title: Delayed vasodilation is associated with cardiovascular risk.
abstract: BACKGROUND
  Flow-mediated dilation (FMD) of the brachial artery is widely used to assess cardiovascular risk. In recent years, much attention has been paid to the kinetics of vasodilation in an attempt to better characterize the endothelial function. Here, we investigated whether FMD magnitude and/or latency are most related to individual cardiovascular risk.
  
  
  METHODS
  Four hundred subjects were recruited. Individual risk prediction was estimated by Framingham cardiovascular risk score and CUORE project calculator. Subjects were divided into Early dilators (peak FMD at 50 s), Late dilators (peak FMD over 50 s) and No dilators.
  
  
  RESULTS
  Cardiovascular risk was highest in No dilators and significantly higher in Late than Early dilators despite comparable peak FMD. When divided according to peak FMD quintiles, Early and Late dilators showed decreased cardiovascular risk with increasing magnitude of vasodilation. However, subjects in the first three quintiles of Late dilators had a markedly higher risk score despite a peak vasodilation similar to that of Early dilators.
  
  
  CONCLUSIONS
  These results suggest that the magnitude of the FMD and its latency are both important for identifying patients at risk of cardiovascular disease. Subjects with a delayed though significant vasodilation associated with a blunted early response exhibit the highest cardiovascular risk.
authors.affiliation: Department of Clinical and Experimental Medicine, University Magna Graecia, Catanzaro, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Irace
authors.forename: Jaume
authors.initials: J
authors.lastname: Padilla
authors.forename: Claudio
authors.initials: C
authors.lastname: Carallo
authors.forename: Faustina
authors.initials: F
authors.lastname: Scavelli
authors.forename: Agostino
authors.initials: A
authors.lastname: Gnasso
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology*
keywords: Atherosclerosis; cardiovascular risk; cardiovascular risk factors; flow-mediated dilation; ultrasound