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European Heart Journal Advance Access published online on November 2, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi619
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received March 1, 2005
Revised October 2, 2005
Accepted October 6, 2005

Clinical research

Flow-mediated changes in pulse wave velocity: a new clinical measure of endothelial function

Katerina K. Naka 1*, Ann C. Tweddel 2, Sagar N. Doshi 3, Jonathan Goodfellow 4, and Andrew H. Henderson 5

1 Michaelidion Cardiac Center, University of Ioannina, Ioannina GR45 110, Greece
2 Department of Cardiology, Hull Royal Infirmary, Hull HU3 2JZ, UK
3 Department of Cardiology, Queen Elizabeth University Hospital, Edgbaston, Birmingham B15 2TH, UK
4 Department of Cardiology, Princess of Wales Hospital, Bridgend CF31 1RQ, UK
5 Cardiovascular Sciences Research Group, Wales Heart Research Institute, Cardiff CF4 4XN, UK

* To whom correspondence should be addressed.
Katerina K. Naka, E-mail: anaka{at}cc.uoi.gr


  Abstract

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.

Keywords: Endothelial function; Pulse wave velocity; Flow-mediated dilatation; Distensibility; Atherogenesis.
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