Assessment of peripheral vascular endothelial function in the ambulatory setting

Abstract

Until now, peripheral vascular endothelial function testing has been performed in research laboratories under highly controlled conditions, thus limiting its clinical applicability. In this study, we evaluated endothelial function in two peripheral vascular beds before and during reactive hyperemia in an outpatient clinic setting. The brachial artery was imaged with a portable ultrasound device and changes in vessel diameter were expressed as percent flow-mediated dilation (%FMD). Pulse wave amplitude of the finger was detected by peripheral arterial tonometry (PAT) and PAT hyperemia was defined as the maximal plethysmographic recording compared to baseline. Sixty individuals (43 men) were enrolled with an average age 53 Ϯ 2 years (mean Ϯ SE). The 31 individuals with more than two cardiac risk factors (CRF) had lower FMD (7.0 Ϯ 1.1%) and PAT hyperemia (2.1 Ϯ 0.9) compared to the 29 individuals with 0-2 CRF (FMD 11.3 Ϯ 0.8%, PAT hyperemia 2.4 Ϯ 0.1; p Ͻ 0.05 for both). The 32 individuals with coronary artery disease (CAD) had lower FMD (6.8 Ϯ 1.1%) and PAT hyperemia (2.0 Ϯ 0.1) compared to the 28 individuals without CAD (FMD 11.5 Ϯ 0.8%, PAT hyperemia 2.4 Ϯ 0.1; p Ͻ 0.05 for both). Thus, peripheral vascular endothelial function testing in the ambulatory setting correlates with the extent of CAD risk and the presence or absence of CAD. In conclusion, these data suggest that peripheral vascular endothelial function testing is feasible in ambulatory patients, and this is an important next step in bringing this technology to clinical applicability.

Short-term Physical Inactivity Impairs Vascular Function

“…Arterial stiffness, like FMD, has been shown to be an independent predictor for increased cardiovascular risk. 14,67,68 A dynamic relationship between these two physiologic parameters has been suggested, 14,[69][70][71][72] and an association could explain how both endothelial cell dysfunction and arterial stiffness are related to worse cardiovascular outcomes. It should be emphasized that our evaluation of arterial resistance is based on non-invasive measurements made with an applanation tonometry device; consequently, the overall arterial stiffening that we observed during the 5 days of BR is likely functional and reversible.…”

Endothelial Function In Stroke Subtypes Using EndoPAT Technology.

“…Quantitative determination of endothelial function was percentages were calculated using a computerized algorithm of the EndoPAT 2000 software system [12]. As this value changes with the heart rate, the device gives the normalized value at 75 bpm, the AI@75 [13].…”

Association Between Endothelial Dysfunction and Acute Brain Dysfunction During Critical Illness

“…Originally validated against coronary angiography, 18;19 the Endo_PAT has also been used to evaluate endothelial function in patients with coronary artery disease, atherosclerosis, hypertension, congestive heart failure, schizophrenia, sepsis, and many other disease processes. [20][21][22][23][24][25] With the participant lying supine in bed with both hands located at the level of the heart, a pneumatic finger probe was placed on each hand to perform a plethysmographic recording of the finger arterial pulse wave amplitude. Baseline pulse wave amplitude measurements were obtained for 5 minutes.…”