Sustained Shear Stress Reveals Agreement between Flow-Mediated Dilation and Flow-Mediated Slowing

Stoner, Lee, Mcdonnell, Barry, Fryer, Simon M ORCID: https://orcid.org/0000-0003-0376-0104, Griffiths, Thomas, Griffiths, Thomas D., Faulkner, James, Williams, Abbie, Pugh, Christopher J., Zieff, Gabriel, Chauntry, Aiden J., Paterson, Craig and Stone, Keeron (2026) Sustained Shear Stress Reveals Agreement between Flow-Mediated Dilation and Flow-Mediated Slowing. Pulse, 14 (1). pp. 158-168. doi:10.1159/pls/aeoag002

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Abstract

Introduction: Flow-mediated slowing (FMS), the decrease in pulse wave velocity (PWV) in response to elevated shear stress, is a simpler, operator-independent alternative to assessing arterial diameter (DIA) increase via flow-mediated dilation (FMD). Traditional flow-mediated assessment uses reactive hyperemia, yet sustained shear (ss) stress is a more ubiquitous in vivo physiological occurrence. This study aimed to determine the agreement between sustained-shear FMD (ssFMD) and sustained-shear FMS (ssFMS) in response to a sustained shear stress stimulus designed to enhance endothelial function. Methods: In 19 participants (12 male, 28 ± 8 years), brachial artery DIA and brachial-radial PWV were measured in experimental and control arms. Following baseline, sustained stepwise increases in shear rate were induced using upper-limb heating (10 min) at 47.5°c and 52.5°c, and handgrip exercise (4 min) at 0.33 Hz and 0.67 Hz in the experimental arm. The agreement was tested by modeling the overall association using a linear mixed-effects model. Results: The sustained shear protocol elicited a large increase in mean shear rate in the experimental arm (Δ 299 1/s, p < 0.001). This resulted in a significant time × condition interaction in the experimental arm, with a moderate increase in DIA (Δ 0.04 cm, ∼13%; p < 0.001) and a moderate decrease in PWV (Δ −1.7 m/s, ∼20%; p < 0.001). There was a significant within-person inverse association between ssFMD and ssFMS (β = −0.200, p < 0.001) in the experimental arm. Conclusion: ssFMS demonstrates a response consistent with ssFMD following a sustained shear stress protocol. Findings support ssFMS as a viable tool for assessing acute improvements in endothelial function.

Item Type:	Article
Article Type:	Article
Uncontrolled Keywords:	Endothelial function; Flow-mediated dilation; Flow-mediated slowing; Arterial stiffness; Pulse wave velocity; Shear stress
Subjects:	Q Science > QP Physiology
Divisions:	Schools and Research Institutes > School of Education, Health and Sciences
Depositing User:	Charlotte Crutchlow
Date Deposited:	03 Nov 2026 14:07
Last Modified:	03 Nov 2026 15:15
URI:	https://eprints.glos.ac.uk/id/eprint/16621

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