„One-Stop-Shop“ ultrasound diagnosis of functional, structural and physicomechanical properties of the brachial artery

Aim: To develop and validate a single non-invasive examination of the brachial artery for simultaneous and highly accurate measurement of endothelial function, intima-media-thickness, and compliance using high resolution ultrasound.

Aims: The pathogenesis of atherosclerosis comprises endothelial dysfunction, thickening as well as impaired compliance of the arterial vessel wall. Early assessment of these functional, structural and physicomechanical alterations of the vessel wall at the same site of the vascular tree has yet been hampered by the lack of highly sensitive diagnostic approaches suitable for clinical routine.

Methods: 20 healthy individuals were investigated using high resolution ultrasound. Flow-mediated dilation (FMD), intima-media-thickness (IMT) and fractional diameter changes(FDC) were measured in the same segment of the brachial artery using standard techniques. Additionally, coefficients of variation, day-to-day-variability, between- and within-observer-variability were investigated in 5 individuals. All measurements were performed manually and by an automated PC-based analyzing system.

Results: Mean values for all measured parameters were 7.65±0.8% (FMD), 0.351±0.007mm (IMT), 0.02±0.002 (FDC) and followed an even distribution throughout the study population. Automated analysis of coefficient of variation, day-to-day-, between- and within-observer variabilities were:0.78,1.3,0.8,0.8 (FMD);1.8,1.1,1.9,1.1 (IMT);4.7,2.8, 4.2,2.7 (FDC) [data are given in%]. Coefficient of variation, day-to-day-,between- and within-observer variabilities for the manual readings were significantly higher.

Conclusions: Functional, structural and physicomechanical parameters of the brachial artery can be quantified simultaneously, time-saving and highly reproducibly as a “one-stop-shop“ in a single session using high resolution ultrasoung with digitized post-processing. This highlights the future possibility of early, sensitive and non-invasive diagnostic testing of vascular function in patients prone to vascular disease