Department of Cardiovascular Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Arterioscler Thromb Vasc Biol. 2012 Sep;32(9):2295-303. doi: 10.1161/ATVBAHA.112.249680. Epub 2012 Jul 12.
Cardiovascular diseases are associated with impaired flow-mediated vasodilation (FMD) and increase in carotid intima-media thickness (IMT). Both FMD and IMT are independent predictors for cardiovascular outcomes. When measuring FMD and nitroglycerine-induced vasodilation in the brachial artery, IMT can also be simultaneously assessed in the same brachial artery. The purpose of this study was to determine the relationships between IMT of the brachial artery, vascular function, and cardiovascular risk factors.
We measured brachial IMT, FMD, and nitroglycerine-induced vasodilation by ultrasound in 388 subjects who underwent health examination (mean age, 45±22 years; age range, 19-86), including patients with cardiovascular diseases. Univariate regression analysis revealed that brachial IMT significantly correlated with age (r=0.71; P<0.001), body mass index (r=0.27; P<0.001), systolic blood pressure (r=0.40; P<0.001), diastolic blood pressure (r=0.31; P<0.001), heart rate (r=0.15; P=0.002), glucose level (r=0.18; P=0.01), and smoking pack-years (r=0.42; P<0.001), as well as Framingham risk score, a cumulative cardiovascular risk index for heart attack (r=0.49; P<0.001). FMD and nitroglycerine-induced vasodilation were inversely associated with brachial IMT (r=-0.39, P<0.001; r=-0.32, P<0.001, respectively). In addition, there was a significant relationship between brachial IMT and carotid IMT (r=0.58; P<0.001). Multivariate analysis revealed that age, sex, hypertension, and brachial artery diameter were independent predictors of brachial IMT.
These findings suggest that brachial IMT may be a marker of the grade of atherosclerosis and may be used as a marker of vascular function, providing additive information for stratifying subjects with cardiovascular risk factors.
心血管疾病与血流介导的血管扩张功能受损（FMD）和颈动脉内膜中层厚度（IMT）增加有关。FMD 和 IMT 都是心血管结局的独立预测因子。在肱动脉测量 FMD 和硝酸甘油诱导的血管舒张时，也可以同时在同一肱动脉评估 IMT。本研究的目的是确定肱动脉 IMT、血管功能和心血管危险因素之间的关系。
我们对 388 名接受健康检查的受试者（平均年龄 45±22 岁；年龄范围 19-86 岁）进行了超声肱动脉 IMT、FMD 和硝酸甘油诱导的血管舒张测量，包括心血管疾病患者。单因素回归分析显示，肱动脉 IMT 与年龄（r=0.71；P<0.001）、体重指数（r=0.27；P<0.001）、收缩压（r=0.40；P<0.001）、舒张压（r=0.31；P<0.001）、心率（r=0.15；P=0.002）、血糖水平（r=0.18；P=0.01）和吸烟包年数（r=0.42；P<0.001）以及 Framingham 风险评分（一种用于评估心脏病发作的累积心血管风险指数，r=0.49；P<0.001）显著相关。FMD 和硝酸甘油诱导的血管舒张与肱动脉 IMT 呈负相关（r=-0.39，P<0.001；r=-0.32，P<0.001）。此外，肱动脉 IMT 与颈动脉 IMT 之间存在显著关系（r=0.58；P<0.001）。多因素分析显示，年龄、性别、高血压和肱动脉直径是肱动脉 IMT 的独立预测因子。
这些发现表明，肱动脉 IMT 可能是动脉粥样硬化程度的标志物，并可作为血管功能的标志物，为分层心血管危险因素患者提供附加信息。
