Abstract
Abstract
Background
Femoral artery (FA) endothelial function is a promising biomarker for peripheral artery disease (PAD) prevention. We assessed FA flow-mediated dilation (FMD) in healthy adults of various ages.
Material and methods
Repeated common FA and brachial artery (BA) FMD measurements were performed with ultrasound induced by5 minutes distal cuff occlusion (thigh, calf, forearm) to assess intra- and interindividual variability and acceptability (n = 10). We then performeda cross-sectional study with FA- and BA-FMD measurements in healthy participants aged 18–80 (n = 53).
Results and conclusions
All FMD protocols had good reproducibility with average deviation of −0.1% (SD 0.6%, 0.9%, 0.6%) but thigh occlusion was less well tolerated. BA- and FA-FMD with thigh occlusion did not significantly differ while FA-FMD with calf occlusion was significantly lower (−1.0 ± 0.9%).
Both FA-FMD and BA-FMD inversely correlated with age and baseline diameter and positively with wall shear stress (WSS). FA-FMD and BA-FMD correlated significantly (r = 0.57, P < 0.001). The baseline diameter was significantly greater in the FA as compared to the BA while the WSS was significantly lower. At the onset of reactive hyperaemia, the mean flow velocity, WSS and flow reserve were lower in the FA as compared to the BA. A large proportion of FA WSS values in older participants were below 5 dyne/ cm2 which is regarded as pro-atherogenic.
FA endothelial function declines with age in parallel with the BA. FAs exhibits stronger age-dependent enlargement as compared to the BA leading to a critical decrease in WSS that may explain part of the age-dependent predisposition for PAD.