Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow-Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events

Haruka Morimoto; Masato Kajikawa; Nozomu Oda; Naomi Idei; Harutoyo Hirano; Eisuke Hida; Tatsuya Maruhashi; Yumiko Iwamoto; Shinji Kishimoto; Shogo Matsui; Yoshiki Aibara; Takayuki Hidaka; Yasuki Kihara; Kazuaki Chayama; Chikara Goto; Kensuke Noma; Ayumu Nakashima; Teiji Ukawa; Toshio Tsuji; Yukihito Higashi

doi:10.1161/JAHA.116.004385

Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow-Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events

J Am Heart Assoc. 2016 Dec 21;5(12):e004385. doi: 10.1161/JAHA.116.004385.

Authors

Haruka Morimoto^{1

2}, Masato Kajikawa³, Nozomu Oda⁴, Naomi Idei⁵, Harutoyo Hirano⁶, Eisuke Hida⁷, Tatsuya Maruhashi⁴, Yumiko Iwamoto⁴, Shinji Kishimoto⁴, Shogo Matsui⁴, Yoshiki Aibara¹, Takayuki Hidaka⁴, Yasuki Kihara⁴, Kazuaki Chayama⁸, Chikara Goto⁹, Kensuke Noma^{1

3}, Ayumu Nakashima¹, Teiji Ukawa², Toshio Tsuji¹⁰, Yukihito Higashi^{11

3}

Affiliations

¹ Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
² Nihon Kohden Co., Tokyo, Japan.
³ Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
⁴ Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
⁵ Department of Cardiology, Hiroshima Red Cross Hospital, Hiroshima, Japan.
⁶ College of Engineering, Academic Institute, Shizuoka University, Hamamatsu, Japan.
⁷ Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan.
⁸ Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
⁹ Hiroshima International University, Hiroshima, Japan.
¹⁰ Institute of Engineering, Hiroshima University, Higashi-Hiroshima, Japan.
¹¹ Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan yhigashi@hiroshima-u.ac.jp.

Abstract

Background: A new device for automatic measurement of flow-mediated vasodilation (FMD) using an oscillometric method has been developed to solve technical problems of conventional FMD measurement. This device measures enclosed zone FMD (ezFMD). The purpose of this study was to evaluate the prognostic value of endothelial function assessed by ezFMD for future cardiovascular events.

Methods and results: We measured ezFMD in 272 participants who underwent health-screening examinations. First, we investigated cross-sectional associations between ezFMD and cardiovascular risk factors, and then we assessed the associations between ezFMD and first major cardiovascular events (death from cardiovascular causes, stroke, and coronary revascularization). Univariate regression analysis revealed that ezFMD was significantly correlated with age, triglycerides, glucose, smoking pack-years, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and Framingham risk score. During a median follow-up period of 36.1 months (interquartile range 18.8-40.1 months), 12 participants died (6 from cardiovascular causes), 3 had stroke, 8 had coronary revascularization, and 10 were hospitalized for heart failure. There was no episode of acute coronary syndrome during the study period. Participants were divided into tertiles (low, intermediate, and high) based on ezFMD. Kaplan-Meier curves for first major cardiovascular events among the 3 groups were significantly different (P=0.004). After adjustment for cardiovascular risk factors, the low group was significantly associated with an increased risk of first major cardiovascular events compared with the high group (hazard ratio 6.47; 95% CI 1.09-125.55; P=0.038).

Conclusions: These findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events.

Clinical trial registration: URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902.

Keywords: atherosclerosis; biomarker; cardiovascular events; endothelial function.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Flow Velocity / physiology*
Brachial Artery / physiopathology*
Cardiovascular Diseases / diagnosis*
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / physiopathology
Cross-Sectional Studies
Endothelium, Vascular / physiopathology*
Equipment Design
Female
Follow-Up Studies
Humans
Incidence
Japan / epidemiology
Male
Middle Aged
Oscillometry / instrumentation*
Predictive Value of Tests
Prognosis
Reproducibility of Results
Retrospective Studies
Vasodilation / physiology*

Associated data

UMIN-CTR/UMIN000004902