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词条 Flow-mediated dilation
释义

  1. Clinical significance

  2. Effects of exercise

  3. See also

  4. References

Flow-mediated dilation (FMD) refers to dilation (widening) of an artery when blood flow increases in that artery.[1] The primary cause of FMD is release of nitric oxide by endothelial cells.[1]

To determine FMD, brachial artery dilation following a transient period of forearm ischemia is measured using ultrasound.[2] Because the value of FMD can be compromised when improperly applied, attempts have been made to standardize the methodology for measuring FMD.[4]

Clinical significance

FMD is a noninvasive measure of blood vessel health (endothelial dysfunction[3]) which is at least as predictive of cardiovascular disease as traditional risk factors.[4] FMD is a sensitive marker for the amount of blood vessel damage caused by cigarette smoke.[5] So-called light cigarettes (having reduced tar and nicotine) were shown to impair FMD as much as regular cigarettes.[5]

Improved FMD results in greater perfusion and oxygen supply to peripheral tissue.[6]

An Israeli study of 618 healthy subjects found FMD to be an excellent predictor of long-term adverse cardiovascular events. Participants with below-mean FMD were 278% more likely to experience cardiovascular events during the 4.6 year average follow-up period than participant with above-mean FMD (95% Confidence Interval: 135-571%, p-value<0.001).[7]

Effects of exercise

A study of healthy young men who normally take over 10,000 steps per day, but were restricted to less than 5,000 steps per day for five days showed impaired FMD in the popliteal (leg) artery, but not the brachial (arm) artery.[8] The reduction of leg FMD caused by prolonged sitting can be reduced by fidgeting (periodic leg movement).[9]

An eight-week program of brisk walking resulted in a 50% increase in brachial artery FMD in middle-aged and older men, but failed to produce this benefit in estrogen-deficient post-menopausal women.[10]

Forty-five minutes of cycling exercise before sitting has been shown to eliminate the impaired leg FMD due to three hours of sitting.[11] Athletes over age 40 show greater FMD than their age-matched peers.[2]

A meta-analysis of 182 subjects showed twice the improvement in FMD resulting from high-intensity interval training compared to endurance training.[6]

See also

  • Atherosclerosis
  • Hypercholesterolemia

References

1. ^1 {{cite journal | author=Kelm M | title=Flow-mediated dilatation in human circulation: diagnostic and therapeutic aspects | journal= American Journal of Physiology | volume=282 | issue=1 | pages=H1-H5 | year=2002 | url = http://www.physiology.org/doi/full/10.1152/ajpheart.2002.282.1.H1 | PMID = 11748041 }}
2. ^1 {{cite journal | vauthors=Montero D, Padilla J, Diaz-Cañestro C, Muris DM, Pyke KE, Obert P, Walther | title=Flow-mediated dilation in athletes: influence of aging | journal= Medicine & Science in Sports & Exercise | volume=46 | issue=11 | pages=2148–2158 | year=2014 | doi= 10.1249/MSS.0000000000000341 | PMID = 24963792 }}
3. ^{{cite journal | vauthors=Calderón-Gerstein WS, López-Peña A, Macha-Ramírez R, Bruno-Huamán A, Espejo-Ramos R, Vílchez-Bravo S, Ramírez-Breña M, Damián-Mucha M, Matos-Mucha A | title=Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population | journal= Vascular Health and Risk Management | volume=13 | pages=421-426 | year=2017 | doi= 10.2147/VHRM.S151886 | PMC=5701560 | PMID = 29200863 }}
4. ^1 {{cite journal | vauthors=Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, Parker B, Widlansky ME, Tschakovsky ME, Green DJ | title=Assessment of flow-mediated dilation in humans: a methodological and physiological guideline | journal= American Journal of Physiology | volume=300 | issue=1 | pages=H2-H12 | year=2011 | doi= 10.1152/ajpheart.00471.2010 | url = http://www.physiology.org/doi/full/10.1152/ajpheart.00471.2010| PMID = 20952670 | pmc=3023245 }}
5. ^1 {{cite journal | vauthors=Messner B, Bernhard D | title=Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis | journal= Arteriosclerosis, Thrombosis, and Vascular Biology | volume=34 |issue=3 | pages=509-515| year=2014 | url=https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.113.300156 | doi=10.1161/ATVBAHA.113.300156 | pmid = 24554606 }}
6. ^1 {{cite journal | vauthors=Cassidy S, Thoma C, Houghton D, Trenell MI | title=High-intensity interval training: a review of its impact on glucose control and cardiometabolic health | journal= Diabetologia | volume=60 | issue=1 | pages=7-23 | year=2017 | doi= 10.1007/s00125-016-4106-1 | PMID = 27681241 }}
7. ^{{cite journal|last1=Shechter|first1=Michael|title=Usefulness of Brachial Artery Flow-Mediated Dilation to Predict Long-Term Cardiovascular Events in Subjects Without Heart Disease|journal=The American Journal of Cardiology|date=January 1, 2014|volume=113|issue=1|pages=162–167|url=http://www.ajconline.org/article/S0002-9149(13)01964-4/fulltext|accessdate=15 December 2017}}
8. ^{{cite journal | vauthors=Boyle LJ, Credeur DP, Jenkins NT, Padilla J, Leidy HJ, Thyfault JP, Fadel PJ | title=Impact of reduced daily physical activity on conduit artery flow-mediated dilation and circulating endothelial microparticles | journal= Journal of Applied Physiology | volume=115 | issue=10 | pages=1519–1525| year=2013| url = http://www.physiology.org/doi/abs/10.1152/japplphysiol.00837.2013 | doi=10.1152/japplphysiol.00837.2013| PMID = 24072406 | pmc=3841822 }}
9. ^{{cite journal | vauthors=Morishima T, Restaino RM, Walsh LK, Kanaley JA, Fadel PJ, Padilla J | title=Prolonged sitting-induced leg endothelial dysfunction is prevented by fidgeting | journal= American Journal of Physiology | volume=311 | issue=1 | pages=H177-H182 | year=2016 | url = http://www.physiology.org/doi/abs/10.1152/ajpheart.00297.2016 | doi= 10.1152/ajpheart.00297.2016 | PMC=4967200 | PMID = 27233765 }}
10. ^{{cite journal | author=Seals DR | title=Edward F. Adolph Distinguished Lecture: The remarkable anti-aging effects of aerobic exercise on systemic arteries | journal= Journal of Applied Physiology | volume=117 | issue=5 | pages=425-239 | year=2014 | doi= 10.1152/japplphysiol.00362.2014 | PMC=4157159 | PMID = 24855137 }}
11. ^{{cite journal | vauthors=Morishima T, Restaino RM, Walsh LK, Kanaley JA, Padilla J | title=Prior exercise and standing as strategies to circumvent sitting-induced leg endothelial dysfunction | journal= Clinical Science | volume=131 | issue=11 | pages=1045–1053 | year=2017 | url = http://www.clinsci.org/content/131/11/1045.long | doi= 10.1042/CS20170031 | PMC=5516793 | PMID = 28385735 }}

2 : Medical diagnosis|Cardiovascular diseases
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