Ultrasound assessment of endothelial function: A technical guideline of the flow-mediated dilation test

Paula Rodriguez-Miguelez, Nichole Seigler, Ryan A. Harris

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Cardiovascular disease is the primary cause of mortality and a major cause of disability worldwide. The dysfunction of the vascular endothelium is a pathological condition characterized mainly by a disruption in the balance between vasodilator and vasoconstrictor substances and is proposed to play an important role in the development of atherosclerotic cardiovascular disease. Therefore, a precise evaluation of endothelial function in humans represents an important tool that could help better understand the etiology of multiple cardio-centric pathologies. Over the past twenty-five years, many methodological approaches have been developed to provide an assessment of endothelial function in humans. Introduced in 1989, the FMD test incorporates a forearm occlusion and subsequent reactive hyperemia that promotes nitric oxide production and vasodilation of the brachial artery. The FMD test is now the most widely utilized, non-invasive, ultrasonic assessment of endothelial function in humans and has been associated with future cardiovascular events. Although the FMD test could have clinical utility, it is a physiological assessment that has inherited several confounding factors that need to be considered. This article describes a standardized protocol for determining FMD including the recommended methodology to help minimize the physiological and technical issues and improve the precision and reproducibility of the assessment.

Original languageEnglish (US)
Article numbere54011
JournalJournal of Visualized Experiments
Issue number110
StatePublished - Apr 2016


  • Brachial artery
  • Cardiovascular disease
  • Endothelial function
  • Endothelium
  • Flow-mediated dilation
  • Issue 110
  • Medicine
  • Ultrasound

ASJC Scopus subject areas

  • Neuroscience(all)
  • Chemical Engineering(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

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