Assessment of peripheral vascular endothelial function in the ambulatory setting
Assessment of peripheral vascular endothelial function in the ambulatory setting
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DOI：
10.1177/1358863x06076227
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发表时间：
2007-01-01
影响因子：
3.5
通讯作者：
Karas, Richard H.
中科院分区：
文献类型：
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作者：
Kuvin, Jeffrey T.;Mammen, Anish;Karas, Richard H.
到目前为止，外周血管内皮功能测试已在研究实验室中在高度受控的条件下进行，从而限制了其临床适用性。在这项研究中，我们评估了两个外周血管床的内皮功能之前和期间的反应性充血在门诊设置。用便携式超声设备对肱动脉进行成像，血管直径的变化表示为血流介导的扩张百分比（%FMD）。通过外周动脉张力计（PAT）检测手指脉搏波振幅，PAT充血定义为与基线相比的最大体积描记图记录。入组了60名个体（43名男性），平均年龄为53 ± 2岁（平均值± SE）。31名有两个以上心脏危险因素（CRF）的患者的FMD（7.0 +/- 1.1%）和PAT充血（2.1 +/- 0.9）低于29名有0-2个CRF的患者（FMD 11.3 +/-0.8%，PAT充血2.4 +/- 0.1;两者p < 0.05）。32名冠心病患者的FMD（6.8 +/- 1.1%）和PAT充血（2.0 +/- 0.1）低于28名非冠心病患者（FMD 11.5 +/-0.8%，PAT充血2.4 +/- 0.1;两者p < 0.05）。因此，在门诊环境中进行外周血管内皮功能检测与CAD风险的程度以及是否存在CAD相关。总之，这些数据表明，外周血管内皮功能测试是可行的，在门诊患者，这是一个重要的下一步，使这项技术的临床应用。
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 +/- 2 years (mean +/- SE). The 31 individuals with more than two cardiac risk factors (CRF) had lower FMD (7.0 +/- 1.1%) and PAT hyperemia (2.1 +/- 0.9) compared to the 29 individuals with 0-2 CRF (FMD 11.3 +/- 0.8%, PAT hyperemia 2.4 +/- 0.1; p < 0.05 for both). The 32 individuals with coronary artery disease (CAD) had lower FMD (6.8 +/- 1.1%) and PAT hyperemia (2.0 +/- 0.1) compared to the 28 individuals without CAD (FMD 11.5 +/- 0.8%, PAT hyperemia 2.4 +/- 0.1; p < 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.