Prognostic value of brachial artery endothelial function and wall thickness.
OBJECTIVE
We sought to examine the prognostic value of brachial artery (BA) flow-mediated vasodilation (FMD) and intima-media thickness (IMT) in patients admitted for invasive evaluation of chest pain.


BACKGROUND
Both FMD and IMT of the BA have been associated with coronary risk factors and the presence of coronary artery disease (CAD). Recent studies on the prognostic value of FMD have been conflicting.


METHODS
In 398 consecutive patients (age 54 +/- 9 years) undergoing coronary angiography, FMD and IMT of the BA were measured using high-resolution ultrasound (13 MHz). Patients were divided into two groups according to the FMD median (7.6%). After a mean follow-up of 39 +/- 12 months, cardiovascular events were documented.


RESULTS
No difference was found in the number of cardiovascular events between groups. On multivariate Cox regression analysis, including age, number of risk factors, BA diameter, presence of CAD, FMD, and IMT, only the presence of CAD and IMT remained significantly associated with cardiovascular events.


CONCLUSIONS
Intima-media thickness predicted late (up to 4 years) cardiovascular events in a large population admitted for evaluation of chest pain. In contrast, the long-term prognostic value of a single baseline measure of BA-FMD seems to be limited.
Frick
Matthias
M
Division of Cardiology, Innsbruck Medical University, Innsbruck, Austria.
Suessenbacher
Alois
A
Alber
Hannes F
HF
Dichtl
Wolfgang
W
Ulmer
Hanno
H
Pachinger
Otmar
O
Weidinger
Franz
F
D000328:Adult; D000368:Aged; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D002637:Chest Pain / Q000000981:diagnostic imaging / Q000209:etiology; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography