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Presence of a high‐flow‐mediated constriction phenomenon prior to flow‐mediated dilation in normal weight, overweight, and obese children and adolescents
Author(s) -
Ostrem Joseph D.,
Evanoff Nicholas,
Kelly Aaron S.,
Dengel Donald R.
Publication year - 2015
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22267
Subject(s) - medicine , brachial artery , reactive hyperemia , percentile , constriction , cuff , overweight , cardiology , anthropometry , body mass index , surgery , blood flow , blood pressure , statistics , mathematics
Purpose When assessing vasomotor endothelial function by reactive hyperemia, the brachial artery, in some individuals, constricts immediately before beginning to dilate following cuff release. We call this response high‐flow‐mediated constriction (H‐FMC). The aim of this study was to describe the rate of the H‐FMC during reactive hyperemia in children and adolescents throughout a range of body mass index (BMI) values, and to investigate differences in flow‐mediated dilation (FMD), cardiovascular, and anthropometric measures between subjects with and without H‐FMC. Methods FMD was assessed in 136 children and adolescents (61 male, 75 female; 13 ± 3 years) by sonographic imaging of the brachial artery. H‐FMC was characterized as the lowest point from the baseline brachial artery diameter immediately following reactive cuff release. Independent t tests were used to compare subjects with and without H‐FMC. Results H‐FMC was observed in 91 of the 136 participants (66.9%). No significant difference was found between H‐FMC and non‐H‐FMC subjects for age ( p = 0.602), gender ( p = 0.767), height ( p = 0.227), or weight ( p = 0.171). BMI percentile was nonsignificantly higher (91.8 ± 14.9th versus 84.6 ± 22.8th percentile, p = 0.057) and FMD was significantly lower (5.43 ± 3.41% versus 8.05 ± 3.97%, p < 0.001) in H‐FMC than in non‐H‐FMC subjects. Adding H‐FMC to FMD produced no significant difference between H‐FMC and non‐H‐FMC individuals (8.03 ± 3.27% versus 8.05 ± 3.97%, p = 0.977). Conclusions Approximately 67% of participants demonstrated an H‐FMC during reactive hyperemia. BMI percentile was nonsignificantly higher and FMD was significantly lower in children and adolescents who displayed this phenomenon. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 43:495–501 2015