Brachial artery diameter and the right ventricle: the Multi-Ethnic Study of Atherosclerosis-right ventricle study.
BACKGROUND
Endothelial dysfunction is associated with left ventricular morphology and long-term cardiovascular outcomes. The purpose of this study was to assess the relationship between both baseline brachial artery diameter and peripheral endothelial function (assessed by brachial artery ultrasonography) and right ventricular (RV) mass, RV end-diastolic volume (RVEDV), and RV ejection fraction (RVEF).


METHODS
The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac MRI and brachial artery ultrasonography on participants without clinical cardiovascular disease. Baseline brachial artery diameter and flow-mediated dilation were assessed.


RESULTS
The mean age was 60.9 years, and 49.4% of subjects were men (n = 2,425). In adjusted models, larger brachial artery diameter was strongly associated with greater RV mass (β = 0.55 g, P &lt; .001), larger RVEDV (β = 3.99 mL, P &lt; .001), and decreased RVEF (β = -0.46%, P = .03). These relationships persisted after further adjustment for the respective left ventricular parameters. Flow-mediated dilation was not associated with RV mass or RVEF and was only weakly associated with RVEDV.


CONCLUSIONS
Brachial artery diameter is associated with greater RV mass and RVEDV, as well as lower RVEF. Changes in the systemic arterial circulation may have pathophysiologic links to pulmonary vascular dysfunction or abnormalities in RV perfusion.
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Christopher T
CT
Dibble
Department of Medicine, Mailman School of Public Health, Columbia University, New York, NY.
Daichi
D
Shimbo
Department of Medicine, Mailman School of Public Health, Columbia University, New York, NY; College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
R Graham
RG
Barr
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
Emilia
E
Bagiella
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Harjit
H
Chahal
Department of Medicine, Alpert Medical School of Brown University, Providence, RI.
Corey E
CE
Ventetuolo
Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC.
David M
DM
Herrington
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
Joao A C
JAC
Lima
Radiology and Imaging Sciences, National Institutes of Health/Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD.
David A
DA
Bluemke
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Electronic address: kawut@upenn.edu.
Steven M
SM
Kawut
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D050197:Atherosclerosis / Q000208:ethnology* / Q000473:pathology* / Q000503:physiopathology; D044383:Black People; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D006630:Hispanic or Latino; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D018084:Ultrasonography, Interventional; D044465:White People