European Heart Journal Advance Access originally published online on November 2, 2005
European Heart Journal 2006 27(3):302-309; doi:10.1093/eurheartj/ehi619
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Flow-mediated changes in pulse wave velocity: a new clinical measure of endothelial function
1Michaelidion Cardiac Center, University of Ioannina, Ioannina GR45 110, Greece
2Department of Cardiology, Hull Royal Infirmary, Hull HU3 2JZ, UK
3Department of Cardiology, Queen Elizabeth University Hospital, Edgbaston, Birmingham B15 2TH, UK
4Department of Cardiology, Princess of Wales Hospital, Bridgend CF31 1RQ, UK
5Cardiovascular Sciences Research Group, Wales Heart Research Institute, Cardiff CF4 4XN, UK
Received 1 March 2005; revised 2 October 2005; accepted 6 October 2005; online publish-ahead-of-print 2 November 2005.
* Corresponding author. Tel: +30 26510 97710; fax: +30 26510 97865. E-mail address: anaka{at}cc.uoi.gr
See page 255 for the editorial comment on this article (doi:10.1093/eurheartj/ehi652)
Aims To test whether measuring hyperaemic changes in pulse wave velocity (PWV) could be used as a new method of assessing endothelial function for use in clinical practice.
Methods and results Flow-mediated changes in vascular tone may be used to assess endothelial function and may be induced by distal hyperaemia, while endothelium-mediated changes in vascular tone can influence PWV. These three known principles were combined to provide and test a novel method of measuring endothelial function by the acute effects of distal hyperaemia on upper and lower limb PWV (measured by a recently developed method). Flow-mediated changes in upper and lower limb PWV were compared in 17 healthy subjects and seven patients with stable chronic heart failure (CHF), as a condition where endothelial function is impaired but endothelium-independent dilator responses are retained. Corroborative measurements of PWV and brachial artery diameter responses to endothelium-dependent and -independent pharmacological stimuli were performed in a further eight healthy subjects. Flow-mediated reduction of PWV (by 14% with no change in blood pressure) was found in normal subjects but was almost abolished in patients with CHF. PWV responses appear to be inversely related to and relatively greater than brachial artery diameter responses.
Conclusion The method may offer potential advantages of practical use and sensitivity over conduit artery diameter responses to measure endothelial dysfunction.
Key Words: Endothelial function • Pulse wave velocity • Flow-mediated dilatation • Distensibility • Atherogenesis
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