caa a22 4500 606221433 CHVBK 20210128101129.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00380-014-0475-x doi (NATIONALLICENCE)springer-10.1007/s00380-014-0475-x Brachial artery diameter has a predictive value in the improvement of flow-mediated dilation after aortic valve replacement for aortic stenosis [Elektronische Daten] [Munenori Takata, Eisuke Amiya, Masafumi Watanabe, Atsuko Ozeki, Aya Watanabe, Shuichi Kawarasaki, Tomoko Nakao, Yumiko Hosoya, Kansei Uno, Aya Saito, Takahide Murasawa, Minoru Ono, Ryozo Nagai, Issei Komuro] Aortic stenosis (AS) is the most common valvular disease and aortic valve replacement (AVR) is one of its most effective interventions. AS affects not only the left ventricle, but also vascular function beyond the stenotic valve, which can lead to various types of vascular dysfunction. However, research evaluating the effect of AS on aortic vascular function is limited. In this study, we investigated clinical meaning to evaluate endothelial function in subjects with AS. From April 2011 to April 2012, 20 consecutive adult patients with degenerative AS (mean age, 74.7±7.4years; range 50-83years) who underwent AVR at our institution were included in the study. We measured flow-mediated dilation (FMD) to evaluate the effect of AS on endothelial function. The difference between brachial artery diameter (BAD) before (4.0±0.7mm) and after AVR (3.9±0.6mm) was not significant (p=0.043), but FMD significantly improved after AVR (from 3.1±1.8 to 6.0±2.7%, p<0.0001). We also analyzed FMD×BAD index, endogenous vasodilatory capability independent of BAD, resulting that it also significantly increased after AVR (12.3±7.0-22.5±9.3, p<0.0001). We divided patients into two groups by pre- to post-AVR change in FMD (ΔFMD); large-ΔFMD group [ΔFMD >3.0% (median value)] and small-ΔFMD group (ΔFMD <3.0%). There were no significant changes in age, blood pressure, heart rate, B-type natriuretic peptide, or echocardiographic parameters in either group. In contrast, BAD was significantly larger in the small ΔFMD group (4.3±0.7mm) than in the large ΔFMD group (3.7±0.7mm) (p=0.030). In addition, cardio-thoracic ratio was significantly greater in the small ΔFMD group (58.4±7.1%) than in the large ΔFMD group (53.7±4.6%) (p=0.048). Receiver operating characteristic curve analysis of BAD to differentiate large and small ΔFMD demonstrated an area under the curve of 0.750 (p=0.059) and that optimal cutoff for BAD was 4.28mm (70% sensitivity, 80% specificity). AVR in subjects with AS is associated with a significant improvement in FMD in the brachial artery. Measurement of the BAD may be helpful in distinguishing whether the impairment of FMD in AS derives from a stenotic valve or vascular remodeling. Springer Japan, 2014 Aortic stenosis nationallicence Flow-mediated dilation nationallicence Brachial artery diameter nationallicence Aortic valve replacement nationallicence Takata Munenori Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Amiya Eisuke Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Watanabe Masafumi Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Ozeki Atsuko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Watanabe Aya Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Kawarasaki Shuichi Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Nakao Tomoko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Hosoya Yumiko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Uno Kansei Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo, Tokyo, Japan aut Saito Aya Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan aut Murasawa Takahide Department of Medical Engineering, The University of Tokyo, Tokyo, Japan aut Ono Minoru Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan aut Nagai Ryozo Jichi Medical School, Shimotsuke, Japan aut Komuro Issei Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut Heart and Vessels Springer Japan 30/2(2015-03-01), 218-226 0910-8327 30:2<218 2015 30 380 https://doi.org/10.1007/s00380-014-0475-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0475-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Takata Munenori Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Amiya Eisuke Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Watanabe Masafumi Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Ozeki Atsuko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Watanabe Aya Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Kawarasaki Shuichi Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Nakao Tomoko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Hosoya Yumiko Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 700 1- Uno Kansei Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo, Tokyo, Japan aut NATIONALLICENCE 700 1- Saito Aya Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan aut NATIONALLICENCE 700 1- Murasawa Takahide Department of Medical Engineering, The University of Tokyo, Tokyo, Japan aut NATIONALLICENCE 700 1- Ono Minoru Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan aut NATIONALLICENCE 700 1- Nagai Ryozo Jichi Medical School, Shimotsuke, Japan aut NATIONALLICENCE 700 1- Komuro Issei Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo Bunkyo-ku Tokyo, 113-8655, Tokyo, Japan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/2(2015-03-01), 218-226 0910-8327 30:2<218 2015 30 380