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Echocardiography. 2014 Feb;31(2):197-202. doi: 10.1111/echo.12307. Epub 2013 Jul 30.

New methodological approach to improve reproducibility of brachial artery flow-mediated dilatation.

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Department of Medical Laboratory Science, Faculty of Health Sciences, Junshin Gakuen University, Fukuoka, Japan.



Measurement of flow-mediated dilation (FMD) is well known as a noninvasive method for an assessment of vascular endothelial function. However, the reproducibility is a major issue of FMD measurement. The purpose of this study is to examine the reproducibility of the new FMD measurement with medial epicondyle method.


First, to evaluate the variability of the brachial artery diameter, 23 volunteers recruited from 32 healthy volunteers were examined for a brachial artery diameter at rest using with FMD equipment. Second, to evaluate the reproducibility of the FMD measurement, all volunteers underwent the FMD measurement, which was repeated at 2-week interval using the traditional method and the medial epicondyle method. The reproducibility in both methods was evaluated by 2 independent observers who measured on the same subject to assess the inter-observer reproducibility, and 1 observer who measured the same subject twice to assess the intra-observer reproducibility regarding the baseline value of arterial diameter and FMD.


The variability of brachial artery diameter was 0.57 ± 0.27 mm in 23 healthy volunteers. In the study of inter- and intra-observer reproducibility, 2 parameters including intra-class correlation coefficient and Pearson's correlation coefficient by medial epicondyle method are superior to those by traditional method.


These results suggest that medial epicondyle methodological approach to measure FMD is superior to traditional method.


flow-mediated dilatation; reproducibility of brachial artery

[Indexed for MEDLINE]

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