Correlation between impaired brachial flow-mediated dilation and hemorrhagic transformation after acute reperfusion therapy
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Abstract:
Hemorrhagic transformation (HT) represents a critical complication of reperfusion therapy, often resulting in unfavorable functional outcomes. Our objective was to explore the correlation between endothelial function, assessed through flow-mediated dilation (FMD), and the occurrence of HT in patients undergoing acute reperfusion therapy.Keywords:
Dilation (metric space)
Brachial artery
Reperfusion Therapy
Brachial artery flow-mediated dilation (FMD) is a strong predictor of future cardiovascular disease and is believed to represent a “barometer” of systemic endothelial health. Although a recent study [Padilla et al. Exp Biol Med (Maywood) 235: 1287–1291, 2010] in pigs confirmed a strong correlation between brachial and femoral artery endothelial function, it is unclear to what extent brachial artery FMD represents a systemic index of endothelial function in humans. We conducted a retrospective analysis of data from our laboratory to evaluate relationships between the upper (i.e., brachial artery) vs. lower limb (superficial femoral n = 75; popliteal artery n = 32) endothelium-dependent FMD and endothelium-independent glyceryl trinitrate (GTN)-mediated dilation in young, healthy individuals. We also examined the relationship between FMD assessed in both brachial arteries ( n = 42). There was no correlation between brachial and superficial femoral artery FMD ( r 2 = 0.008; P = 0.46) or between brachial and popliteal artery FMD ( r 2 = 0.003; P = 0.78). However, a correlation was observed in FMD between both brachial arteries ( r 2 = 0.34; P < 0.001). Brachial and superficial femoral artery GTN were modestly correlated ( r 2 = 0.13; P = 0.007), but brachial and popliteal artery GTN responses were not ( r 2 = 0.08; P = 0.11). Collectively, these data indicate that conduit artery vasodilator function in the upper limbs (of healthy humans) is not predictive of that in the lower limbs, whereas measurement of FMD in one arm appears to be predictive of FMD in the other. These data do not support the hypothesis that brachial artery FMD in healthy humans represents a systemic index of endothelial function.
Brachial artery
Popliteal artery
Endothelial Dysfunction
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Brachial artery
Reactive hyperemia
Endothelial Dysfunction
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Objective: To study the change of endothelium-dcpendent dilatation function of brachia! artery in young long term smokers. Methods: The internal diameters of brachial arteries of flow-mediate (FMD) and glyceryl trinitrate-induced (GTN-induced) were measured in 20 cases young long-term smokers and 15 controls (no smoking). Results: The basic internal diameter of brachial artery and GTN-induced dilatation of brachial artery had no difference (P0. 05) while FMD dilatation had significantly difference [ (3. 61±2.90)% : (8. 32 + 4. 75)%] ( P0. 01). Endothelium-dependent dilatation of brachial artery was negatively associated with quantity of cigarette. Conclusion: The function of endotheiium-dependent dilatation of brachial artery in young long-term smokers is significantly damaged and their damage degree is significantly correlation with quantity of cigarette.
Brachial artery
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The purpose of this study was to evaluate the effect of anatomical variation of the brachial artery on flow-mediated vasodilation (FMD) in healthy subjects and patients with cardiovascular disease (CVD).There was no significant difference in the prevalence of double brachial artery between healthy subjects (6.1%) and patients with CVD (6.5%). In healthy subjects, FMD was larger in a single brachial artery than in large and small vessels of a double brachial artery (7.2±3.4% vs. 4.7±3.3% and 4.5±2.5%, P<0.01, respectively). In patients with CVD, there were no significant differences in FMD among a single brachial artery, large vessel of a double brachial artery and small vessel of a double brachial artery (3.3±1.4%, 3.1±2.3% and 3.6±2.1%). FMD in a single brachial artery was smaller in patients with CVD than in healthy subjects. There were no significant differences in FMD in the large vessel of a double brachial artery between the 2 groups or in the small vessel of a double brachial artery between the 2 groups. Nitroglycerine-induced vasodilation was similar in all arteries in healthy subjects and patients with CVD.When measuring FMD, the existence of a double brachial artery should be checked. FMD measured in a double brachial artery may be underestimated in healthy subjects.
Brachial artery
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Objective: To investigate the effect of losartan on endothelial function in patients with essential hypertension by using flow-mediated vasodilation(FMD) of brachial artery. Methods: We tested the basic FMD and maximum velocity(Vmax) of brachial artery in 20 patients with essential hypertension. After giving the patients 50mg losartan per day for 8 weeks, the FMD and Vmax was tested again. The blood pressure (BP) was measured simultaneously. Results: After the treatment there were no significant changes of brachial artery initial diameter while FMD increased significantly (4. 64% ± 3. 72% vs 7. 68% ± 6. 12% , P = 0.024) and the change was independent of BP decreasing. The Vmax was also increased significantly. Conclusions: The brachial FMD can be regarded as a useful method to evaluate endothelial-dependent vasodilative function. Flow-mediated brachial artery dilation would be improved afer taking losartan 50mg/d for 8 weeks, and this is independent of BP decreasing.
Brachial artery
Essential hypertension
Endothelial Dysfunction
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Brachial artery
Dilation (metric space)
Sublingual administration
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Using high resolution ultrasound, we measured the diameter of brachial arteries at rest, during reactive hyperemia and after glyceryl trinitrate (GTN) taking in 22 healthy persons. The results showed that brachial artery dilation was present both in reactive hyperemia and response to GTN. The mean flow-mediated dilation was 13.8 +/- 3.9% increment. The mean increment of dilation in response to GTN was 24.9 +/- 9.7%. The diameters of brachial arteries during reactive hyperemia and after sublingual GTN had significant difference compared with that in baseline (P < 0.01). It indicates that increased flow may mediate endothelium-dependent vessel dilatation and GTN cause endothelium-independent vessel dilatation in normal subjects. This paper presents a new non-invasive method of detecting endothelium-dependent dilation, which is proved to be simple, secure and practical.
Brachial artery
Reactive hyperemia
Dilation (metric space)
Sublingual administration
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Brachial artery flow-mediated dilation (FMD) is a common measure of endothelial function. Anatomical variations of the brachial artery (e.g., unilateral dual-brachial arteries) have been documented in ~5-10% of cadavers post-mortem, but our understanding of endothelial or vascular smooth muscle cell function in these rare cases is unknown. Investigating these rare arterial anomalies may provide unique opportunities to further knowledge on arterial function. PURPOSE: To determine FMD and endothelial-independent vasodilatory responses between a bifurcated versus non-bifurcated brachial artery. METHODS: A 28-year healthy female presenting with a double right brachial artery [right superficial brachial artery (RSBA), right deep brachial artery (RDBA)], but a non-bifurcated left brachial artery (LBA) was examined. Duplex ultrasonography was used to perform endothelial-dependent and -independent vasodilation assessments via the FMD and nitroglycerin-mediated dilation (NMD, 0.4 mg sublingual spray) techniques, respectively. Absolute (mm) and relative (% baseline) changes in diameter were calculated for FMD and NMD. The shear rate area under the curve (SRAUC) between distal cuff deflation and the peak FMD response was also calculated. RESULTS: The RSBA and RDBA split at the axilla and converged at the antecubital fossa. Baseline lumen diameters were similar between the intact LBA (2.92 mm) and the RSBA (3.05 mm), but the RDBA was smaller (2.04 mm). However, the SRAUC responses were similar between arteries (RSBA = 11455 au, RDBA = 10904 au, LBA = 12254 au). Absolute and relative FMD were lower in the bifurcated artery (RSBA = 0.10 mm, 3.5%; RDBA = 0.09 mm, 4.2%) compared to the intact LBA (0.22 mm, 7.6%). Similar observations were note for absolute NMD (RSBA = 0.42 mm, RDBA = 0.47 mm, LBA = 0.62 mm), but not relative NMD (RSBA = 13.3%, RDBA = 24.9%, LBA = 21.3%). CONCLUSIONS: Unilateral bifurcation of the brachial artery promotes lower endothelial-dependent vasodilation in the bifurcated vessels relative to the intact contralateral artery. Compared to an intact brachial artery, unilateral bifurcation was associated with reduced vascular smooth muscle sensitivity to exogenous nitric oxide in the RSBA (absolute + relative NMD responses), and in the RDBA (absolute NMD only), compared to the intact LBA.
Brachial artery
Cuff
Sphygmomanometer
Electrical impedance myography
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1. The aim of the present study was to determine the relationship between plasma levels of nitrite/nitrite (NO(x)) and brachial flow-mediated dilation (FMD) in healthy young men and women. 2. Brachial artery FMD was assessed non-invasively using high-resolution ultrasound in 36 young men and women (21 +/- 3 years; 18 men and 18 women). Blood samples for NO(x) assays were collected from an indwelling venous catheter in the forearm following an overnight fast and a 36 h low-nitrate diet. 3. Plasma levels of NO(x) were related to peak brachial FMD% (r = 0.53; P = 0.001). The relationship was maintained when the brachial dilation was expressed as absolute diameter change (Deltamm; r = 0.51; P = 0.002) and when it was normalized (/s) to the mean shear rate (r = 0.50; P = 0.002). 4. The present study demonstrates a relationship between peak FMD in the brachial artery and plasma levels of NO(x) in young men and women. This relationship suggests that brachial FMD and/or plasma NO(x) may be used as markers of peripheral endothelial function.
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In this letter, we adapt the dilation operator from mathematical morphology to propose dilation distances. These dilation distances are then used for band selection in hyperspectral images. It is shown that dilation distances between bands can capture the spatial distance between the objects. Hence, using dilation-based distances would select those bands which identify spatially separated objects. This is illustrated using both toy and real data sets. Furthermore, we compare the proposed approach with existing methods and show empirically that dilation-distance-based band selection provided competitive results outperforming several methods.
Dilation (metric space)
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