Comparison of peripheral arterial tonometry and flow-mediated vasodilation for assessment of the severity and complexity of coronary artery disease.

Abstract:

OBJECTIVE:Noninvasive flow-mediated vasodilation (FMD) is a widely used method to assess endothelial function, but its technical difficulty and problems remain obstacles for use in clinical practice. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) was developed as a simpler and more reproducible method. We compared FMD and RH-PAT in patients with stable angina. Furthermore, the differences in these two techniques according to coronary artery disease (CAD) severity and complexity were also assessed. MATERIALS AND METHODS:We consecutively enrolled 80 patients who underwent elective coronary angiography. Endothelial function was assessed before angiography using brachial artery FMD and RH-PAT. The complexity and extent of the coronary lesions were assessed angiographically. The extent of CAD was defined as the number of diseased coronary arteries (>70%) and complexity of CAD was assessed by the SYNTAX score algorithm. RESULTS:In the overall study group (61±9 years, 57% men), the mean FMD was 8.5±5.1% and the mean reactive hyperemia index (RHI) measured by RH-PAT was 1.7±0.4. A significant correlation was observed between FMD and RHI irrespective of sex, diabetes, or presence of CAD. FMD and RHI were significantly lower in patients with multivessel and complex CAD. A receiver-operating characteristic curve analysis showed that both techniques were comparable in terms of predicting the presence of CAD and complexity. CONCLUSION:Assessment of RH-PAT could be a less operator-dependent and noninvasive method of evaluating vascular endothelial function in patients with stable angina.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Woo JS,Jang WS,Kim HS,Lee JH,Choi EY,Kim JB,Kim WS,Kim KS,Kim W

doi

10.1097/MCA.0000000000000094

subject

Has Abstract

pub_date

2014-08-01 00:00:00

pages

421-6

issue

5

eissn

0954-6928

issn

1473-5830

journal_volume

25

pub_type

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