Abstract
Brachial artery Flow Mediated Dilation (FMD) is widely used as a non-invasive measure of endothelial function. Adherence to expert consensus guidelines on FMD measurement has been found to be of vital importance to obtain reproducible data. This article lists the literature data which was considered in the development of a tool to aid in the objective judgement of the extent to which published studies adhered to expert guidelines for FMD measurement. Application of this tool in a systematic review of FMD studies (http://dx.doi.org/10.1016/j.atherosclerosis.2016.03.011) (Greyling et al., 2016 [1]) indicated that adherence to expert consensus guidelines is strongly correlated to the reproducibility of FMD data.
Keywords: Cardiovascular disease, Atherosclerosis, Endothelial function, Reproducibility, Methodology
Specifications Table
| Subject area | Medicine |
| More specific subject area | Vascular Physiology |
| Type of data | Table |
| How data was acquired | Systematic literature survey and expert consensus |
| Data format | Processed |
| Experimental factors | Methodological parameters related to valid measurement FMD |
| Experimental features | Assessment tool based on 33 studies pertaining to the most appropriate methods to assess FMD in humans identified from literature and expert guidelines for FMD measurement |
| Data source location | Nijmegen, The Netherlands |
| Data accessibility | Data is within this article |
Value of the data
-
•
The literature data provided here establishes an evidence base and a physiological background rationale for the individual components included in the Adherence Score, aiding in the improvement of the practical guidance and technical approaches to FMD measurement and analysis.
-
•
This “Adherence Score” which ranges between 0 (i.e. no adherence) and 10 (i.e. full adherence) can conceivably be employed to evaluate the perceived quality of studies reporting FMD data, with a higher outcome of this measure being strongly related to better reproducibility of the FMD data [1].
-
•
This tool may prove useful additional information when pooling, contrasting and comparing different studies, e.g. for the purpose of meta-analyses or systematic reviews.
1. Data
A tool to enable objective assessment of the level adherence to the FMD guidelines was developed. Table 1 presents the 19 different factors that make up the “Adherence Score” tool along with citations to the literature data which justify the inclusion of each factor in question.
Table 1.
Scoring tool based on currently accepted guidelines for the assessment of the perceived quality of FMD studies [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34].
![]() |
2. Experimental design, materials and methods
Based on previous expert-consensus guidelines [35], we devised a scoring system reliant on the reporting of 19 different methodological factors related to FMD measurement. These factors were identified after critical review and appraisal of published physiological studies pertaining to the most appropriate methods to assess FMD in humans. Values were assigned to each component proportional to its perceived importance for valid assessment of the FMD. This was done through expert consensus discussion within the Working Group (AG, LG and DHJT). The “Adherence Score” that any given study can be assigned ranges from 0 to 10 points depending on how many of the 19 different factors that are reported or referred to in the text of the paper in question.
Acknowledgements
Ms. Anke van Mil is financially supported by a Top Institute for Food and Nutrition-grant.
Dr. Dick Thijssen is financially supported by the Netherlands Heart Foundation (E Dekker-stipend, 2009T064). Professor Green receives Fellowship and grant funding from the National Heart Foundation of Australia (APP1045204).
Footnotes
Supplementary data associated with this article can be found in the online version at doi:10.1016/j.dib.2016.05.011.
Appendix A. Supplementary material
Supplementary material
References
- 1.Greyling A., van Mil A.C., Zock P.L. Adherence to guidelines strongly improves reproducibility of brachial artery flow-mediated dilation. Atherosclerosis. 2016;248:196–202. doi: 10.1016/j.atherosclerosis.2016.03.011. [DOI] [PubMed] [Google Scholar]
- 2.Padilla J., Harris R.A., Fly A.D. The effect of acute exercise on endothelial function following a high-fat meal. Eur. J. Appl. Physiol. 2006;98:256–262. doi: 10.1007/s00421-006-0272-z. [DOI] [PubMed] [Google Scholar]
- 3.Vogel R.A., Corretti M.C., Plotnick G.D. Effect of a single high-fat meal on endothelial function in healthy subjects. Am. J. Cardiol. 1997;79:350–354. doi: 10.1016/s0002-9149(96)00760-6. [DOI] [PubMed] [Google Scholar]
- 4.Ceriello A., Cavarape A., Martinelli L. The post-prandial state in Type 2 diabetes and endothelial dysfunction: effects of insulin aspart. Diabet. Med. 2004;21:171–175. doi: 10.1111/j.1464-5491.2004.01101.x. [DOI] [PubMed] [Google Scholar]
- 5.Kato T., Inoue T., Morooka T. Short-term passive smoking causes endothelial dysfunction via oxidative stress in nonsmokers. Can. J. Physiol. Pharmacol. 2006;84:523–529. doi: 10.1139/y06-030. [DOI] [PubMed] [Google Scholar]
- 6.Karatzi K., Papamichael C., Karatzis E. Acute smoke-induced endothelial dysfunction is more prolonged in smokers than in non-smokers. Int. J. Cardiol. 2007;120:404–406. doi: 10.1016/j.ijcard.2006.07.200. [DOI] [PubMed] [Google Scholar]
- 7.Neunteufl T., Priglinger U., Heher S. Effects of vitamin E on chronic and acute endothelial dysfunction in smokers. J. Am. Coll. Cardiol. 2000;35:277–283. doi: 10.1016/s0735-1097(99)00542-2. [DOI] [PubMed] [Google Scholar]
- 8.Tjonna A.E., Rognmo O., Bye A. Time course of endothelial adaptation after acute and chronic exercise in patients with metabolic syndrome. J. Strength. Cond. Res. 2011;25:2552–2558. doi: 10.1519/JSC.0b013e3181fb4809. [DOI] [PubMed] [Google Scholar]
- 9.Tinken T.M., Thijssen D.H., Hopkins N. Impact of shear rate modulation on vascular function in humans. Hypertension. 2009;54:278–285. doi: 10.1161/HYPERTENSIONAHA.109.134361. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Dawson E.A., Whyte G.P., Black M.A. Changes in vascular and cardiac function after prolonged strenuous exercise in humans. J. Appl. Physiol. 1985;2008(105):1562–1568. doi: 10.1152/japplphysiol.90837.2008. [DOI] [PubMed] [Google Scholar]
- 11.Hijmering M.L., de Lange D.W., Lorsheyd A. Binge drinking causes endothelial dysfunction, which is not prevented by wine polyphenols: a small trial in healthy volunteers. Neth. J. Med. 2007;65:29–35. [PubMed] [Google Scholar]
- 12.Papamichael C.M., Aznaouridis K.A., Karatzis E.N. Effect of coffee on endothelial function in healthy subjects: the role of caffeine. Clin. Sci. 2005;109:55–60. doi: 10.1042/CS20040358. [DOI] [PubMed] [Google Scholar]
- 13.Kay C.D., Hooper L., Kroon P.A. Relative impact of flavonoid composition, dose and structure on vascular function: a systematic review of randomised controlled trials of flavonoid-rich food products. Mol. Nutr. Food Res. 2012;56:1605–1616. doi: 10.1002/mnfr.201200363. [DOI] [PubMed] [Google Scholar]
- 14.Harris R.A., Nishiyama S.K., Wray D.W. The effect of oral antioxidants on brachial artery flow-mediated dilation following 5 and 10 min of ischemia. Eur. J. Appl. Physiol. 2009;107:445–453. doi: 10.1007/s00421-009-1147-x. [DOI] [PubMed] [Google Scholar]
- 15.Richardson R.S., Donato A.J., Uberoi A. Exercise-induced brachial artery vasodilation: role of free radicals. Am. J. Physiol. Heart Circ. Physiol. 2007;292:H1516–H1522. doi: 10.1152/ajpheart.01045.2006. [DOI] [PubMed] [Google Scholar]
- 16.Eskurza I., Monahan K.D., Robinson J.A. Effect of acute and chronic ascorbic acid on flow-mediated dilatation with sedentary and physically active human ageing. J. Physiol. 2004;556:315–324. doi: 10.1113/jphysiol.2003.057042. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Magen E., Viskoper J.R., Mishal J. Effects of low-dose aspirin on blood pressure and endothelial function of treated hypertensive hypercholesterolaemic subjects. J. Hum. Hypertens. 2005;19:667–673. doi: 10.1038/sj.jhh.1001910. [DOI] [PubMed] [Google Scholar]
- 18.Zhang L., Gong D., Li S. Meta-analysis of the effects of statin therapy on endothelial function in patients with diabetes mellitus. Atherosclerosis. 2012;223:78–85. doi: 10.1016/j.atherosclerosis.2012.01.031. [DOI] [PubMed] [Google Scholar]
- 19.Dyson K.S., Shoemaker J.K., Hughson R.L. Effect of acute sympathetic nervous system activation on flow-mediated dilation of brachial artery. Am. J. Physiol. Heart Circ. Physiol. 2006;290:H1446–H1453. doi: 10.1152/ajpheart.00771.2005. [DOI] [PubMed] [Google Scholar]
- 20.Widlansky M.E., Vita J.A., Keyes M.J. Relation of season and temperature to endothelium-dependent flow-mediated vasodilation in subjects without clinical evidence of cardiovascular disease (from the Framingham Heart Study) Am. J. Cardiol. 2007;100:518–523. doi: 10.1016/j.amjcard.2007.03.055. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Ghiadoni L., Donald A.E., Cropley M. Mental stress induces transient endothelial dysfunction in humans. Circulation. 2000;102:2473–2478. doi: 10.1161/01.cir.102.20.2473. [DOI] [PubMed] [Google Scholar]
- 22.Hashimoto M., Akishita M., Eto M. Modulation of endothelium-dependent flow-mediated dilatation of the brachial artery by sex and menstrual cycle. Circulation. 1995;92:3431–3435. doi: 10.1161/01.cir.92.12.3431. [DOI] [PubMed] [Google Scholar]
- 23.Williams M.R., Westerman R.A., Kingwell B.A. Variations in endothelial function and arterial compliance during the menstrual cycle. J. Clin. Endocrinol. Metab. 2001;86:5389–5395. doi: 10.1210/jcem.86.11.8013. [DOI] [PubMed] [Google Scholar]
- 24.Jones H., Green D.J., George K. Intermittent exercise abolishes the diurnal variation in endothelial-dependent flow-mediated dilation in humans. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2010;298:R427–R432. doi: 10.1152/ajpregu.00442.2009. [DOI] [PubMed] [Google Scholar]
- 25.Jarvisalo M.J., Jartti L., Marniemi J. Determinants of short-term variation in arterial flow-mediated dilatation in healthy young men. Clin. Sci. 2006;110:475–482. doi: 10.1042/CS20050333. [DOI] [PubMed] [Google Scholar]
- 26.ter Avest E., Holewijn S., Stalenhoef A.F. Variation in non-invasive measurements of vascular function in healthy volunteers during daytime. Clin. Sci. 2005;108:425–431. doi: 10.1042/CS20040300. [DOI] [PubMed] [Google Scholar]
- 27.Kizhakekuttu T.J., Gutterman D.D., Phillips S.A. Measuring FMD in the brachial artery: how important is QRS gating? J. Appl. Physiol. 1985;2010(109):959–965. doi: 10.1152/japplphysiol.00532.2010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Gemignani V., Bianchini E., Faita F. Ultrasound measurement of the brachial artery flow-mediated dilation without ECG gating. Ultrasound Med. Biol. 2008;34:385–391. doi: 10.1016/j.ultrasmedbio.2007.08.006. [DOI] [PubMed] [Google Scholar]
- 29.Padilla J., Johnson B.D., Newcomer S.C. Normalization of flow-mediated dilation to shear stress area under the curve eliminates the impact of variable hyperemic stimulus. Cardiovasc. Ultrasound. 2008;6:44. doi: 10.1186/1476-7120-6-44. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Padilla J., Johnson B.D., Newcomer S.C. Adjusting flow-mediated dilation for shear stress stimulus allows demonstration of endothelial dysfunction in a population with moderate cardiovascular risk. J. Vasc. Res. 2009;46:592–600. doi: 10.1159/000226227. [DOI] [PubMed] [Google Scholar]
- 31.Pyke K.E., Tschakovsky M.E. Peak vs. total reactive hyperemia: which determines the magnitude of flow-mediated dilation? J. Appl. Physiol. 2007;102:1510–1519. doi: 10.1152/japplphysiol.01024.2006. [DOI] [PubMed] [Google Scholar]
- 32.Sonka M., Liang W., Lauer R.M. Automated analysis of brachial ultrasound image sequences: early detection of cardiovascular disease via surrogates of endothelial function. IEEE Trans. Med. Imaging. 2002;21:1271–1279. doi: 10.1109/TMI.2002.806288. [DOI] [PubMed] [Google Scholar]
- 33.Woodman R.J., Playford D.A., Watts G.F. Improved analysis of brachial artery ultrasound using a novel edge-detection software system. J. Appl. Physiol. 2001;91:929–937. doi: 10.1152/jappl.2001.91.2.929. [DOI] [PubMed] [Google Scholar]
- 34.Gemignani V., Faita F., Ghiadoni L. A system for real-time measurement of the brachial artery diameter in B-mode ultrasound images. IEEE Trans. Med. Imaging. 2007;26:393–404. doi: 10.1109/TMI.2006.891477. [DOI] [PubMed] [Google Scholar]
- 35.Thijssen D.H., Black M.A., Pyke K.E. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am. J Physiol. Heart Circ. Physiol. 2011;300:H2–12. doi: 10.1152/ajpheart.00471.2010. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Supplementary Materials
Supplementary material

