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Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia.

Abstract：

OBJECTIVES:We investigated the value of reactive hyperemia peripheral arterial tonometry (RH-PAT) as a noninvasive tool to identify individuals with coronary microvascular endothelial dysfunction. BACKGROUND:Coronary endothelial dysfunction, a systemic disorder, represents an early stage of atherosclerosis; RH-PAT is a technique to assess peripheral microvascular endothelial function. METHODS:Using RH-PAT, digital pulse volume changes during reactive hyperemia were assessed in 94 patients without obstructive coronary artery disease and either normal (n = 39) or abnormal (n = 55) coronary microvascular endothelial function; RH-PAT index, a measure of reactive hyperemia, was calculated as the ratio of the digital pulse volume during reactive hyperemia divided by that at baseline. RESULTS:Average RH-PAT index was lower in patients with coronary endothelial dysfunction compared with those with normal coronary endothelial function (1.27 +/- 0.05 vs. 1.78 +/- 0.08: p < 0.001). An RH-PAT index <1.35 was found to have a sensitivity of 80% and a specificity of 85% to identify patients with coronary endothelial dysfunction. CONCLUSIONS:Digital hyperemic response, as measured by RH-PAT, is attenuated in patients with coronary microvascular endothelial dysfunction, suggesting a role for RH-PAT as a noninvasive test to identify patients with this disorder.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Bonetti PO,Pumper GM,Higano ST,Holmes DR Jr,Kuvin JT,Lerman A

doi

10.1016/j.jacc.2004.08.062

subject

Has Abstract

pub_date

2004-12-07 00:00:00

pages

2137-41

issue

11

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(04)01754-1

journal_volume

44

pub_type

杂志文章

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