scholarly journals Endothelial function assessed by peripheral arterial tonometry is not related to cardiovascular risk score in healthy subjects

2017 ◽  
Vol 9 ◽  
Author(s):  
Ylfa Rún Sigurðardóttir ◽  
Bylgja Rún Stefánsdóttir ◽  
Thor Aspelund ◽  
Thorgeirsson Guðmundur ◽  
Linda Björk Kristinsdóttir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Risk Score ◽  
Healthy Subjects ◽  
Pulse Amplitude ◽  
Font Size ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial

<p><span style="font-size: medium;"><strong>Background: </strong>The majority of first cases of myocardial infarction stem from those classified as intermediate- or low-risk in CV risk prediction calculators. Risk prediction models need to be refined in their capacity to discriminate high-risk from low-risk. Peripheral arterial tonometry (PAT) is a non-invasive method to assess peripheral endothelial function that could potentially improve primary prevention of CVD. We investigated the relation of PAT results to CV risk factors and risk score in a healthy cohort.</span></p><p><span style="font-size: medium;"><strong>Methods: </strong>PAT measurements were performed on 102 individuals, with no previous history of CAD, attending a Risk Preventive Clinic.<strong> </strong>Traditional CV risk factors were evaluated and integrated into a CV risk score calculator. Outcome was expressed as absolute and relative 10-year risk of developing CVD. </span></p><p><strong><span style="font-size: medium;">Results: </span></strong><span style="font-size: medium;">PAT results of reactive hyperemia index (RHI) and augmentation index (AI) had no statistically significant relation to risk score while baseline pulse amplitude was positively correlated with both absolute (<em>p </em>= 0.02) and relative (<em>p </em>= 0.02) 10-year risk of developing CVD. Among CV risk factors only heart rate was significantly associated with RHI (r = - 0.24, R</span><sup><span style="font-size: small;">2</span></sup><span style="font-size: medium;"> = 0.06, <em>p</em> = 0.01). AI and baseline pulse amplitude both correlated with several risk factors.</span></p><p><span style="font-size: medium;"><strong>Conclusions: </strong>Endothelial dysfunction, as measured by PAT, was not associated with an increased 10-year risk of developing CVD. The relation between endothelial dysfunction and established CV risk factors was limited. Further clinical end point studies are needed to fully comprehend the diagnostic and predictive value of PAT measurements in healthy subjects.</span></p>

Abstract 527: Obstructive Sleep Apnea and Endothelial Dysfunction in Resistant Hypertension

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Nádia M Amorim ◽  
Fabiana B Bassan ◽  
Luciene d Araújo ◽  
Julia F Fernandes ◽  
Maria d Rodrigues ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Resistant Hypertension ◽  
Anthropometric Parameters ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Obstructive Sleep ◽  
Peripheral Arterial

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease and reported as the most common secondary cause of high blood pressure (BP) maintenance. Objective: To determine the prevalence of OSA and verify its association with endothelial function behavior and anthropometric parameters in patients with resistant hypertension (RHGroup) and BP controlled by medication (CHGroup). Methods: Cross-sectional study involving 40 hypertensive patients (20 in RHG and 20 in CHG), aged between 18 and 75 years. Endothelial function and OSA were assessed by peripheral arterial tonometry. BP was measured by oscillometric method on automatic device. Endothelial function was assessed by peripheral arterial tonometry (PAT) by EndoPAT2000 and the OSA diagnosis also through PAT, using the portable device WatchPAT200. Anthropometric evaluation was performed through measurements of waist (WaC), hip and neck circumference (NC), BMI, waist to height ratio (WHtR), and body composition assessed by BIA. Results: The prevalence of OSA in RHG was 85% (17 of 20)[apnea-hypopnea index = 12.39±1.89], and 80% (16 of 20) in CHG (AHI=20.74±4.69) and it was more frequent in men (93.7% [15 of 16] vs 75% [16 of 24]; p=0.0455, OR =3.86; 95% IC 0.99 to 5.09). Both groups presented similar anthropometric parameters values. Endothelial function evaluated by reactive hyperemia index was similar in both groups (RHG: 1.88±0.44 vs CHG: 2.03±0.43; p=0.47). Although we found differences in oxygen desaturation> 4% (RHG: 28.75 ± 5.08 vs CHG: 64.15 ± 16.97, p = 0.05), total sleep time (RHG: 307.2 ± 71.3 vs CHG: 323.3 ± 83.8 min) and minimum saturation (RHG: 87.8±3.8 vs CHG: 83.3±10.6%) was not different. In general, OSA was correlated with weight (r = 0.5135, p = 0.0007), BMI (r = 0.4146, p = 0.0078), WaC (r = 0, 4458, p = 0.005), NC (r = 0.3863, p = 0.01) and WHtR (r = 0.3907, p = 0.01) and independently associated with impairment of endothelial function (p = 0.0297, OR = 0.17, 95% CI 0.04 to 0.72). Conclusions: The findings of the present study show that the prevalence of OSA was similar in both groups and suggest that, in hypertensive subjects, OSA occurs more frequently in men, being associated with endothelial dysfunction and correlated positively with weight, BMI and WaC.

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&lt;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.

scholarly journals Predicting Preeclampsia with Noninvasive Measures of Endothelial Dysfunction: A Pilot Study

2020 ◽  
Vol 10 (01) ◽  
pp. e20-e25
Author(s):  
Emmanuel U. Emeasoba ◽  
Rodney A. McLaren ◽  
Rebecca Landau ◽  
Jeremy Weedon ◽  
Shoshana Haberman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Endothelial Dysfunction ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Peripheral Arterial Tonometry ◽  
Receiver Operating Characteristic Plot ◽  
Arterial Tonometry ◽  
History Of ◽  
Peripheral Arterial

Abstract Objective This study evaluates the assessment of endothelial function and its prediction for preeclampsia among women with high-risk factors. Study Design A prospective cohort study of 107 pregnant women at 20 weeks or greater gestation with risk factors for developing preeclampsia. Endothelial dysfunction was assessed using peripheral arterial tonometry by generating a reactive hyperemia index (RHI) score. An index score of <1.67 was defined as endothelial dysfunction. The primary outcome was preeclampsia. Logistic regression was used to predict preeclampsia from RHI scores, body mass index, gestational age at RHI evaluation, history of preeclampsia, history of pregestational diabetes mellitus, chronic hypertension, and fetal number. A receiver operating characteristic plot was constructed to predict preeclampsia from the RHI score. Results Among 107 women, 99 had interpretable RHI scores. Among those with an abnormal RHI (n = 61), 17 (28%) developed preeclampsia. Among women with a normal score (n = 38), six (16%) developed preeclampsia (p = 0.166). After logistic regression, there was no significant association. A receiver operating characteristic plot also revealed no association between RHI score and preeclampsia. Conclusion An abnormal RHI score using peripheral arterial tonometry indicating endothelial dysfunction was not predictive of developing preeclampsia in this cohort. Future studies are needed to further evaluate this relationship.

Predicting Severity of Coronary Artery Disease in Patients With Diabetes Using Endothelial Function Measured With Peripheral Arterial Tonometry: PROCEED Study

Angiology ◽  
2019 ◽  
Vol 70 (7) ◽  
pp. 613-620 ◽  
Author(s):  
Shreenidhi Venuraju ◽  
Anand Jeevarethinam ◽  
Vishal Shahil Mehta ◽  
Sherezade Ruano ◽  
Alain Dumo ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Reactive Hyperemia ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Artery Disease ◽  
Peripheral Arterial

Endothelial dysfunction is common in patients with type 2 diabetes mellitus (T2DM) and is associated with atherosclerotic disease. This study aimed to determine prognostic factors for endothelial dysfunction and identify relationships between reactive hyperemia index (RHI) score, clinically relevant coronary artery disease (>50% stenosis), and major adverse cardiovascular events (MACEs) in patients with T2DM. Endothelial function was assessed using peripheral arterial tonometry and correlated with patient characteristics and cardiovascular outcomes during a median follow-up of 22.8 months. Among 235 patients with a median duration of T2DM of 13 years, mean (standard deviation) RHI score was 2.00 (0.76). Serum low- and high-density lipoprotein cholesterol levels positively ( P = .004) and negatively ( P = .02) predicted RHI score, respectively. Median coronary artery calcium (CAC) score was 109 Agatston units, but no correlation between CAC and RHI scores was observed. The RHI score did not predict the number or severity of coronary plaques identified using computed tomography coronary angiography. Additionally, there was no association between RHI score and the risk of an MACE during follow-up. Overall, endothelial function was not predictive of CAC score, extent, and severity of coronary plaque or MACEs and did not demonstrate utility in cardiovascular risk stratifying patients with T2DM.

scholarly journals Variability of Peripheral Arterial Tonometry in the Measurement of Endothelial Function in Healthy Men

2009 ◽  
Vol 32 (12) ◽  
pp. 700-704 ◽  
Author(s):  
Jianmin Liu ◽  
Jingzhu Wang ◽  
Yan Jin ◽  
Hans J. Roethig ◽  
Martin Unverdorben
Keyword(s):  
Endothelial Function ◽  
Peripheral Arterial Tonometry ◽  
Healthy Men ◽  
Arterial Tonometry ◽  
Peripheral Arterial

scholarly journals Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events

2010 ◽  
Vol 31 (9) ◽  
pp. 1142-1148 ◽  
Author(s):  
R. Rubinshtein ◽  
J. T. Kuvin ◽  
M. Soffler ◽  
R. J. Lennon ◽  
S. Lavi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Endothelial Function ◽  
Peripheral Arterial Tonometry ◽  
Non Invasive ◽  
Arterial Tonometry ◽  
Peripheral Arterial

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.

Abstract 536: Poor Correlation Between FMD and PAT-Ratio in Patients With Metabolic Syndrome

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Ueda Tomohiro
Keyword(s):  
Metabolic Syndrome ◽  
Endothelial Function ◽  
Multivariable Analysis ◽  
Control Group ◽  
Poor Correlation ◽  
Study Group ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Coronary Lesions ◽  
Peripheral Arterial

Background: Flow mediated dilatation (FMD) and peripheral arterial tonometry (PAT) are commonly used methods for assessing endothelial function in a research setting but it is unclear how well they correlate. The aim of this study is to compare and correlate these methods in patients with metabolic syndrome. Methods: The study involved 105 subjects (mean age68±10 years) with metabolic syndrome. Based on the results of coronary angiography, they were divided into 2 groups: a study group with coronary lesions (n=68) and a control group without coronary lesions (n=37). Flow mediated vasodilatation (FMD) and nitroglycerine-induced vasodilatation (NID) in the brachial artery was measured by using UNEXEF18G (UNEX CO, Japan). At the same time, PAT ratio was measured by using Endo-PAT 2000 (Itamar Medical, Israel) Results: FMD was not correlated with PAT ratio by Spearman`s analysis. FMD was significantly impaired in the study group compared to that in the control group (3.9±1.8% vs. 2.6±1.5%, respectively; P<0.001). However, NID and PAT ratio had no deference in the two groups. Multivariable analysis revealed that FMD (odds ratio: 0.53, 95% confidence interval [CI]: 0.31-0.90) were independent variables for CAD in metabolic syndrome patients. Conclusion: This study showed that poor correlation between FMD and PAT in patients with metabolic syndrome. PAT may not be used as a substitute for FMD as a measure of endothelial function

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