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Heart. Oct 1998; 80(4): 349–354.
PMCID: PMC1728800

Comparison of peripheral endothelial dysfunction and intimal media thickness in patients with suspected coronary artery disease


Objective—Flow associated dilatation (FAD%) and intimal media thickness are established markers of early atherosclerosis. This study aimed to compare the ability of the non-invasive measurements FAD% and intimal media thickness to predict coronary artery disease.
Methods—FAD% and intimal media thickness were determined using high resolution ultrasound in 122 patients with clinically suspected coronary artery disease before coronary angiography. Results are given as mean (SD).
Results—Patients with coronary artery disease had reduced FAD% compared with those with angiographically normal coronary vessels (3.7 (4.1) v 7.0 (3.5)%, p < 0.001), whereas intimal media thickness tended to be increased in patients with coronary artery disease (0.58 (0.35) v 0.47 (0.11)mm, p = 0.054). There was a negative correlation between FAD% and intimal media thickness (R = −0.317, p = 0.0004). Receiver operating characteristic analysis showed that FAD% [less-than-or-eq, slant] 4.5% predicted coronary artery disease with a sensitivity of 0.71 (95% confidence interval 0.61 to 0.80) and a specificity of 0.81 (0.58 to 0.95). In contrast, intimal media thickness showed a positive correlation with the extent of coronary artery disease (number of vessels with a lesion [gt-or-equal, slanted] 50%) (R = 0.324, p = 0.0003), without a clear cut off point.
Conclusions—In patients with clinically suspected coronary artery disease, FAD% discriminates between the presence or absence of coronary artery disease, whereas intimal media thickness is associated more with the extent of coronary artery disease.

Keywords: coronary artery disease;  endothelial dysfunction;  intimal media thickness;  flow associated dilatation

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Selected References

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Figures and Tables

Figure 1
Flow associated vasodilatation (FAD%) related to the extent of coronary artery disease (CAD). NCAD, no vessel alterations; CAD-0, vessel alterations but lesion < 50%; CAD-1, lesion > 50% in one vessel; CAD-2, lesion > 50% ...
Figure 2
Intimal media thickness related to the extent of coronary artery disease (CAD). NCAD, no vessel alterations; CAD-0, vessel alterations, but lesion < 50%; CAD-1, lesion > 50% in one vessel; CAD-2, lesion > 50% ...
Figure 3
Inverse relation of flow associated vasodilatation (FAD%) and intimal media thickness (R = − 0.317, p = 0.0004, FAD% log transformed). FAD% derived as percentage change during reactive hyperaemia relative ...
Figure 4
Receiver operator characteristic (ROC) analysis of flow associated vasodilatation (FAD%). Determination of a cut off point of FAD% [less-than-or-eq, slant] 4.5% as a predictor for coronary artery disease, showing a positive linear relation between intimal media ...

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