BACKGROUND: Flow-mediated dilation (FMD) and reactive hyperemia-peripheral arterial tonometry (RH-PAT) are both established modalities to assess vascular endothelial function. However, clinical significance of FMD and RH-PAT may be different because these methods measure vascular function in different vessels (conduit arteries and resistance vessels). METHODS: To elucidate differences in the clinical significance of FMD and RH-PAT, a simultaneous determination of FMD was performed and reactive hyperemia index (RHI) measured by RH-PAT in 131 consecutive patients who underwent coronary angiography for suspicion of coronary artery disease (CAD). RESULTS: There was no significant correlation between FMD and RHI in patients overall. When patients were divided into four groups: FMD ≥ 6%/RHI ≥ 1.67 group, FMD ≥ 6%/RHI < 1.67 group, FMD < 6%/RHI ≥ 1.67 group and FMD < 6%/RHI < 1.67 group, the highest incidence of multivessel CAD was seen in the FMD < 6%/RHI < 1.67 group (52%). Multiple logistic regression analysis showed that a prevalence of both FMD < 6% and RHI < 1.67 was an independent predictor of multivessel CAD (odds ratio: 4.160, 95% confidence interval: 1.505-11.500, p = 0.006). RHI was negatively correlated with the baseline vessel diameter (R = -0.268, p = 0.0065) and maximum vessel diameter (R = -0.266, p = 0.0069) in patients with FMD < 6%, whereas these correlations were absent in patients with FMD ≥ 6%. CONCLUSIONS: Present results suggest that noninvasive assessment of vascular endothelial functions provide pathophysiological information on both conduit arteries and resistance vessels in patients with CAD.
BACKGROUND: Flow-mediated dilation (FMD) and reactive hyperemia-peripheral arterial tonometry (RH-PAT) are both established modalities to assess vascular endothelial function. However, clinical significance of FMD and RH-PAT may be different because these methods measure vascular function in different vessels (conduit arteries and resistance vessels). METHODS: To elucidate differences in the clinical significance of FMD and RH-PAT, a simultaneous determination of FMD was performed and reactive hyperemia index (RHI) measured by RH-PAT in 131 consecutive patients who underwent coronary angiography for suspicion of coronary artery disease (CAD). RESULTS: There was no significant correlation between FMD and RHI in patients overall. When patients were divided into four groups: FMD ≥ 6%/RHI ≥ 1.67 group, FMD ≥ 6%/RHI < 1.67 group, FMD < 6%/RHI ≥ 1.67 group and FMD < 6%/RHI < 1.67 group, the highest incidence of multivessel CAD was seen in the FMD < 6%/RHI < 1.67 group (52%). Multiple logistic regression analysis showed that a prevalence of both FMD < 6% and RHI < 1.67 was an independent predictor of multivessel CAD (odds ratio: 4.160, 95% confidence interval: 1.505-11.500, p = 0.006). RHI was negatively correlated with the baseline vessel diameter (R = -0.268, p = 0.0065) and maximum vessel diameter (R = -0.266, p = 0.0069) in patients with FMD < 6%, whereas these correlations were absent in patients with FMD ≥ 6%. CONCLUSIONS: Present results suggest that noninvasive assessment of vascular endothelial functions provide pathophysiological information on both conduit arteries and resistance vessels in patients with CAD.
Authors: Renate B Schnabel; Andreas Schulz; Philipp S Wild; Christoph R Sinning; Sandra Wilde; Medea Eleftheriadis; Stephanie Herkenhoff; Tanja Zeller; Edith Lubos; Karl J Lackner; Ascan Warnholtz; Tommaso Gori; Stefan Blankenberg; Thomas Münzel Journal: Circ Cardiovasc Imaging Date: 2011-05-06 Impact factor: 7.792
Authors: Piero O Bonetti; Geralyn M Pumper; Stuart T Higano; David R Holmes; Jeffrey T Kuvin; Amir Lerman Journal: J Am Coll Cardiol Date: 2004-12-07 Impact factor: 24.094
Authors: Andreas J Flammer; Todd Anderson; David S Celermajer; Mark A Creager; John Deanfield; Peter Ganz; Naomi M Hamburg; Thomas F Lüscher; Michael Shechter; Stefano Taddei; Joseph A Vita; Amir Lerman Journal: Circulation Date: 2012-08-07 Impact factor: 29.690
Authors: R Joannides; W E Haefeli; L Linder; V Richard; E H Bakkali; C Thuillez; T F Lüscher Journal: Circulation Date: 1995-03-01 Impact factor: 29.690