Document Detail


Noninvasive tests of vascular function and structure: why and how to perform them.
MedLine Citation:
PMID:  11320355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Early atherosclerosis involves the endothelium of many arteries. Information about peripheral arterial anatomy and function derived from vascular imaging studies such as brachial artery reactivity (BAR) and carotid intima media thickness (IMT) may be pertinent to the coronary circulation. The prevention and early treatment of atherosclerosis is gaining more attention, and these tests might be used as indications or perhaps guides to the effectiveness of therapy, but their application in clinical practice has been limited. This review seeks to define the anatomy and pathophysiology underlying these investigations, their methodology, the significance of their findings, and the issues that must be resolved before their application. METHODS: The literature on BAR and IMT is extensively reviewed, especially in relation to clinical use. RESULTS: Abnormal flow-mediated dilation is present in atherosclerotic vessels, is associated with cardiovascular risk factors, and may be a marker of preclinical disease. Treatment of known atherosclerotic risk factors has been shown to improve flow-mediated dilation, and some data suggest that vascular responsiveness is related to outcome. Carotid IMT is associated with cardiovascular risk factors, and increased levels can predict myocardial infarction and stroke. Aggressive risk factor management can decrease IMT. CONCLUSIONS: BAR and IMT are functional and structural markers of the atherosclerotic process. The clinical use of BAR has been limited by varying reproducibility and the influence by exogenous factors, but IMT exhibits less variability. A desirable next step in the development of BAR and IMT as useful clinical tools would be to show an association of improvement in response to treatment with improvement in prognosis.
Authors:
R Fathi; T H Marwick
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  American heart journal     Volume:  141     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-26     Completed Date:  2001-05-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-703     Citation Subset:  AIM; IM    
Affiliation:
University of Queensland, Brisbane, Australia.
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MeSH Terms
Descriptor/Qualifier:
Arteries / pathology,  physiopathology*,  ultrasonography
Arteriosclerosis / diagnosis*,  physiopathology
Blood Flow Velocity
Endothelium, Vascular / physiopathology,  ultrasonography
Humans
Magnetic Resonance Imaging / methods*
Plethysmography / methods*
Reproducibility of Results
Ultrasonography / methods*
Vascular Resistance
Vasodilation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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