeling. Mechanisms and clinical implications.
        Circulation. 2000; 102: 1186-1191
        • Greenland S.
        • Pearl J.
        • Robins J.M.
        Causal diagrams for epidemiologic research.
        Epidemiology. 1999; 10: 37-48
        • Pencina M.J.
        • D'Agostino Sr., R.B.
        • Steyerberg E.W.
        Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers.
        Statistics in Medicine. 2011; 30: 11-21
        • Vilahur G.
        • Padro T.
        • Badimon L.
        Atherosclerosis and thrombosis: insights from large animal models.
        Journal of Biomedicine & Biotechnology. 2011; 2011: 907575

      Linked Article