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.

scholarly journals Vascular Aging Detected by Peripheral Endothelial Dysfunction Is Associated With ECG‐Derived Physiological Aging

2021 ◽  
Vol 10 (3) ◽  
Author(s):  
Takumi Toya ◽  
Ali Ahmad ◽  
Zachi Attia ◽  
Michal Cohen‐Shelly ◽  
Ilke Ozcan ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Reactive Hyperemia ◽  
Major Adverse Cardiovascular Events ◽  
Vascular Aging ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial

Background An artificial intelligence algorithm that detects age using the 12‐lead ECG has been suggested to signal “physiologic age.” This study aimed to investigate the association of peripheral microvascular endothelial function (PMEF) as an index of vascular aging, with accelerated physiologic aging gauged by ECG‐derived artificial intelligence–estimated age. Methods and Results This study included 531 patients who underwent ECG and a noninvasive PMEF assessment using reactive hyperemia peripheral arterial tonometry. Abnormal PMEF was defined as reactive hyperemia peripheral arterial tonometry index ≤2.0. Accelerated or delayed physiologic aging was calculated by the Δ age (ECG‐derived artificial intelligence–estimated age minus chronological age), and the association between Δ age and PMEF as well as its impact on composite major adverse cardiovascular events were investigated. Δ age was higher in patients with abnormal PMEF than in patients with normal PMEF (2.3±7.8 versus 0.5±7.7 years; P =0.01). Reactive hyperemia peripheral arterial tonometry index was negatively associated with Δ age after adjustment for cardiovascular risk factors (standardized β coefficient, –0.08; P =0.048). The highest quartile of Δ age was associated with an increased risk of major adverse cardiovascular events compared with the first quartile of Δ age in patients with abnormal PMEF, even after adjustment for cardiovascular risk factors (hazard ratio, 4.72; 95% CI, 1.24–17.91; P =0.02). Conclusions Vascular aging detected by endothelial function is associated with accelerated physiologic aging, as assessed by the artificial intelligence–ECG Δ age. Patients with endothelial dysfunction and the highest quartile of accelerated physiologic aging have a marked increase in risk for cardiovascular events.

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 Augmentation Index Derived from Peripheral Arterial Tonometry Correlates with Cardiovascular Risk Factors

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Eshan Patvardhan ◽  
Kevin S. Heffernan ◽  
Jenny Ruan ◽  
Michael Hession ◽  
Patrick Warner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Augmentation Index ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial

scholarly journals Impact of Peripheral Microvascular Endothelial Dysfunction on White Matter Hyperintensity

2021 ◽  
Author(s):  
Takumi Toya ◽  
Jaskanwal D. Sara ◽  
Eugene L. Scharf ◽  
Ali Ahmad ◽  
Valentina Nardi ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Reactive Hyperemia ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Hyperintensity ◽  
Intracranial Volume ◽  
Resonance Imaging ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Increased Risk ◽  
Peripheral Arterial

Background White matter hyperintensity (WMH), characterized by hyperintensities on T2‐weighted fluid‐attenuated inversion recovery brain magnetic resonance imaging, has been linked to an increased risk of ischemic stroke (IS). Endothelial dysfunction is an indicator of vascular dysfunction, predicting the risk of IS. This study aimed to investigate the association between endothelial dysfunction and regional WMH, and its impact on future risk of IS. Methods and Results We enrolled 219 patients (mean age, 53.1±14.1 years; 34.7% men) who underwent peripheral endothelial function assessment using reactive hyperemia peripheral arterial tonometry and brain magnetic resonance imaging without any history of IS. Volumetric WMH segmentation was automatically extrapolated using a validated automated digital tool. Total and juxtacortical WMH volume/intracranial volume (%) increased with aging and became more prominent in patients aged >50 years (n=131) than those aged ≤50 years (n=88) (total WMH: ≤50 years, Pearson r =0.24, P =0.03; >50 years, Pearson r =0.62, P <0.0001; juxtacortical WMH: ≤50 years, Pearson r =0.09, P =0.40; >50 years, Pearson r =0.55, P <0.0001). Reactive hyperemia peripheral arterial tonometry index was negatively associated with total and juxtacortical WMH volume/intracranial volume (%) in patients aged >50 years after adjustment for other covariates (reactive hyperemia peripheral arterial tonometry index, standardized β coefficient −0.17, P =0.04). Juxtacortical WMH volume/intracranial volume (%) was associated with an increased risk of IS during median follow‐up of 6.5 years (hazard ratio, 1.47; 95% CI, 1.05–1.92; P =0.03). Conclusions Peripheral endothelial dysfunction is associated with an increased volume of juxtacortical WMH in patients aged >50 years, which is a potential marker to predict future risk of IS.

Reactive hyperemia peripheral arterial tonometry as a measure of endothelial dysfunction in COPD

2017 ◽  
Author(s):  
Desiree Schumann ◽  
Andreas Scherr ◽  
Werner Strobel ◽  
Michael Zellweger ◽  
Michael Tamm ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Reactive Hyperemia ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Peripheral Arterial

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>

scholarly journals Assessment of peripheral endothelial function predicts future risk of solid-tumor cancer

2019 ◽  
Vol 27 (6) ◽  
pp. 608-618 ◽  
Author(s):  
Takumi Toya ◽  
Jaskanwal D Sara ◽  
Michel T Corban ◽  
Riad Taher ◽  
Shigeo Godo ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Confidence Interval ◽  
Solid Tumor ◽  
Reactive Hyperemia ◽  
Peripheral Arterial Tonometry ◽  
Arterial Tonometry ◽  
Future Risk ◽  
Microvascular Endothelial ◽  
Peripheral Arterial

Aims Cardiovascular health metrics predict the risk not only of cardiovascular diseases but also of several types of cancers. Microvascular endothelial dysfunction can predict future cardiovascular adverse events, but the predictive value of microvascular endothelial dysfunction for future risk of solid-tumor cancer has not been characterized. Methods A total of 488 patients who underwent microvascular endothelial function assessment using reactive hyperemia peripheral arterial tonometry were included in this study. Microvascular endothelial dysfunction was defined as a reactive hyperemia peripheral arterial tonometry index ≤2.0. Results Of 221 patients with a baseline reactive hyperemia peripheral arterial tonometry index ≤2.0, 21 patients (9.5%) were diagnosed with incident solid-tumor cancer during follow-up, whereas of 267 patients with a baseline reactive hyperemia peripheral arterial tonometry index >2.0, 10 patients (3.7%) were diagnosed with incident solid-tumor cancer during follow-up ( p = 0.009). Patients with a reactive hyperemia peripheral arterial tonometry index ≤2.0 had lower solid-tumor cancer-free survival compared to patients with a reactive hyperemia peripheral arterial tonometry index >2.0 (log-rank p = 0.017) (median follow-up 6.0 (3.0–9.1) years). Cox proportional hazard analyses showed that a reactive hyperemia peripheral arterial tonometry index ≤2.0 predicted the incidence of solid-tumor cancer, with a hazard ratio of 2.52 (95% confidence interval 1.17–5.45; p = 0.019) after adjusting for age, sex, and coronary artery disease, 2.83 (95% confidence interval 1.30–6.17; p = 0.009) after adjusting for diabetes mellitus, hypertension, smoking status, and body mass index >30 kg/m2, 2.79 (95% confidence interval 1.21–6.41; p = 0.016) after adjusting for fasting plasma glucose, systolic blood pressure, smoking status (current or former), and body mass index, and 2.43 (95% confidence interval 1.10–5.34; p = 0.028) after adjusting for Framingham risk score. Conclusion Microvascular endothelial dysfunction, as defined by a reactive hyperemia peripheral arterial tonometry index ≤2.0, was associated with a greater than two-fold increased risk of solid-tumor cancer. Microvascular endothelial dysfunction may be a useful marker to predict the future risk of solid-tumor cancer, in addition to its known ability to predict cardiovascular disease. Further research is necessary to develop adequate cancer screening strategies for patients with microvascular endothelial dysfunction.

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