CLINICAL STUDY: TECHNIQUE REPORT
Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery
A report of the International Brachial Artery Reactivity Task Force
Mary C. Corretti, MD, FACC*,*,
Todd J. Anderson, MD ,
Emelia J. Benjamin, MD, MSc ,
David Celermajer, MD ,
Francois Charbonneau, MD||,
Mark A. Creager, MD¶,
John Deanfield, MD#,
Helmut Drexler, MD**,
Marie Gerhard-Herman, MD¶,
David Herrington, MD, MHS,
Patrick Vallance, MD,
Joseph Vita, MD and
Robert Vogel, MD*
* Division of Cardiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
University of Calgary, Calgary, Alberta, Canada
Boston University School of Medicine, Boston, Massachusetts, USA
Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
|| Royal Victoria Hospital, Montreal, Quebec, Canada
¶ Vascular Diagnostic Laboratory Cardiac Division, Brigham and Women’s Hospital, Boston, Massachusetts, USA
# Vascular Physiology Unit, Great Ormond Street Hospital, London, United Kingdom
** Department of Cardiology and Angiology, Medizinische Hochscule, Hannover, Germany
Departments of Internal Medicine and Cardiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
University College, London, United Kingdom
Manuscript received January 10, 2001;
revised manuscript received September 18, 2001,
accepted October 19, 2001.
* Reprint requests and correspondence: Dr. Mary C. Corretti, Department of Medicine, Division of Cardiology, University of Maryland School of Medicine, 22 South Greene Street, Gudelsky Tower Room G3K17, Baltimore, Maryland 21201-1595, USA.
mcorrett{at}medicine.umaryland.edu
Endothelial function is thought to be an important factor in the pathogenesis of atherosclerosis, hypertension and heart failure. In the 1990s, high-frequency ultrasonographic imaging of the brachial artery to assess endothelium-dependent flow-mediated vasodilation (FMD) was developed. The technique provokes the release of nitric oxide, resulting in vasodilation that can be quantitated as an index of vasomotor function. The noninvasive nature of the technique allows repeated measurements over time to study the effectiveness of various interventions that may affect vascular health. However, despite its widespread use, there are technical and interpretive limitations of this technique. State-of-the-art information is presented and insights are provided into the strengths and limitations of high-resolution ultrasonography of the brachial artery to evaluate vasomotor function, with guidelines for its research application in the study of endothelial physiology.
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Abbreviations and Acronyms
| | ECG | | electrocardiogram/electrocardiographic | | eNOS | | endothelial nitric oxide synthase | | FMD | | flow-mediated vasodilation | | NO | | nitric oxide | | NOS | | nitric oxide synthase | | NTG | | nitroglycerin | | 2D | | two-dimensional |
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October 1, 2008;
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[Abstract]
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S. Westphal, C. Abletshauser, and C. Luley
Fluvastatin Treatment and Withdrawal: Effects on Endothelial Function
Angiology,
October 1, 2008;
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S. E. E. Berry, S. Tucker, R. Banerji, B. Jiang, P. J. Chowienczyk, S. M. Charles, and T. A. B. Sanders
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D. H. J. Thijssen, M. M. van Bemmel, L. M. Bullens, E. A. Dawson, N. D. Hopkins, T. M. Tinken, M. A. Black, M. T. E. Hopman, N. T. Cable, and D. J. Green
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R. C. Thurston, K. Sutton-Tyrrell, S. A. Everson-Rose, R. Hess, and K. A. Matthews
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[Abstract]
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A. M. Abbatecola, M. Barbieri, M. R. Rizzo, R. Grella, M. T. Laieta, E. Quaranta, A. M. Molinari, M. Cioffi, P. Fioretto, and G. Paolisso
Arterial Stiffness and Cognition in Elderly Persons With Impaired Glucose Tolerance and Microalbuminuria
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[Abstract]
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D. Romualdi, B. Costantini, L. Selvaggi, M. Giuliani, F. Cristello, F. Macri, A. Bompiani, A. Lanzone, and M. Guido
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[Abstract]
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S. K. Nishiyama, D. W. Wray, and R. S. Richardson
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Am J Physiol Heart Circ Physiol,
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T. Sugiura, T. Kondo, Y. Kureishi-Bando, Y. Numaguchi, O. Yoshida, Y. Dohi, G. Kimura, R. Ueda, T. J. Rabelink, and T. Murohara
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Hypertension,
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[Abstract]
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F. J. Torriani, L. Komarow, R. A. Parker, B. R. Cotter, J. S. Currier, M. P. Dube, C. J. Fichtenbaum, M. Gerschenson, C. K.C. Mitchell, R. L. Murphy, et al.
Endothelial Function in Human Immunodeficiency Virus-Infected Antiretroviral-Naive Subjects Before and After Starting Potent Antiretroviral Therapy: The ACTG (AIDS Clinical Trials Group) Study 5152s
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M. Dhindsa, S. M. Sommerlad, A. E. DeVan, J. N. Barnes, J. Sugawara, O. Ley, and H. Tanaka
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C. T. Minson and D. J. Green
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K. Karatzi, C. Papamichael, E. Karatzis, T. G. Papaioannou, P. Th. Voidonikola, G. D. Vamvakou, J. Lekakis, and A. Zampelas
Postprandial Improvement of Endothelial Function by Red Wine and Olive Oil Antioxidants: A Synergistic Effect of Components of the Mediterranean Diet
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E. Anastasakis, K. I. Paraskevas, N. Papantoniou, G. Daskalakis, S. Mesogitis, D. P. Mikhailidis, and A. Antsaklis
Association Between Abnormal Uterine Artery Doppler Flow Velocimetry, Risk of Preeclampsia, and Indices of Arterial Structure and Function: A Pilot Study
Angiology,
August 1, 2008;
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[Abstract]
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E. R. Rabelo, K. Ruschel, H. Moreno Jr., M. Rubira, F. M. Consolim-Colombo, M. C. Irigoyen, and L. E. Rohde
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Eur J Heart Fail,
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[Abstract]
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E. Mannarino and M. Pirro
Endothelial Injury and Repair: A Novel Theory for Atherosclerosis
Angiology,
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M. Juonala, J. S.A. Viikari, M. Kahonen, T. Solakivi, H. Helenius, A. Jula, J. Marniemi, L. Taittonen, T. Laitinen, T. Nikkari, et al.
Childhood Levels of Serum Apolipoproteins B and A-I Predict Carotid Intima-Media Thickness and Brachial Endothelial Function in Adulthood: The Cardiovascular Risk in Young Finns Study
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A. E. Tjonna, S. J. Lee, O. Rognmo, T. O. Stolen, A. Bye, P. M. Haram, J. P. Loennechen, Q. Y. Al-Share, E. Skogvoll, S. A. Slordahl, et al.
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F. Khan
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J Appl Physiol,
July 1, 2008;
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B. Fernhall and S. Agiovlasitis
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L. Moro, C. Pedone, S. Scarlata, V. Malafarina, F. Fimognari, and R. Antonelli-Incalzi
Endothelial Dysfunction in Chronic Obstructive Pulmonary Disease
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R. Belardinelli, F. Lacalaprice, C. Ventrella, L. Volpe, and E. Faccenda
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W. L. Hall, N. L. Formanuik, D. Harnpanich, M. Cheung, D. Talbot, P. J. Chowienczyk, and T. A. B. Sanders
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M. Rakobowchuk, S. Tanguay, K. A. Burgomaster, K. R. Howarth, M. J. Gibala, and M. J. MacDonald
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J. Aittokallio, O. Polo, J. Hiissa, A. Virkki, J. Toikka, O. Raitakari, T. Saaresranta, and T. Aittokallio
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S. Ashfaq, J. L. Abramson, D. P. Jones, S. D. Rhodes, W. S. Weintraub, W. C. Hooper, V. Vaccarino, R. W. Alexander, D. G. Harrison, and A. A. Quyyumi
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J. R. Jennings, M. F. Muldoon, J. Price, I. C. Christie, and C. C. Meltzer
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J. Muller-Ehmsen, D. Braun, T. Schneider, R. Pfister, N. Worm, K. Wielckens, C. Scheid, P. Frommolt, and M. Flesch
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K. E. Pyke, V. Poitras, and M. E. Tschakovsky
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R. Vogel
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D. S. Celermajer
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M. Juonala, M. Kahonen, T. Laitinen, N. Hutri-Kahonen, E. Jokinen, L. Taittonen, M. Pietikainen, H. Helenius, J. S.A. Viikari, and O. T. Raitakari
Effect of age and sex on carotid intima-media thickness, elasticity and brachial endothelial function in healthy adults: The Cardiovascular Risk in Young Finns Study
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A. Leone and A. Balbarini
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C. Pizzi, L. Manzoli, S. Mancini, and G. M. Costa
Analysis of potential predictors of depression among coronary heart disease risk factors including heart rate variability, markers of inflammation, and endothelial function
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E. Linden, W. Cai, J. C. He, C. Xue, Z. Li, J. Winston, H. Vlassara, and J. Uribarri
Endothelial Dysfunction in Patients with Chronic Kidney Disease Results from Advanced Glycation End Products (AGE)-Mediated Inhibition of Endothelial Nitric Oxide Synthase through RAGE Activation
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S. Jelic, M. Padeletti, S. M. Kawut, C. Higgins, S. M. Canfield, D. Onat, P. C. Colombo, R. C. Basner, P. Factor, and T. H. LeJemtel
Inflammation, Oxidative Stress, and Repair Capacity of the Vascular Endothelium in Obstructive Sleep Apnea
Circulation,
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