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Measuring FMD in the brachial artery: how important is QRS gating? J Appl Physiol (1985) 2010 Oct;109(4):959-65

Date

07/31/2010

Pubmed ID

20671033

Pubmed Central ID

PMC2963331

DOI

10.1152/japplphysiol.00532.2010

Scopus ID

2-s2.0-78149321354   37 Citations

Abstract

Recommendations for the measurement of brachial flow-mediated dilation (FMD) typically suggest images be obtained at identical times in the cardiac cycle, usually end diastole (QRS complex onset). This recommendation presumes that inter-individual differences in arterial compliance are minimized. However, published evidence is conflicting. Furthermore, ECG gating is not available on many ultrasound systems; it requires an expensive software upgrade or increased image processing time. We tested whether analysis of images acquired with QRS gating or with the more simplified method of image averaging would yield similar results. We analyzed FMD and nitroglycerin-mediated dilation (NMD) in 29 adults with type 2 diabetes mellitus and in 31 older adults and 12 young adults without diabetes, yielding a range of brachial artery distensibility. FMD and NMD were measured using recommended QRS-gated brachial artery diameter measurements and, alternatively, the average brachial diameters over the entire R-R interval. We found strong agreement between both methods for FMD and NMD (intraclass correlation coefficients = 0.88-0.99). Measuring FMD and NMD using average diameter measurements significantly reduced post-image-processing time (658.9 ± 71.6 vs. 1,024.1 ± 167.6 s for QRS-gated analysis, P < 0.001). FMD and NMD measurements based on average diameter measurements can be performed without reducing accuracy. This finding may allow for simplification of FMD measurement and aid in the development of FMD as a potentially useful clinical tool.

Author List

Kizhakekuttu TJ, Gutterman DD, Phillips SA, Jurva JW, Arthur EI, Das E, Widlansky ME

Authors

David D. Gutterman MD Sr Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Michael E. Widlansky MD Associate Director, Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Blood Flow Velocity
Blood Pressure
Brachial Artery
Case-Control Studies
Compliance
Diabetes Mellitus, Type 2
Diastole
Electrocardiography
Female
Heart Rate
Humans
Hyperemia
Image Interpretation, Computer-Assisted
Male
Middle Aged
Nitroglycerin
Observer Variation
Predictive Value of Tests
Regional Blood Flow
Reproducibility of Results
Ultrasonography
Vasodilation
Vasodilator Agents
Young Adult
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d