NONINVESIVE ASSESSMENT OF VASCULAR ENDOTHELIAL. FUNCTION BY MEANS OF THE CHANGE IN PULSE CONDUCTION VEROCITY WITH FLOW MEDIATED DILATION

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We developed a novel method for noninvasive assessment of vascular endothelial function by means of the changes in pulse wave conduction velocity with flow mediated dilation (FMD). Although FMD is gathering attention as a noninvasive index of vascular endothelial function, conventional assessment using vascular ultrasound imaging has serious limitations, such as artifact accompanying the ultrasound measurement of vascular diameter and physiological spontaneous fluctuations in vascular diameter, which preclude the distribution of FMD in general clinical practice. FMD is accompanied by reduction in pulse wave conduction velocity through an increase in vascular diameter and a decrease in the thickness and elasticity of the vascular wall We therefore tried to detect the changes in pulse wave conduction velocity with FMD induced by reactive hyperemia caused by 5-min ischemia with an arm-cuff on an arm. Small changes in pulse wave conduction velocity were detected with contrasting to the pul … More se wave conduction velocity in the lateral arm. The influences of the changes in systemic blood pressure, heart rate and autonomic neural activity on pulse wave conduction velocity could be also excluded by this method. We made a prototype of the instrument and measured the FMD-related changes in pulse wave conduction velocity in 120 subjects including healthy people and patients with hypertension and coronary artery diseases. The pulse wave conduction velocity showed a transient decrease after release of the arm cuff with the peak response occurring about 1 min after the release. The response resembled to those known as FMD. The magnitude of the response was decreasing with age and reduced in patients with hypertension and those with coronary artery disease. Furthermore, the response disappeared after sublingual nitroglycerin. These observations indicate that our method is potentially useful assessment of vascular endothelial function. The clinical application of our method, however, requires refinement of the pulse wave sensor and software for measurement of pulse wave conduction time. Less