Variability of flow-mediated dilation measurements with repetitive reactive hyperemia

Abstract

To capture the response of an acute intervention, multiple post intervention measurements of flow-mediated dilation (FMD) must be performed. The effect of repetitive reactive hyperemia on endothelial function and the measurement of FMD are unknown. The purpose of this investigation was (1) to examine the effect of repetitive reactive hyperemia on brachial artery FMD and (2) to determine whether brachial artery FMD is stable during a 2-h morning period. We investigated FMD in 20 apparently healthy college students on three randomized treatment days every 30 min (T₃₀), 60 min (T₆₀), and 120 min (T₁₂₀) throughout a 2-h morning period (08.00 h to 10.00 h). An ANOVA (p > 0.05) and ICC (>0.40) were both needed to confirm no difference among repetitive reactive hyperemia treatments. In response to repetitive reactive hyperemia, there was no difference (p = 0.307; ICC > 0.40) within the first and last FMD measurements of each treatment condition or between treatment conditions (p = 0.344; ICC > 0.40). FMD was similar (p = 0.348) throughout the 2-h morning period. In conclusion, repetitive reactive hyperemia over a 2-h period has no effect on FMD measurements in apparently healthy college students. In addition, this study found no time trends for FMD measurements during the 2-h morning period to allow for pre/post intervention FMD measurements.

Keywords

blood flow endothelium ischemia repetitive reactive hyperemia

References

Lerman A , Burnett JC Jr. Intact and altered endothelium in regulation of vasomotion. Circulation 1992; 86: III-12-II-19.

Muiesan M , Salvetti M , Monteduro C et al. Effect of treatment on flow dependent vasodilation of the brachial artery in essential hypertension. Hypertension 1999; 33: 575-580.

Widlansky ME , Price DT , Gokce N , Eberhardt RT , Duffy SJ , Holbrook M. Short and long term cox-2 inhibition reverses endothelial dysfunction in patients with hypertension. Hypertension 2003; 42: 310-315.

Fuchsjager-Mayrl G , Pleiner J , Wiesinger GF et al. Exercise training improves vascular endothelial function in patients with type 1 diabetes. Diabetes Care 2002; 25: 1795-1801.

Schmidt A , Pleiner J , Bayerle-Eder M et al. Regular physical exercise improves endothelial function in heart transplant recipients. Clin Transplant 2002; 16: 137-143.

Katz SD , Yuen J , Bijou R , LeJemtel TH. Training improves endothelium-dependent vasodilation in resistance vessels of patients with heart failure. J Appl Physiol 1997; 82: 1488-1492.

Hamdy O , Ledbury S , Mullooly C et al. Lifestyle modification improves endothelial function in obese subjects with the insulin resistance syndrome. Diabetes Care 2003; 26: 2119-2125.

Uehata A , Lieberman EH , Gerhard MD et al. Noninvasive assessment fo endothelium-dependent flow-mediated dilation of the brachial artery. Vasc Med 1997; 2: 87-92.

Takase B , Uehata A , Akima T et al. Endothelium-dependent flow-mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease. Am J Cardiol 1998; 82: 1535-1539.

10.

Anderson TJ , Uehata A , Gerhard MD. Close relationship of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26: 1235-1241.

11.

Celermajer D.

Endothelial dysfunction: does it matter? Is it reversible?

J Am Coll Cardiol 1997; 30: 325-333.

12.

Corretti MC , Anderson TJ , Benjamin EJ et al. Guidelines for the Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery. J Am Coll Cardiol 2002; 39: 257-265.

13.

Rinder MR , Spina RJ , Ehsani A. Enhanced endothelium-dependent vasodilation in older endurance-trained men. J Appl Physiol 2000; 88: 761-766.

14.

Stewart K , Sung J , Silber H et al. Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. AM J Hypertens 2004; 17: 314-320.

15.

Landis J , Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174.

16.

Sorensen KE , Celermajer D , Spiegelhalter D. Non-invasive measurement of human endothelium dependent arterial responses: accuracy and reproducibility. Br Heart J 1995; 74: 247-253.

17.

Otto ME , Svatikova A , Barretto RB et al. Early morning attenuation of endothelial function in healthy humans. Circulation 2004; 109: 2507-2510.

18.

Etsuda H , Takase B , Uehata A et al.

Morning attenuation of endothelium-dependent, flow-mediated dilation in healthy young men: possible connection to morning peak of cardiac events?

Clin Cardiol 1999; 22: 417-421.

19.

Vita JA , Keaney JF.

Endothelial function: a barometer for cardiovascular risk?

Circulation 2002;106: 640-642.

20.

Bots ML , Westerink J , Rabelink TJ , Koning EJPD. Assessment of flow-mediated vasodilation (FMD) of the brachial artery: effects of technical aspects of the FMD measurement on the FMD response. Eur Heart J 2005; 26: 363-368.

21.

Tsai W-C , Li Y-H , Lin C-C , Chao T-H , Chen J-H. Effects of oxidative stress on endothelial function after a high-fat meal. Clin Sci 2004; 106: 315-319.

22.

Plotnick G , Corretti M , Vogel R. Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity following a single high-fat meal. JAMA 1997; 278: 1682-1686.