Several modifiable cardiovascular risk factors such as hypercholesterolemia, smoking, diabetes, hypertension, and hyperhomocysteinemia are associated with impaired endothelium-dependent vasodilation in the preclinical phase of vascular disease. 1–5 We have previously found that endothelial dysfunction is more pronounced in patients with angiographically proved coronary artery disease (CAD) compared with patients with a similar risk factor profile but who have smooth coronary arteries. 6 Thus, endothelial dysfunction not only reflects the risk factor burden but also the presence, and perhaps, stages of coronary disease. 6 Brachial artery ultrasound, first described by Celermajer et al, 1 utilizes high resolution ultrasound to assess flow-mediated dilation (FMD), an endothelium-dependent response, 7–9 which is largely mediated by nitric oxide 10 and closely related to coronary endothelial function. 11 Vessel size, age, gender, menstrual cycle, and therapeutic interventions also influence FMD. 1,12,13 Thus, it is difficult to interpret impairment of FMD in patients and it is very questionable whether FMD can be recommended as a screening test for the detection of significant CAD. However, the evaluation of FMD is increasingly used to assess short-term effects of therapeutic interventions on systemic endothelial function. 14–16 The present study attempted to assess whether FMD was correlated with prognosis
The American Journal of Cardiology – Elsevier
Published: Jul 1, 2000
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