Kanahara Masaaki, Harada Haruhito, Katoh Atsushi, Ikeda Hisao
Department of Medical Laboratory Science, Faculty of Health Sciences, Junshin Gakuen University, Fukuoka, Japan.
Echocardiography. 2014 Feb;31(2):197-202. doi: 10.1111/echo.12307. Epub 2013 Jul 30.
Measurement of flow-mediated dilation (FMD) is well known as a noninvasive method for an assessment of vascular endothelial function. However, the reproducibility is a major issue of FMD measurement. The purpose of this study is to examine the reproducibility of the new FMD measurement with medial epicondyle method.
First, to evaluate the variability of the brachial artery diameter, 23 volunteers recruited from 32 healthy volunteers were examined for a brachial artery diameter at rest using with FMD equipment. Second, to evaluate the reproducibility of the FMD measurement, all volunteers underwent the FMD measurement, which was repeated at 2-week interval using the traditional method and the medial epicondyle method. The reproducibility in both methods was evaluated by 2 independent observers who measured on the same subject to assess the inter-observer reproducibility, and 1 observer who measured the same subject twice to assess the intra-observer reproducibility regarding the baseline value of arterial diameter and FMD.
The variability of brachial artery diameter was 0.57 ± 0.27 mm in 23 healthy volunteers. In the study of inter- and intra-observer reproducibility, 2 parameters including intra-class correlation coefficient and Pearson's correlation coefficient by medial epicondyle method are superior to those by traditional method.
These results suggest that medial epicondyle methodological approach to measure FMD is superior to traditional method.
血流介导的血管舒张功能（FMD）测量作为一种评估血管内皮功能的非侵入性方法已广为人知。然而，FMD测量的可重复性是一个主要问题。本研究的目的是检验采用内上髁法进行FMD测量的可重复性。
首先，为评估肱动脉直径的变异性，从32名健康志愿者中招募了23名志愿者，使用FMD设备在静息状态下检测其肱动脉直径。其次，为评估FMD测量的可重复性，所有志愿者均接受FMD测量，分别采用传统方法和内上髁法，每隔2周重复测量一次。由2名独立观察者对同一受试者进行测量以评估观察者间的可重复性，1名观察者对同一受试者进行两次测量以评估观察者内关于动脉直径基线值和FMD的可重复性，以此评估两种方法的可重复性。
23名健康志愿者肱动脉直径的变异性为0.57±0.27mm。在观察者间和观察者内可重复性研究中，内上髁法的组内相关系数和皮尔逊相关系数这两个参数优于传统方法。
这些结果表明，采用内上髁法测量FMD优于传统方法。
