Cutaneous microvascular reactivity and aortic elasticity in coronary artery disease: Comparison of the laser Doppler flowmetry and echocardiography

Cutaneous microvascular responses to physiological stimuli are currently being investigated as indices of vascular function and to monitor responses to therapy. We attempted to systematically assess various microvascular cutaneous flow indices in response to reactive hyperaemia in control subjects and in patients with coronary artery disease (CAD), and to correlate these with brachial artery flow-mediated dilation (FMD). Groups of 24 healthy controls and 24 subjects with CAD underwent sequential brachial FMD determination in the dominant arm, and laser Doppler imaging to assess skin blood flow in the contralateral arm in response to reactive hyperaemia induced by cuff inflation and release. Laser Doppler values were expressed as: (a) AUC5min (area under the curve over 5min of release), (b) time to peak response, (c) % reactive hyperaemia, and (d) peak perfusion ratio. As expected, FMD was attenuated in CAD patients compared with controls (1.85±4.29% compared with 4.30±4.00%; P = 0.05). Percentage reactive hyperaemia (CAD, 294±290%; controls, 501±344%; P = 0.04) and the time to peak response as measured by laser Doppler imaging (CAD, 16.84±9.61s; controls, 9.13±4.43s; P = 0.001) were significantly different between the CAD and control groups, while AUC5min and the peak perfusion ratio did not show significant differences. Receiver operator curves for sensitivity/specificity analysis suggested that the time to peak response derived by laser Doppler imaging was superior to FMD for the diagnosis of CAD, with an overall specificity of 91.3% (positive predictive value of 89.4%) and a sensitivity of 73.7% (negative predictive value of 77.6%). In conclusion, laser Doppler-derived indices of microvascular flow do not correlate with conduit vessel responses. However, a time to peak response of >10s as measured by laser Doppler imaging offers superior specificity for the diagnosis of CAD compared with brachial FMD.

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Prolongation of Left Atrial Augmentation After Handgrip Stress in Coronary Artery Disease: Observation Using Pulsed Doppler Flowmetry

Angiology ◽

10.1177/000331979905000405 ◽

1999 ◽

Vol 50 (4) ◽

pp. 299-308 ◽

Cited By ~ 1

Author(s):

Tetsuya Tanaka ◽

Katsufumi Mizushige ◽

Hisashi Masugata ◽

Hirohide Matsuo ◽

Katsufumi Mizushige

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Left Atrial ◽

Pulsed Doppler ◽

Doppler Flowmetry ◽

Artery Disease

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Effects of exenatide on microvascular reactivity in patients with type 2 diabetes and coronary artery disease: A randomized controlled study

Microcirculation ◽

10.1111/micc.12670 ◽

2020 ◽

Author(s):

Nikolaos Östlund Papadogeorgos ◽

Jeanette Kuhl ◽

Angela Shore ◽

Thomas Kahan ◽

Gun Jörneskog ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Randomized Controlled Study ◽

Controlled Study ◽

Microvascular Reactivity ◽

Randomized Controlled ◽

Artery Disease

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Clinical outcome of the patients with femoropopliteal artery disease after endovascular therapy: focused on drug-coated-balloon-related distal embolism detected by laser doppler flowmetry

Cardiovascular Intervention and Therapeutics ◽

10.1007/s12928-021-00815-1 ◽

2021 ◽

Author(s):

Kuniyoshi Fukai ◽

Takuo Nakagami ◽

Tetsuro Hamaoka ◽

Masakazu Kikai ◽

Shinichiro Yamaguchi

Keyword(s):

Clinical Outcome ◽

Clinical Outcomes ◽

Laser Doppler Flowmetry ◽

Endovascular Therapy ◽

Previous History ◽

Laser Doppler ◽

Lesion Length ◽

Doppler Flowmetry ◽

Femoropopliteal Artery ◽

Artery Disease

AbstractSeveral trials have shown that paclitaxel drug-coated balloons (DCBs) significantly reduce restenosis rates. However, some reports have shown distal embolisms occurring after DCBs. No study has analyzed the clinical outcomes of patients with DCB-induced distal embolism. This study aimed to investigate the clinical outcomes of DCB-induced distal embolism in patients with femoropopliteal artery disease. Between February 2018 and April 2019, consecutive patients (n = 32) who presented with de novo femoropopliteal artery disease and underwent endovascular therapy using DCB were retrospectively reviewed in a single-center study. Patients were divided into two groups based on whether distal embolism was detected using laser doppler flowmetry (DEL group) or not (non-DEL group). Baseline characteristics and 1-year clinical outcomes were compared between the groups. DEL was found in 44% of limbs (DEL group: n = 15, non-DEL group: n = 19). Below-the-knee arterial runoff ≤ 1 (p = 0.033), popliteal lesion (p = 0.044), ambulation difficulty (p = 0.021), and previous history of coronary artery disease (p = 0.013) were identified as predictive factors of DEL. Procedural factors, reference vessel diameter, lesion length, and total drug amount were not predictive of DEL. The overall target lesion restenosis (TLR) rate was 17.4% (n = 5). The TLR rate was not significantly different between the DEL and non-DEL groups (13.3% vs. 15.8%, p = 0.55). Severe calcification was the only significant factor for TLR (4.2% vs. 40.0%, p = 0.02). Among patients with femoropopliteal disease, there was no difference in 1-year clinical outcome between patients who underwent DEL and those who did not.

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Aortic wall elasticity and left ventricular function in hypertensive patients with nonsignificant coronary artery disease

Ultrasound ◽

10.1177/1742271x20963346 ◽

2020 ◽

pp. 1742271X2096334

Author(s):

Maryam Nabati ◽

Shojaoddin Namazi ◽

Jamshid Yazdani

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Left Ventricular Function ◽

Ventricular Function ◽

Aortic Stiffness ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Hypertensive Patients ◽

Aortic Elasticity ◽

Artery Disease

Purpose Hypertension is an important cause of nonischemic heart failure. It is important to identify subclinical left ventricular dysfunction in patients with hypertension in an early stage to lower the risk of progression to more severe illness. The aim of our study was to assess the correlation between indices of left ventricular function and aortic stiffness in patients with hypertension. Methods Our study was a case control study of 42 hypertensive and 40 normotensive patients with nonsignificant coronary artery disease. All the patients underwent echocardiography and left ventricular ejection fraction, global longitudinal strain, post systolic index, pulsed Doppler early transmitral peak flow velocity, early diastolic mitral annular velocity (e′), and aortic elasticity measurements were calculated. Results The hypertensive patients were older (58.47 ± 9.57 vs. 52.94 ± 10.38 years, p = 0.018) and had a higher body mass index (30.09 ± 5.08 vs. 27.48 ± 4.17 kg/m2, p = 0.013) and E/e′ ratio (8.16 ± 1.81 vs. 6.56 ± 1.71, p < 0.001) and a lower e′ velocity (8.25 ± 2.28 vs. 9.52 ± 2.34 cm/s, p = 0.015) than normotensives. They also had a lower aortic distensibility ( p = 0.008) and a higher aortic stiffness index ( p = 0.039) compared with the normotensive group. The hypertensive patients did not show any association between aortic elasticity and stiffness with age or e′ velocity despite significant association in normotensives. Conclusion Hypertension is associated with a high prevalence of diastolic dysfunction, elevated left ventricular filling pressure, and increased arterial stiffness, all of which have significant association with adverse outcomes. The measurements found in the hypertensive patients compared with the normotensive group may be due to several age-independent mechanisms.

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