Is allometric scaling really a panacea for flow-mediated dilation? Commentary on paper by Atkinson and Batterham

      We read with interest the well-written and thought-provoking article by Atkinson and Batham [
      • Atkinson G.
      • Batterham A.M.
      Allometric scaling of diameter change in the original flow-mediated dilation protocol.
      ] This article aptly introduces one of the inherent weaknesses of current flow-mediated dilation (FMD) methodology, i.e., inappropriate scaling to baseline diameter (Dbase). Atkinson and Batham argue that statistical assumptions are violated when expressing FMD as percentage change from Dbase, and present an alternative approach. While we agree with the premise of their argument, we believe that several considerations have been omitted. The authors argue that conduit arteries from different vascular beds, i.e., femoral and brachial arteries, should provide equivalent FMD%. This assumption may be violated if there are differences between arteries in terms of: (1) the structural composition, (2) vasomotor tone, (3) hemodynamic stimuli, or most importantly (4) endothelial function.


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      • Allometric scaling of diameter change in the original flow-mediated dilation protocol
        AtherosclerosisVol. 226Issue 2
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          The negative correlation between percent flow-mediated dilation (FMD%) and baseline diameter (Dbase) has only recently been recognised as a fundamental ratio-scaling problem, which is not resolved by significance-testing of Dbase inequality between groups/conditions, nor by covariate-adjusting FMD% itself by Dbase. It is resolved appropriately by allometric scaling of the relationship between peak diameter (Dpeak) and Dbase using statistical models. Therefore, we extracted data from a seminal study on FMD%, and re-analysed it using allometric methods.
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