Nuffield Department of Surgical Sciences, University of Oxford.
J Atheroscler Thromb. 2017 Aug 1;24(8):779-787. doi: 10.5551/jat.40964. Epub 2017 Jul 1.
Endothelial dysfunction is one of the hallmarks of atherogenesis, and correlates with many cardiovascular risk factors. One of the features of endothelial dysfunction is the loss of nitric oxide (NO) bioavailability, resulting in derangements in the vasodilatory response of the vessel wall. Flow mediated dilatation (FMD) of the brachial artery is an accepted method for non-invasive assessment of systemic endothelial function. FMD is examined extensively in the context of cardiovascular research, and has been utilised as a routine assessment in large cohorts such as the Framingham Heart Study, Young Finns Study, and Gutenberg Heart Study. However, FMD is less known in the context of vascular surgery research, despite the similarities between the underpinning disease mechanisms. This review will provide a summary of FMD in terms of its history of development and the conduct of the test in research settings. It will further highlight the key literature of FMD as a biomarker for vascular surgeons, particularly in the context of abdominal aortic aneurysms and lower limb peripheral arterial disease.
内皮功能障碍是动脉粥样硬化形成的特征之一，与许多心血管危险因素相关。内皮功能障碍的特征之一是一氧化氮（NO）生物利用度的丧失，导致血管壁舒张反应失调。肱动脉血流介导的扩张（FMD）是一种公认的非侵入性评估全身内皮功能的方法。FMD 在心血管研究中得到了广泛的研究，并在弗雷明汉心脏研究、年轻芬兰人研究和古腾堡心脏研究等大型队列中作为常规评估进行了应用。然而，尽管潜在的疾病机制相似，但 FMD 在血管外科学研究中却鲜为人知。本综述将概述 FMD 的发展历史及其在研究中的检测方法。它还将重点介绍 FMD 作为血管外科医生的生物标志物的关键文献，特别是在腹主动脉瘤和下肢外周动脉疾病的背景下。
