Clinical significance of flow-mediated dilation, brachial intima-media thickness and pulse wave velocity in patients with and without coronary artery disease

Circ J. 2012;76(6):1469-75. doi: 10.1253/circj.cj-11-1283. Epub 2012 Apr 3.


Background: Little is known about the interrelationships among brachial flow-mediated vasodilatation (bFMD), brachial-ankle pulse wave velocity (baPWV) and brachial intima-media thickness (bIMT) in patients with and without coronary artery disease (CAD).

Methods and results: Two-hundred consecutive patients with stable angina pectoris (SAP) were enrolled as the CAD group and 50 age-, sex- and body mass index-matched patients without CAD were selected as the non-CAD group. bFMD, diastolic blood pressure (DBP) and high-density lipoprotein cholesterol (HDL-C) in the CAD group were significantly lower. The CAD group showed significantly higher levels of hemoglobin A(1c)(HbA(1c)) and low-density lipoprotein cholesterol (LDL-C), but not baPWV. CAD was independently associated with bFMD, DBP, HbA(1c) and HDL-C. bFMD and HDL-C significantly decreased and LDL-C increased as the number of diseased vessels with significant stenosis increased. The number of diseased vessels was independently associated with bFMD and HDL-C. In addition, bFMD, bIMT, the time constant of the shear rate and the time constant of the flow rate as assessed by a new program, Trend Plus(®), were associated with the presence of CAD. Among these parameters, the presence of CAD was independently associated with bIMT as well as bFMD.

Conclusions: bFMD was a better predictor of the severity of CAD than either baPWV or coronary risk factors in patients with SAP. In addition, bIMT may be a critical predictor of CAD.

MeSH terms

  • Aged
  • Angina Pectoris / pathology
  • Angina Pectoris / physiopathology
  • Atherosclerosis / blood
  • Atherosclerosis / complications*
  • Atherosclerosis / pathology
  • Atherosclerosis / physiopathology
  • Biomarkers / blood
  • Blood Pressure
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / pathology*
  • Brachial Artery / physiopathology*
  • Case-Control Studies
  • Chi-Square Distribution
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Coronary Angiography / methods
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / physiopathology
  • Coronary Stenosis / etiology
  • Coronary Stenosis / pathology
  • Coronary Stenosis / physiopathology
  • Cross-Sectional Studies
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hyperemia / physiopathology
  • Japan
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Multivariate Analysis
  • Predictive Value of Tests
  • Pulsatile Flow*
  • Regional Blood Flow
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Tunica Intima / pathology*
  • Tunica Media / pathology*
  • Ultrasonography
  • Vasodilation*


  • Biomarkers
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human