Brachial artery low-flow-mediated constriction is increased early after coronary intervention and reduces during recovery after acute coronary syndrome: characterization of a recently described index of vascular function.

Spiro, JR; Digby, J; Ghimire, G; Mason, M; Mitchell, A; Ilsley, C; Donald, A; Dalby, M; Kharbanda, R

Journal article

Brachial artery low-flow-mediated constriction is increased early after coronary intervention and reduces during recovery after acute coronary syndrome: characterization of a recently described index of vascular function.

Abstract:: AIMS: The endothelium plays a role in regulating vascular tone. Acute and dynamic changes in low-flow-mediated constriction (L-FMC) and how it changes with regard to traditional flow-mediated dilatation (FMD) have not been described. We aimed to investigate the changes in brachial artery L-FMC following percutaneous coronary intervention (PCI) and during recovery from non-ST-segment elevation myocardial infarction (NSTEMI). METHODS AND RESULTS: FMD was performed in accordance with a previously described technique in patients before and after PCI and in the recovery phase of NSTEMI, but in addition, L-FMC data were acquired from the last 30 s of cuff inflation. About 135 scans were performed in 96 participants (10 healthy volunteers and 86 patients). Measurement of brachial L-FMC was reproducible over hours. L-FMC was greater among patients with unstable vs. stable coronary atherosclerosis (-1.33 ±1.09% vs. -0.03 ± 1.26%, P < 0.01). Following PCI, FMD reduced (4.43 ± 2.93% vs. 1.66 ± 2.16%, P < 0.01) and L-FMC increased (-0.33 ± 0.76% vs. -1.63 ± 1.15%, P = 0.02). Furthermore, during convalescence from NSTEMI, L-FMC reduced (-1.37 ± 1.19% vs. 0.01 ± 0.82%, P = 0.02) in parallel with improvements in FMD (2.54 ± 2.19% vs. 5.15 ± 3.07%, P < 0.01). CONCLUSION: Brachial L-FMC can be measured reliably. Differences were observed between patients with stable and unstable coronary disease. L-FMC was acutely increased following PCI associated with reduced FMD and, in the recovery from NSTEMI, L-FMC reduced associated with increased FMD. These novel findings characterize acute and subacute variations in brachial L-FMC. The pathophysiological and clinical implications of these observations require further study.

Publication status:: Published

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APA Style

Spiro, J. R., Digby, J., Ghimire, G., Mason, M., Mitchell, A., Ilsley, C., Donald, A., Dalby, M., & Kharbanda, R. (2011). Brachial artery low-flow-mediated constriction is increased early after coronary intervention and reduces during recovery after acute coronary syndrome: characterization of a recently described index of vascular function. European Heart Journal, 32(7), 856–866.

MLA Style

Spiro, J. R., et al. “Brachial Artery Low-Flow-Mediated Constriction Is Increased Early after Coronary Intervention and Reduces during Recovery after Acute Coronary Syndrome: Characterization of a Recently Described Index of Vascular Function.” European Heart Journal, vol. 32, no. 7, 2011, pp. 856–66.

Chicago Style

Spiro, JR, J Digby, G Ghimire, M Mason, A Mitchell, C Ilsley, A Donald, M Dalby, and R Kharbanda. 2011. “Brachial Artery Low-Flow-Mediated Constriction Is Increased Early after Coronary Intervention and Reduces during Recovery after Acute Coronary Syndrome: Characterization of a Recently Described Index of Vascular Function.” European Heart Journal 32 (7): 856–66.
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