title: Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow-Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events.
abstract: 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.
  
  
  
  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).
  
  
  
  These findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events.
  
  
  
  URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902.
authors.affiliation: Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.|Nihon Kohden Co., Tokyo, Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Morimoto
authors.affiliation: Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kajikawa
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Oda
authors.affiliation: Department of Cardiology, Hiroshima Red Cross Hospital, Hiroshima, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Idei
authors.affiliation: College of Engineering, Academic Institute, Shizuoka University, Hamamatsu, Japan.
authors.forename: Harutoyo
authors.initials: H
authors.lastname: Hirano
authors.affiliation: Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Eisuke
authors.initials: E
authors.lastname: Hida
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Maruhashi
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Iwamoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kishimoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Matsui
authors.affiliation: Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Aibara
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hidaka
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
authors.affiliation: Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.affiliation: Hiroshima International University, Hiroshima, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Goto
authors.affiliation: Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.|Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Noma
authors.affiliation: Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Nakashima
authors.affiliation: Nihon Kohden Co., Tokyo, Japan.
authors.forename: Teiji
authors.initials: T
authors.lastname: Ukawa
authors.affiliation: Institute of Engineering, Hiroshima University, Higashi-Hiroshima, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan yhigashi@hiroshima-u.ac.jp.|Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Higashi
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology*; D001916:Brachial Artery / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014664:Vasodilation / Q000502:physiology*
keywords: atherosclerosis; biomarker; cardiovascular events; endothelial function