Tracy M Frech1, Maureen A Murtaugh2. 1. Division of Rheumatology, Department of Internal Medicine, University of Utah and Salt Lake Veterans Affair Medical Center, Salt Lake City, UT, USA. tracy.frech@hsc.utah.edu. 2. Division of Epidemiology, Department of Internal Medicine, University of Utah and Salt Lake Veterans Affair Medical Center, Salt Lake City, UT, USA.
Abstract
OBJECTIVES: The fingers, toes, and tips of the nose and ears have specialised structural and functional features for thermoregulation, and are the most common areas of Raynaud's phenomenon in systemic sclerosis. Digital thermal monitoring (DTM) of vascular reactivity assesses Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery and fingertip vascular function. Flow mediated dilation (FMD) is an indirect measure of endothelial function, perfusion, and vasodilator ability. In this study, we investigated the cross-sectional correlation of FMD and DTM variables to inform an optimised noninvasive study of SSc endothelial function. A student's T-test was used to compare means of DTM across binary variables. METHODS: Consented SSc registry patients were included in this analysis. The subjects were prepared for FMD and DTM per standardised guidelines. The SSc clinical features were recorded. Spearman's Rank Correlation was used to assess the strength of a relationship FMD and DTM variables. RESULTS: Thirty-four SSc subjects had FMD and DTM performed on the same day. Relative (0.42, p=<0.02), absolute FMD (0.41, p<0.02), and shear rate (0.32, p<0.07) were weakly, but significantly correlated with the DTM. Reactive hyperemia (-0.44, p=0.000) was weakly inversely, but significantly related with DTM. Baseline diameter and flow were not significantly related to the DTM. CONCLUSIONS: This non-invasive study of SSc endothelial function suggests that macrocirculation (including relative and absolute FMD, shear rate, and peak hyperemia) and microcirculatory thermoregulation (characterised by DTM) are significantly correlated, thus warrants further prospective study.
OBJECTIVES: The fingers, toes, and tips of the nose and ears have specialised structural and functional features for thermoregulation, and are the most common areas of Raynaud's phenomenon in systemic sclerosis. Digital thermal monitoring (DTM) of vascular reactivity assesses Doppler ultrasound hyperemic, low frequency, blood velocity of radial artery and fingertip vascular function. Flow mediated dilation (FMD) is an indirect measure of endothelial function, perfusion, and vasodilator ability. In this study, we investigated the cross-sectional correlation of FMD and DTM variables to inform an optimised noninvasive study of SSc endothelial function. A student's T-test was used to compare means of DTM across binary variables. METHODS: Consented SSc registry patients were included in this analysis. The subjects were prepared for FMD and DTM per standardised guidelines. The SSc clinical features were recorded. Spearman's Rank Correlation was used to assess the strength of a relationship FMD and DTM variables. RESULTS: Thirty-four SSc subjects had FMD and DTM performed on the same day. Relative (0.42, p=<0.02), absolute FMD (0.41, p<0.02), and shear rate (0.32, p<0.07) were weakly, but significantly correlated with the DTM. Reactive hyperemia (-0.44, p=0.000) was weakly inversely, but significantly related with DTM. Baseline diameter and flow were not significantly related to the DTM. CONCLUSIONS: This non-invasive study of SSc endothelial function suggests that macrocirculation (including relative and absolute FMD, shear rate, and peak hyperemia) and microcirculatory thermoregulation (characterised by DTM) are significantly correlated, thus warrants further prospective study.
Authors: Steven K Nishiyama; D Walter Wray; Kimberly Berkstresser; Murali Ramaswamy; Russell S Richardson Journal: J Appl Physiol (1985) Date: 2007-06-07
Authors: Frank van den Hoogen; Dinesh Khanna; Jaap Fransen; Sindhu R Johnson; Murray Baron; Alan Tyndall; Marco Matucci-Cerinic; Raymond P Naden; Thomas A Medsger; Patricia E Carreira; Gabriela Riemekasten; Philip J Clements; Christopher P Denton; Oliver Distler; Yannick Allanore; Daniel E Furst; Armando Gabrielli; Maureen D Mayes; Jacob M van Laar; James R Seibold; Laszlo Czirjak; Virginia D Steen; Murat Inanc; Otylia Kowal-Bielecka; Ulf Müller-Ladner; Gabriele Valentini; Douglas J Veale; Madelon C Vonk; Ulrich A Walker; Lorinda Chung; David H Collier; Mary Ellen Csuka; Barri J Fessler; Serena Guiducci; Ariane Herrick; Vivien M Hsu; Sergio Jimenez; Bashar Kahaleh; Peter A Merkel; Stanislav Sierakowski; Richard M Silver; Robert W Simms; John Varga; Janet E Pope Journal: Arthritis Rheum Date: 2013-10-03
Authors: Michael Hughes; Voon H Ong; Marina E Anderson; Frances Hall; Pia Moinzadeh; Bridget Griffiths; Eileen Baildam; Christopher P Denton; Ariane L Herrick Journal: Rheumatology (Oxford) Date: 2015-06-26 Impact factor: 7.580
Authors: Tracy M Frech; Daniel R Machin; Maureen A Murtaugh; Gregory J Stoddard; Samuel I Bloom; Jessica V Phibbs; Anthony J Donato Journal: Clin Exp Rheumatol Date: 2018-09-20 Impact factor: 4.473
Authors: Gary L McQuilkin; David Panthagani; Ralph W Metcalfe; Haider Hassan; Albert A Yen; Morteza Naghavi; Craig J Hartley Journal: Conf Proc IEEE Eng Med Biol Soc Date: 2009
Authors: Otylia Kowal-Bielecka; Jaap Fransen; Jerome Avouac; Mike Becker; Agnieszka Kulak; Yannick Allanore; Oliver Distler; Philip Clements; Maurizio Cutolo; Laszlo Czirjak; Nemanja Damjanov; Francesco Del Galdo; Christopher P Denton; Jörg H W Distler; Ivan Foeldvari; Kim Figelstone; Marc Frerix; Daniel E Furst; Serena Guiducci; Nicolas Hunzelmann; Dinesh Khanna; Marco Matucci-Cerinic; Ariane L Herrick; Frank van den Hoogen; Jacob M van Laar; Gabriela Riemekasten; Richard Silver; Vanessa Smith; Alberto Sulli; Ingo Tarner; Alan Tyndall; Joep Welling; Frederic Wigley; Gabriele Valentini; Ulrich A Walker; Francesco Zulian; Ulf Müller-Ladner Journal: Ann Rheum Dis Date: 2016-11-09 Impact factor: 19.103
Authors: D Walter Wray; Melissa A H Witman; Stephen J Ives; John McDaniel; Joel D Trinity; Jamie D Conklin; Mark A Supiano; Russell S Richardson Journal: Hypertension Date: 2013-06-17 Impact factor: 10.190
Authors: Daniel R Machin; Heather L Clifton; Russell S Richardson; D Walter Wray; Anthony J Donato; Tracy M Frech Journal: Clin Exp Rheumatol Date: 2017-09-14 Impact factor: 4.473