Preserved flow-mediated dilation but delayed time-to-peak diameter in individuals with metabolic syndrome
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2014-07-01
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Silva, Bruno M. 
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Introduction: Inconsistent evidences of the metabolic syndrome (MetS) impact on vascular reactivity raise questions on flow-mediated dilation (FMD) discriminatory power for disturbances induced by this clustering of risk factors. Previous reports, however, suggest that covariates such as the follow-up of the artery diameter changes, the arterial size and shear stress affect FMD responses and consequently its discriminatory power for distinctive clinical profiles.Objective: To determine the impact of MetS on traditional, arterial size-and shear-rate-adjusted FMD, the follow-up-derived time-to-peak diameter (TP), as well as their power for discriminating subjects with this clustering of risk factors from a sample of healthy individuals.Methods: Twenty-one MetS and ten healthy subjects underwent an assessment of endothelial function via FMD.Results: Traditional and allometrically scaled FMD did not differ between groups (P>0.05) as well as the approach in which the covariate was the peak diameter shear rate. in the existence of MetS, TP was longer (67.7 +/- 16.4 s versus healthy 42.1 +/- 16.3 s, P = 0.001). ROC curve analysis indicated that TP (AUC = 0.871 [95% CI, 0.718-1.000]) had greater power of discrimination for MetS than FMD approaches. in addition, TP presented a moderate and significant association with sE-selectin (r = 0.458, P = 0.048).Conclusion: Time-to-peak diameter (TP) rather than FMD distinguished MetS from a healthy profile. Therefore, at least in subjects with MetS, TP may provide insights into the impact of this clustering of risk factors on the vascular phenotype.
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Clinical Physiology and Functional Imaging. Hoboken: Wiley-Blackwell, v. 34, n. 4, p. 270-276, 2014.