Assessment of flow-mediated dilation in humans: A methodological and physiological guideline

Dick H.J. Thijssen, Mark A. Black, Kyra E. Pyke, Jaume Padilla, Greg Atkinson, Ryan A. Harris, Beth Parker, Michael E. Widlansky, Michael E. Tschakovsky, Daniel J. Green

Research output: Contribution to journalReview article

777 Scopus citations

Abstract

Endothelial dysfunction is now considered an important early event in the development of atherosclerosis, which precedes gross morphological signs and clinical symptoms. The assessment of flow-mediated dilation (FMD) was introduced almost 20 years ago as a noninvasive approach to examine vasodilator function in vivo. FMD is widely believed to reflect endothelium-dependent and largely nitric oxide-mediated arterial function and has been used as a surrogate marker of vascular health. This noninvasive technique has been used to compare groups of subjects and to evaluate the impact of interventions within individuals. Despite its widespread adoption, there is considerable variability between studies with respect to the protocols applied, methods of analysis, and interpretation of results. Moreover, differences in methodological approaches have important impacts on the response magnitude, can result in spurious data interpretation, and limit the comparability of outcomes between studies. This review results from a collegial discussion between physiologists with the purpose of developing considered guidelines. The contributors represent several distinct research groups that have independently worked to advance the evidence base for improvement of the technical approaches to FMD measurement and analysis. The outcome is a series of recommendations on the basis of review and critical appraisal of recent physiological studies, pertaining to the most appropriate methods to assess FMD in humans.

Original languageEnglish (US)
Pages (from-to)H2-H12
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume300
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • Atherosclerosis
  • Cardiovascular risk
  • Endothelial function
  • Methodology
  • Recommendations
  • Shear rate
  • Vascular function

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Thijssen, D. H. J., Black, M. A., Pyke, K. E., Padilla, J., Atkinson, G., Harris, R. A., Parker, B., Widlansky, M. E., Tschakovsky, M. E., & Green, D. J. (2011). Assessment of flow-mediated dilation in humans: A methodological and physiological guideline. American Journal of Physiology - Heart and Circulatory Physiology, 300(1), H2-H12. https://doi.org/10.1152/ajpheart.00471.2010