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Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans.

Thijssen, DHJ, Bruno, RM, van Mil, ACCM, Holder, SM, Faita, F, Greyling, A, Zock, PL, Taddei, S, Deanfield, JE, Luscher, T, Green, DJ and Ghiadoni, L (2019) Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. European Heart Journal. ISSN 0195-668X

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Abstract

Endothelial dysfunction is involved in the development of atherosclerosis, which precedes asymptomatic structural vascular alterations as well as clinical manifestations of cardiovascular disease (CVD). Endothelial function can be assessed non-invasively using the flow-mediated dilation (FMD) technique. Flow-mediated dilation represents an endothelium-dependent, largely nitric oxide (NO)-mediated dilatation of conduit arteries in response to an imposed increase in blood flow and shear stress. Flow-mediated dilation is affected by cardiovascular (CV) risk factors, relates to coronary artery endothelial function, and independently predicts CVD outcome. Accordingly, FMD is a tool for examining the pathophysiology of CVD and possibly identifying subjects at increased risk for future CV events. Moreover, it has merit in examining the acute and long-term impact of physiological and pharmacological interventions in humans. Despite concerns about its reproducibility, the available evidence shows that highly reliable FMD measurements can be achieved when specialized laboratories follow standardized protocols. For this purpose, updated expert consensus guidelines for the performance of FMD are presented, which are based on critical appraisal of novel technical approaches, development of analysis software, and studies exploring the physiological principles underlying the technique. Uniformity in FMD performance will (i) improve comparability between studies, (ii) contribute to construction of reference values, and (iii) offer an easy accessible and early marker of atherosclerosis that could complement clinical symptoms of structural arterial disease and facilitate early diagnosis and prediction of CVD outcomes.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in European Heart Journal following peer review. The version of record Dick H J Thijssen, Rosa Maria Bruno, Anke C C M van Mil, Sophie M Holder, Francesco Faita, Arno Greyling, Peter L Zock, Stefano Taddei, John E Deanfield, Thomas Luscher, Daniel J Green, Lorenzo Ghiadoni, Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans, European Heart Journal, , ehz350, is available online at: https://doi.org/10.1093/eurheartj/ehz350
Uncontrolled Keywords: 1102 Cardiorespiratory Medicine and Haematology
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sports & Exercise Sciences
Publisher: Oxford University Press (OUP)
Related URLs:
Date Deposited: 25 Jun 2019 10:30
Last Modified: 25 Jun 2019 10:30
DOI or Identification number: 10.1093/eurheartj/ehz350
URI: http://researchonline.ljmu.ac.uk/id/eprint/10926

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