title: Ultrasound Assessment of Endothelial Function: A Technical Guideline of the Flow-mediated Dilation Test.
abstract: Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies. Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events. Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.
authors.affiliation: Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University.
authors.forename: Paula
authors.initials: P
authors.lastname: Rodriguez-Miguelez
authors.affiliation: Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University.
authors.forename: Nichole
authors.initials: N
authors.lastname: Seigler
authors.affiliation: Division of Clinical and Translational Sciences, Georgia Prevention Institute, Georgia Regents University; Sport and Exercise Science Research Institute, University of Ulster; RYHARRIS@gru.edu.
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Harris
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D005542:Forearm / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*; D014664:Vasodilation / Q000502:physiology