Irrespective of the presence or not of type 2 diabetes, capillary density is normal in hypertensive patients with reasonable control of blood pressure achieved with a blocker of the renin-angiotensin system.

Key message: The possibility of potentially serious cardiac complications after sclerotherapy for varicose veins has to be kept in mind. Chest symptoms lasting longer than 5 minutes or with typical features of acute coronary syndrome have to be investigated.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp he endothelium plays an important role in controlling arterial vasomotion and its function is crucial in cardiovascular event-free survival. 1,2 Altered endothelium-dependent coronary vasoreactivity is considered the earliest stage of coronary atherosclerosis. 3 The influence of numerous cardiovascular risk factors on coronary vasomotion has been invasively studied by coronary angiography, whereby endothelial vasomotor dysfunction results in both impaired myocardial blood flow (MBF) and cross-sectional artery area changes in response to intracoronary acetylcholine infusion 4 or cold pressor testing (CPT). 5,6 Whereas quantitative angiography allows assessment of both MBF and cross-sectional artery area, it has a procedure-associated morbidity (1.5%) and mortality (0.15%) that prevents its use in a low-risk coronary artery disease (CAD) probability population. 7 Non-invasive techniques have been developed, assuming that peripheral artery vasoreactivity reflects coronary artery vasoreactivity, 8 but their reproducibility and repeatability are limited. 9,10 Quantitative positron emission tomography (PET) using different positron emitting radiotracers 11 allows non-invasive assessment of the in vivo myocardial microvasculature 12 with good reproducibility and repeatability. 13-16 PET assessment of MBF has been found to be well suited for the evaluation of endothelium-dependent vasoreactivity discharge when combined with a sympathetic stress test such as CPT. During this test, coldinduced pain leads to a discharge of catecholamines, which have a direct vasoconstrictive effect on the vascular smooth muscle with an increase in myocardial oxygen consumption, the rate-pressure product (RPP). This increases vascular wall shear stress, finally causing the release of the potent vasodila- Background: Positron emission tomography (PET) during the cold pressor test (CPT) has been used to assess endothelium-dependent coronary vasoreactivity, a surrogate marker of cardiovascular events. However, its use remains limited by cardiac PET availability. As multidetector computed tomography (MDCT) is more widely available, we aimed to develop a measurement of endothelium-dependent coronary vasoreactivity with MDCT and similar radiation burden as with PET.

No abstract

No abstract