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Original Research |

Brachial Artery Diameter and the Right VentricleBrachial Artery and the Right Ventricle: The Multi-Ethnic Study of Atherosclerosis-Right Ventricle Study

Christopher T. Dibble, MD, MSCE; Daichi Shimbo, MD; R. Graham Barr, MD, DrPH; Emilia Bagiella, PhD; Harjit Chahal, MD, MPH; Corey E. Ventetuolo, MD; David M. Herrington, MD; Joao A. C. Lima, MD; David A. Bluemke, MD; Steven M. Kawut, MD, FCCP
Author and Funding Information

From the Department of Medicine (Drs Dibble and Kawut), the Center for Clinical Epidemiology and Biostatistics (Drs Dibble and Kawut), and the Penn Cardiovascular Institute (Dr Kawut), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; the Department of Medicine (Drs Shimbo and Barr), College of Physicians and Surgeons, the Department of Epidemiology (Dr Barr), and the Department of Biostatistics (Dr Bagiella), Mailman School of Public Health, Columbia University, New York, NY; the Department of Medicine (Drs Chahal and Lima), Johns Hopkins School of Medicine, Baltimore, MD; Radiology and Imaging Sciences (Dr Bluemke), National Institutes of Health/Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD; the Department of Medicine (Dr Ventetuolo), Alpert Medical School of Brown University, Providence, RI; and the Department of Medicine (Dr Herrington), Wake Forest University Health Sciences, Winston-Salem, NC.

Correspondence to: Steven M. Kawut, MD, FCCP, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Room 718, Philadelphia, PA 19104; e-mail: kawut@upenn.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.

Funding/Support: This work was supported by the National Institutes of Health [Grants and Contracts HL086719, HL103844, HL077612, N01-HC95159 through HC95165, and HL007891]. This research was also supported (in part) by the Intramural Research Program of the National Institutes of Health (National Institute of Biomedical Imaging and Bioengineering).


Chest. 2012;142(6):1399-1405. doi:10.1378/chest.12-0028
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Background:  Endothelial dysfunction is associated with left ventricular morphology and long-term cardiovascular outcomes. The purpose of this study was to assess the relationship between both baseline brachial artery diameter and peripheral endothelial function (assessed by brachial artery ultrasonography) and right ventricular (RV) mass, RV end-diastolic volume (RVEDV), and RV ejection fraction (RVEF).

Methods:  The Multi-Ethnic Study of Atherosclerosis (MESA) performed cardiac MRI and brachial artery ultrasonography on participants without clinical cardiovascular disease. Baseline brachial artery diameter and flow-mediated dilation were assessed.

Results:  The mean age was 60.9 years, and 49.4% of subjects were men (n = 2,425). In adjusted models, larger brachial artery diameter was strongly associated with greater RV mass (β = 0.55 g, P < .001), larger RVEDV (β = 3.99 mL, P < .001), and decreased RVEF (β = −0.46%, P = .03). These relationships persisted after further adjustment for the respective left ventricular parameters. Flow-mediated dilation was not associated with RV mass or RVEF and was only weakly associated with RVEDV.

Conclusions:  Brachial artery diameter is associated with greater RV mass and RVEDV, as well as lower RVEF. Changes in the systemic arterial circulation may have pathophysiologic links to pulmonary vascular dysfunction or abnormalities in RV perfusion.

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