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The comparison of endothelial function between conduit artery and microvasculature in patients with coronary artery disease
Affiliations- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan
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Abstract
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.
Abstract
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.
Keywords
flow mediated-dilation, reactive hyperemia-peripheral arterial tonometry, reactive hyperemia index, vascular endothelial function, coronary artery disease
About this articleTitle
The comparison of endothelial function between conduit artery and microvasculature in patients with coronary artery disease
Journal
Issue
Pages
38-46
Published online
2018-08-14
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2497
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915
DOI
Pubmed
Bibliographic record
Cardiol J 2020;27(1):38-46.
Keywords
flow mediated-dilation
reactive hyperemia-peripheral arterial tonometry
reactive hyperemia index
vascular endothelial function
coronary artery disease
Authors
Emi Tajima
Masashi Sakuma
Seiko Tokoi
Hisae Matsumoto
Fumiya Saito
Ryo Watanabe
Shigeru Toyoda
Shichiro Abe
Teruo Inoue
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