Assessing endothelial vasodilator function with the Endo-PAT 2000.
Assessing endothelial vasodilator function with the Endo-PAT 2000.
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DOI：
10.3791/2167
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发表时间：
2010-10-15
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影响因子：
--
通讯作者：
Cooke, John P
中科院分区：
文献类型：
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作者：
Axtell, Andrea L;Gomari, Fatemeh A;Cooke, John P
内皮是一种脆弱的单层细胞，排列在所有血管中，包括全身毛细血管和淋巴毛细血管。凭借其分泌的大量旁分泌因子，内皮细胞调节下面的血管平滑肌的收缩和增殖状态，以及血管壁与循环血液成分的相互作用。由于其在调节血管张力和生长中的核心作用、作为循环免疫细胞的门户的地位以及对止血和凝血的局部调节，功能正常的内皮是心血管健康的关键。相反，大多数血管疾病最早的紊乱是内皮功能障碍。在动脉循环中，健康的内皮通常对血管平滑肌产生血管舒张作用。有多种方法可以评估内皮血管舒张功能。 Endo-PAT 2000 是一种新设备，用于以快速、无创的方式评估内皮血管舒张功能。与评估血流介导的血管舒张的常用双超声检查技术不同，它完全不依赖于操作员，并且设备便宜一个数量级。该设备记录内皮介导的数字脉冲波形变化，称为 PAT（外周动脉张力）信号，通过位于每只手食指上的一对新型改良体积描记探针进行测量。内皮介导的 PAT 信号变化是通过产生下游充血反应引起的。通过使用一只手的充气袖带阻断流经肱动脉的血流 5 分钟来诱发充血。对反应性充血的反应由系统自动计算。 PAT 比率是使用遮挡后值和遮挡前值创建的。这些值被标准化为对侧臂的测量值，作为非内皮依赖性全身效应的对照。最值得注意的是，这种正常化控制了交感神经流出的波动，这可能会引起叠加在充血反应上的外周动脉张力的变化。在本视频中，我们演示了如何使用 Endo-PAT 2000 对内皮血管舒张功能进行临床相关评估。
The endothelium is a delicate monolayer of cells that lines all blood vessels, and which comprises the systemic and lymphatic capillaries. By virtue of the panoply of paracrine factors that it secretes, the endothelium regulates the contractile and proliferative state of the underlying vascular smooth muscle, as well as the interaction of the vessel wall with circulating blood elements. Because of its central role in mediating vessel tone and growth, its position as gateway to circulating immune cells, and its local regulation of hemostasis and coagulation, the the properly functioning endothelium is the key to cardiovascular health. Conversely, the earliest disorder in most vascular diseases is endothelial dysfunction. In the arterial circulation, the healthy endothelium generally exerts a vasodilator influence on the vascular smooth muscle. There are a number of methods to assess endothelial vasodilator function. The Endo-PAT 2000 is a new device that is used to assess endothelial vasodilator function in a rapid and non-invasive fashion. Unlike the commonly used technique of duplex ultra-sonography to assess flow-mediated vasodilation, it is totally non-operator-dependent, and the equipment is an order of magnitude less expensive. The device records endothelium-mediated changes in the digital pulse waveform known as the PAT (peripheral Arterial Tone) signal, measured with a pair of novel modified plethysmographic probes situated on the finger index of each hand. Endothelium-mediated changes in the PAT signal are elicited by creating a downstream hyperemic response. Hyperemia is induced by occluding blood flow through the brachial artery for 5 minutes using an inflatable cuff on one hand. The response to reactive hyperemia is calculated automatically by the system. A PAT ratio is created using the post and pre occlusion values. These values are normalized to measurements from the contra-lateral arm, which serves as control for non-endothelial dependent systemic effects. Most notably, this normalization controls for fluctuations in sympathetic nerve outflow that may induce changes in peripheral arterial tone that are superimposed on the hyperemic response. In this video we demonstrate how to use the Endo-PAT 2000 to perform a clinically relevant assessment of endothelial vasodilator function.