Abstract P37: Evidence of Impaired Vascular Reactivity Following Dust Exposure in Participants in the World Trade Center Medical Monitoring and Treatment Program

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Simonette T Sawit ◽  
Mary Ann McLaughlin ◽  
Ana Garcia Alvarez ◽  
Dewan Kazi Fahima ◽  
Cynara Maceda ◽  
...  
Keyword(s):  
Treatment Program ◽  
Vascular Reactivity ◽  
Reactive Hyperemia ◽  
Medical Monitoring ◽  
Volume Changes ◽  
Peripheral Arterial Tonometry ◽  
Pulse Volume ◽  
Arterial Tonometry ◽  
Digital Pulse ◽  
Peripheral Arterial

INTRODUCTION: Exposure to particulate matter (PM) has been investigated as an additional risk factor for cardiovascular disease (CVD). It is likely that different mechanisms, including vascular dysfunction, are responsible for acute and chronic toxic effects. In participants of the Law Enforcement Cardiovascular Screening Program (LECS), a subset of the WTC Medical Monitoring and Treatment Program, we look to characterize the relationship between PM exposure and vascular reactivity (surrogate for endothelial function), as measured by peripheral arterial tonometry (PAT). METHODS: PAT, a system comprised of a finger probe to assess digital volume changes accompanying pulse waves, was used. Digital pulse volume changes during reactive hyperemia was assessed in 60 patients with either high (n=33) or low (n=27) PM exposure. 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. All data were prospectively obtained. We define highest inhaled PM exposure as occurring on 9/11/2001, and lower inhaled PM exposure as occurring on or after 9/13/2001. A PAT index of 1.67 or less was considered to represent abnormal vascular reactivity. RESULTS: Mean age was 49 years (range 45-53), 83% were male. There were no significant differences in baseline characteristics, including CVD risk factors. Median PAT was 1.87 (1.30-2.75) for subjects with lower exposure and 1.68 (1.15-3.22) for subjects with highest exposure to PM. Of subjects with highest exposure to PM, 68% (17/33) had a PAT index 1.67 or less, compared with 32% (8/27), of subjects with lower exposure (p value=0.17). The odds of having abnormal PAT index to normal PAT index was 2.1 times higher in subjects with highest exposure compared to those with lower exposure to PM (95%CI 0.7-6.2). CONCLUSION: We observe a trend correlating highest WTC inhaled PM exposure with abnormal vascular reactivity as measured by peripheral arterial tonometry index of 1.67 or less. The clinical impact of this finding, in this pilot study, requires further investigation.

scholarly journals Endothelial dysfunction in type 2 diabetic patients with normal coronary arteries. A peripheral arterial tonometry study

2015 ◽  
Vol 78 (1) ◽  
Author(s):  
Donatella Ruggiero ◽  
Gianluigi Savarese ◽  
Roberto Formisano ◽  
Ada Bologna ◽  
Giacomo Mattiello ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Endothelial Dysfunction ◽  
Reactive Hyperemia ◽  
Diabetic Patients ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Digital Pulse ◽  
Peripheral Arterial ◽  
The Impact

Aim: to evaluate endothelial function (EF) in diabetic and non-diabetic patients without CAD by peripheral artery tonometry (PAT) technique. Methods: a cohort of 94 patients (55 men and 39 postmenopausal women; mean age 63±9 years) undergoing coronary angiography was divided into 2 groups: 58 patients with DM and (group 1) and 36 patients without DM. Endothelial dysfunction (ED) was assessed by digital pulse amplitude, using a fingertip peripheral arterial tonometry (PAT). As a measure of ED, reactive hyperemia index (RHI) was calculated as the ratio of the digital pulse volume during reactive hyperemia following 5 min ischemia and its basal value. Results: prevalence of cardiovascular risk factors was similar between the two groups. RHI values were significantly lower in diabetic patients compared to non-diabetics (1.72±0.34 vs 2.00±0.44; p<0.005) and they correlated with levels of glycosylated hemoglobin (p=0.05; r=-0.266). Conclusion: despite similar level of other risk factors, EF was much more impaired in diabetic patients than in non-diabetics. These evidences further support the impact of DM on cardiovascular risk.

Abstract 11845: Impaired Peripheral Endothelial Function Assessed by Digital Reactive Hyperemia Peripheral Arterial Tonometry and Risk of In-Stent Restenosis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Naohiro Komura ◽  
Kenichi Tsujita ◽  
Kenshi Yamanaga ◽  
Kenji Sakamoto ◽  
Takashi Miyazaki ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Prognostic Value ◽  
Reactive Hyperemia ◽  
Characteristic Analysis ◽  
Peripheral Arterial Tonometry ◽  
Stent Restenosis ◽  
Arterial Tonometry ◽  
Stent Length ◽  
Peripheral Arterial ◽  
In Stent Restenosis

Introduction: Drug-eluting stents (DESs) are replacing bare-metal stents (BMSs), but in-stent restenosis (ISR) remains a problem. Impaired endothelial function is a key event in the atherosclerosis process and a predictor of future cardiovascular events. Reactive hyperemia index (RHI) assessed by peripheral arterial tonometry (PAT) evaluates endothelial function noninvasively. Hypothesis: We prospectively assessed the prognostic value of RHI in predicting ISR after percutaneous coronary intervention (PCI). Methods: RHI was measured using Endo-PAT 2000 before PCI (initial RHI) and at follow-up angiography (F/U RHI) in 249 consecutive patients who had successful PCI. F/U angiography was performed at six and nine months after PCI with BMS and DES, respectively. ISR was defined as percent diameter stenosis >50% at F/U angiography assessed by quantitative coronary angiography. Results: At F/U, ISR was seen in 68 patients (27.3%). F/U ln(RHI) was significantly lower in patients with ISR than in those without (0.52 ± 0.23 vs. 0.65 ± 0.27, p < 0.01); no between-group difference in initial ln(RHI) was seen (0.60 ± 0.26 vs. 0.62 ± 0.25, p = 0.56). By multivariate logistic regression analysis, even after adjusting for other significant parameters in univariate analysis (BMS use, total stent length, HDL-Cholesterol, HbA1c, calcium antagonist use, and post-PCI minimum lumen diameter), F/U ln(RHI) independently predicted ISR (odds ratio: 0.13; 95% confidence interval [CI]: 0.04-0.48; p = 0.002). In receiver operating-characteristic analysis, F/U RHI was the strongest predictor of ISR (area under the curve [AUC]: 0.67; 95% CI: 0.60-0.75; p < 0.01; RHI < 1.73 had 67.6% sensitivity, 64.1% specificity); AUC significantly improved from 0.62 to 0.70 when RHI was added to traditional ISR risk factors (diabetes mellitus, total stent length, minimum stent diameter) (p = 0.02). Net reclassification index was significant after addition of RHI (26.5%, p = 0.002). Conclusions: To our knowledge, this is the first study indicating that impaired RHI at F/U angiography independently predicts occurrence of ISR. The simple and noninvasive assessment of endothelial function by RH-PAT adds incremental prognostic value to ISR-risk stratification following PCI.

scholarly journals Improvement of Vascular Endothelial Function Reflects Nonrecurrence After Catheter Ablation for Atrial Fibrillation

2021 ◽  
Author(s):  
Hisanori Kanazawa ◽  
Koichi Kaikita ◽  
Miwa Ito ◽  
Yusei Kawahara ◽  
Tadashi Hoshiyama ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Endothelial Function ◽  
Sinus Rhythm ◽  
Reactive Hyperemia ◽  
Vascular Endothelial ◽  
Vascular Endothelial Function ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial ◽  
Af Recurrence

Background The clinical implication of vascular endothelial dysfunction in patients with atrial fibrillation (AF) remains unclear. This study aimed to elucidate the correlation between changes in vascular endothelial function assessed by reactive hyperemia‐peripheral arterial tonometry and the effect of sinus rhythm restoration after catheter ablation (CA) for AF. Methods and Results Consecutive 214 patients who underwent CA for AF were included in this single center, retrospective study. The natural logarithmic transformed reactive hyperemia‐peripheral arterial tonometry index (LnRHI) of all patients was measured before CA as well as 3 and 6 months after CA. LnRHI in sinus rhythm was significantly higher than that in AF before CA. Multivariate logistic regression analysis revealed that the presence of AF was an independent risk factor for lowering of LnRHI (odds ratio, 4.092; P =0.002) before CA. The LnRHI was significantly improved 3 and 6 months after CA in patients without AF recurrence. Multivariate Cox hazard analysis revealed that changes in LnRHI from before to 3 months after CA independently correlated with recurrence of AF (hazard ratio, 0.106; P =0.001). Receiver operating characteristic analysis showed the decrease in LnRHI levels from before to 3 months after CA as a significant marker that suspects AF recurrence (area under the curve, 0.792; log‐rank test, P <0.001). Conclusions The presence of AF was independently correlated with the impaired vascular endothelial function assessed by the reactive hyperemia‐peripheral arterial tonometry. Long‐term sinus rhythm restoration after CA for AF might contribute to the improvement of vascular endothelial function, which may reflect the nonrecurrence of AF.

scholarly journals Reactive hyperemia test: methods of analysis, mechanisms of reaction and prospects

2018 ◽  
Vol 17 (3) ◽  
pp. 5-22 ◽  
Author(s):  
A. A. Sagaidachnyi
Keyword(s):  
Reactive Hyperemia ◽  
Test Methods ◽  
Short Term ◽  
Peripheral Arterial Tonometry ◽  
Doppler Flowmetry ◽  
Instrumental Assessment ◽  
Arterial Tonometry ◽  
Peripheral Arterial ◽  
Intensive Development

The analysis and generalization of the results of the works devoted to the study of the reaction to the post-occlusive reactive hyperemia (PORH) test have been carried out with the aim of forming the model of reaction and determining the growth of new scientific directions, not only in diagnostics, but also in therapy. The mechanisms of reaction, protocol, methods of instrumental assessment of the reaction to PORH test, the role of the test in the diagnosis of atherosclerosis, arterial hypertension, and diabetes mellitus are discussed. The reaction to multiple occlusion is analyzed, which is potentially useful as a therapeutic procedure for improving microcirculation. Usefulness is compared between the methods of laser Doppler flowmetry, photoplethysmography, infrared thermography and peripheral arterial tonometry. In the short term, the most intensive development and wide application is predicted for the photoplethysmography.

scholarly journals Digital Peripheral Arterial Tonometry and Cardiovascular Disease Events: The Framingham Heart Study

Stroke ◽  
2021 ◽  
Author(s):  
Leroy L. Cooper ◽  
Na Wang ◽  
Alexa S. Beiser ◽  
José Rafael Romero ◽  
Hugo J. Aparicio ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Framingham Heart Study ◽  
Vascular Function ◽  
Lower Risk ◽  
Reactive Hyperemia ◽  
Pulse Amplitude ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Heart Study ◽  
Peripheral Arterial

Background and Purpose: Novel noninvasive measures of vascular function are emerging as subclinical markers for cardiovascular disease (CVD) and may be useful to predict CVD events. The purpose of our prospective study was to assess associations between digital peripheral arterial tonometry (PAT) measures and first-onset major CVD events in a sample of FHS (Framingham Heart Study) participants. Methods: Using a fingertip PAT device, we assessed pulse amplitude in Framingham Offspring and Third Generation participants (n=3865; mean age, 55±14 years; 52% women) at baseline and in 30-second intervals for 4 minutes during reactive hyperemia. The PAT ratio (relative hyperemia index) was calculated as the post-to-pre occlusion pulse signal ratio in the occluded arm, relative to the same ratio in the control (nonoccluded) arm, and corrected for baseline vascular tone. Baseline pulse amplitude and PAT ratio during hyperemia are measures of pressure pulsatility and microvascular function in the finger, respectively. We used Cox proportional hazards regression to relate PAT measures in the fingertip to incident CVD events. Results: During follow-up (median, 9.2 years; range, 0.04–10.0 years), 270 participants (7%) experienced new-onset CVD events (n=270). In multivariable models adjusted for cardiovascular risk factors, baseline pulse amplitude (hazard ratio [HR] per 1 SD, 1.04 [95% CI, 0.90–1.21]; P =0.57) and PAT ratio (HR, 0.95 [95% CI, 0.84–1.08]; P =0.43) were not significantly related to incident composite CVD events, including myocardial infarction or heart failure. However, higher PAT ratio (HR, 0.76 [95% CI, 0.61–0.94]; P =0.013), but not baseline pulse amplitude (HR, 1.15 [95% CI, 0.89–1.49]; P =0.29), was related to lower risk for incident stroke. In a sensitivity analysis by stroke subtype, higher PAT ratio was related to lower risk of incident ischemic stroke events (HR, 0.68 [95% CI, 0.53–0.86]; P =0.001). Conclusions: Novel digital PAT measures may represent a marker of stroke risk in the community.

scholarly journals Evaluation of Endothelial Function by Reactive Hyperemia Peripheral Arterial Tonometry (RH-PAT) in Health Evaluation and Promotion

2012 ◽  
Vol 39 (2) ◽  
pp. 277-284
Author(s):  
Ryotaro Takahashi ◽  
Kenji Okumura ◽  
Chisuzu Ohyama ◽  
Akiko Ogawa ◽  
Masahiro Ohno ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Health Evaluation ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial
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