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 Flow-mediated dilation and peripheral arterial tonometry are disturbed in preeclampsia and reflect different aspects of endothelial function

2017 ◽  
Vol 313 (5) ◽  
pp. R518-R525 ◽  
Author(s):  
Dominique Mannaerts ◽  
Ellen Faes ◽  
Inge Goovaerts ◽  
Tibor Stoop ◽  
Jerome Cornette ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Endothelial Function ◽  
Systemic Inflammation ◽  
Vascular Function ◽  
Reactive Hyperemia ◽  
Normal Pregnancy ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial ◽  
In Pregnancy

Endothelial function and arterial stiffness are known to be altered in preeclamptic pregnancies. Previous studies have shown conflicting results regarding the best technique for assessing vascular function in pregnancy. In this study, we made a comprehensive evaluation of in vivo vascular function [including flow-mediated dilatation (FMD), peripheral arterial tonometry (PAT), and arterial stiffness] in preeclamptic patients and compared them with normal pregnancies. In addition, we assessed the relation between vascular function and systemic inflammation. Fourteen patients with preeclampsia (PE) and 14 healthy pregnant controls were included. Endothelial function was determined by FMD and PAT and arterial stiffness by carotid-femoral pulse-wave velocity and augmentation index. Systemic inflammation was assessed using mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR). The reactive hyperemia index, assessed using PAT, is decreased at the third trimester compared with the first trimester in a normal, uncomplicated pregnancy ( P = 0.001). Arterial stiffness is significantly higher in PE versus normal pregnancy ( P < 0.001). Endothelial function, obtained by FMD, is deteriorated in PE versus normal pregnancy ( P = 0.015), whereas endothelial function assessment by PAT is improved in PE versus normal pregnancy ( P = 0.001). Systemic inflammation (MPV and NLR) increases during normal pregnancy. FMD and PAT are disturbed in PE. Endothelial function, assessed by FMD and PAT, shows distinct results. This may indicate that measurements with FMD and PAT reflect different aspects of endothelial function and that PAT should not be used as a substitute for FMD as a measure of endothelial function in pregnancy.

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.

The relationship between peripheral arterial tonometry and classic measures of endothelial function

2012 ◽  
Vol 18 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Billie-Jean Martin ◽  
Vikram Gurtu ◽  
Sammy Chan ◽  
Todd J Anderson
Keyword(s):  
Endothelial Function ◽  
Vascular Function ◽  
Cardiac Risk ◽  
Peripheral Arterial Tonometry ◽  
Velocity Time Integral ◽  
Time Integral ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial ◽  
The Relationship

The aim of this study was to assess the association between peripheral arterial tonometry (PAT) and two more traditional measures of endothelial function – flow-mediated dilation (FMD) and its hyperemic stimulus, hyperemic peak velocity time integral (VTI). We related three vascular function measures (natural log transformed PAT, FMD, and VTI) from 304 patients (mean age 48.9 ± 12.5 years), including 105 with coronary artery disease (CAD). Using linear regression, we studied the relationships between lnPAT, FMD, and VTI, and compared differences in these parameters in those with and without CAD. Although FMD and lnPAT both had a correlation with VTI (Pearson’s r = 0.119, p = 0.039 and r = 0.167, p = 0.004, respectively), lnPAT had no correlation with FMD ( r = −0.0471, p = 0.414). lnPAT was also lower in patients with CAD compared to controls (mean 0.51 ± 0.19 versus 0.65 ± 0.26, respectively, p < 0.0001). In multivariate analysis, VTI remained associated with lnPAT (standardized β = 0.1369, p = 0.04). Among this group of subjects with and without CAD, lnPAT was found to be unrelated to FMD but correlated with VTI. This would suggest that lnPAT is a measure of microvascular function. Although it is unrelated to FMD, lnPAT is decreased in patients with pre-existing cardiovascular disease. Further studies are required to determine if this can be used clinically as a tool for cardiac risk stratification and prediction of CAD.

scholarly journals Repeatability of Peripheral Artery Tonometry in Female Subjects

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Andrew J. Degnan ◽  
Nandini Shah ◽  
David M. Carty ◽  
John R. Petrie ◽  
Christian Delles ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Endothelial Function ◽  
Estrous Cycle ◽  
Vascular Function ◽  
Augmentation Index ◽  
Reactive Hyperemia ◽  
Intraclass Correlation ◽  
Peripheral Arterial Tonometry ◽  
Peripheral Arterial ◽  
Female Subjects

Background. Peripheral arterial tonometry (PAT) is a novel, non-invasive and operator-independent method for simultaneous assessment of endothelial function and arterial stiffness. We examined the repeatability of PAT in females and the influence of the estrous cycle. Methods. In 14 healthy female and five healthy male control subjects, PAT was performed on three separate occasions with 10 days between visits. Reactive hyperemia index (RHI), a measure of endothelial function, and peripheral augmentation index (AIx), a measure of arterial stiffness, were determined with the EndoPAT-2000 system. Intraclass correlation coefficient (ICC) was calculated as a measure of repeatability. Results. In both female and male groups, RHI and AIx did not differ between the three measurements (all n.s. by 1-way ANOVA). In females, reanalyzing the data after taking phase of estrous cycle into account had no effect on the results. Repeatability for RHI and AIx in females (ICC for RHI = 0.43, ICC for AIx = 0.78) was similar to that in male subjects (ICC for RHI = 0.42, ICC for AIx = 0.63). Conclusions. PAT measurements were not affected by the estrous cycle in females, and repeatability was comparable to that in males. This should facilitate inclusion of female subjects into vascular function studies using PAT.

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 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
Sign in / Sign up

Export Citation Format

Share Document