Assessment of flow-mediated dilation in humans: a methodological and physiological guideline

Author:

Thijssen Dick H. J.12,Black Mark A.13,Pyke Kyra E.4,Padilla Jaume5,Atkinson Greg1,Harris Ryan A.6,Parker Beth7,Widlansky Michael E.8,Tschakovsky Michael E.9,Green Daniel J.110

Affiliation:

1. Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool;

2. Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;

3. Vascular Laboratory, Russells Hall Hospital, Dudley Group Of Hospitals, NHS Foundation Trust, Dudley, United Kingdom;

4. Cardiovascular Stress Response Laboratory and

5. Department of Biomedical Sciences, University of Missouri, Columbia, Missouri;

6. Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta, Georgia;

7. Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut;

8. Departments of Medicine and Pharmacology and the Cardiovascular Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin;

9. Human Vascular Control Laboratory, School of Kinesiology and Health Studies and Department of Physiology, Queen's University, Kingston, Ontario, Canada;

10. School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia

Abstract

Endothelial dysfunction is now considered an important early event in the development of atherosclerosis, which precedes gross morphological signs and clinical symptoms. The assessment of flow-mediated dilation (FMD) was introduced almost 20 years ago as a noninvasive approach to examine vasodilator function in vivo. FMD is widely believed to reflect endothelium-dependent and largely nitric oxide-mediated arterial function and has been used as a surrogate marker of vascular health. This noninvasive technique has been used to compare groups of subjects and to evaluate the impact of interventions within individuals. Despite its widespread adoption, there is considerable variability between studies with respect to the protocols applied, methods of analysis, and interpretation of results. Moreover, differences in methodological approaches have important impacts on the response magnitude, can result in spurious data interpretation, and limit the comparability of outcomes between studies. This review results from a collegial discussion between physiologists with the purpose of developing considered guidelines. The contributors represent several distinct research groups that have independently worked to advance the evidence base for improvement of the technical approaches to FMD measurement and analysis. The outcome is a series of recommendations on the basis of review and critical appraisal of recent physiological studies, pertaining to the most appropriate methods to assess FMD in humans.

Publisher

American Physiological Society

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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