Tomiyama Hirofumi, Kohro Takahide, Higashi Yukihito, Takase Bonpei, Suzuki Toru, Ishizu Tomoko, Ueda Shinichiro, Yamazaki Tsutomu, Furumoto Tomoo, Kario Kazuomi, Inoue Teruo, Koba Shinji, Watanabe Kentaro, Takemoto Yasuhiko, Hano Takuzo, Sata Masataka, Ishibashi Yutaka, Node Koichi, Maemura Koji, Ohya Yusuke, Furukawa Taiji, Ito Hiroshi, Yamashina Akira
Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan.
Int Heart J. 2012;53(3):170-5. doi: 10.1536/ihj.53.170.
Flow-mediated vasodilatation of the brachial artery (FMD) is a marker which is related to endothelial nitric oxide bioavailability. Commercially available ultrasound machines equipped with online computer-assisted semi-automatic analysis software to measure FMD have recently become available in Japan. These devices enable more convenient examination, enhanced reproducibility of FMD measurement, and a shortened examination time. Using such devices, in the present multicenter prospective study we propose to: 1) establish standardized FMD values and determine the annual rates of FMD change in healthy subjects; 2) confirm the predictive value of FMD for future cardiovascular events in Japanese subjects; 3) evaluate the potential usefulness of a multimarker strategy, including measurements of FMD, pulse-wave velocity (PWV), ankle-brachial pressure index, biochemical markers, and proteomic biomarkers obtained by mass spectroscopic analysis to assess the prognosis of subjects with coronary artery disease; and 4) clarify the usefulness of FMD measurement to predict the rate of progression of carotid atherosclerosis, arterial stiffness and microalbuminuria in subjects with hypertension or diabetes mellitus. In total, we estimate that approximately 4000 Japanese subjects in 3 different study groups will eventually be enrolled in this prospective observational investigation. We anticipate that the present study will provide important evidence for the usefulness of FMD measurement in the risk stratification for cardiovascular disease.
肱动脉血流介导的血管舒张功能（FMD）是一种与内皮一氧化氮生物利用度相关的标志物。配备在线计算机辅助半自动分析软件以测量FMD的商用超声设备最近在日本上市。这些设备使检查更加便捷，提高了FMD测量的可重复性，并缩短了检查时间。在本多中心前瞻性研究中，我们使用此类设备旨在：1）建立健康受试者的标准化FMD值并确定FMD的年变化率；2）确认FMD对日本受试者未来心血管事件的预测价值；3）评估多标志物策略的潜在效用，该策略包括测量FMD、脉搏波速度（PWV）、踝臂压力指数、生化标志物以及通过质谱分析获得的蛋白质组学生物标志物，以评估冠状动脉疾病患者的预后；4）阐明FMD测量对预测高血压或糖尿病患者颈动脉粥样硬化进展速度、动脉僵硬度和微量白蛋白尿的有用性。我们估计，总共约4000名来自3个不同研究组的日本受试者最终将参与这项前瞻性观察研究。我们预计本研究将为FMD测量在心血管疾病风险分层中的有用性提供重要证据。
