Endothelial function estimated by digital reactive hyperemia in patients with atherosclerotic risk factors or coronary artery disease

Heart Vessels. 2018 Jul;33(7):706-712.

Endothelial function estimated by digital reactive hyperemia in patients with atherosclerotic risk factors or coronary artery disease.

Kang J1,2, Kim HL1, Seo JB1,  Lee JY1, Moon MK1,2, Chung WY3,4.

Author information

1 Seoul National University, Boramae Medical Center, Seoul, South Korea.
2 Seoul National University, College of Medicine, Seoul, South Korea.
3 Seoul National University, Boramae Medical Center, Seoul, South Korea.
4 Seoul National University, College of Medicine, Seoul, South Korea. chungwy3023@gmail.com.

Abstract

Due to the complex profile of atherosclerotic risk factors, an integrated analysis of a specific individual is difficult. Endothelial function reflects a composite of various risk factors, and may be used as an optimal tool to estimate the overall atherosclerotic risk. In this study, we investigated the value of digital Reactive Hyperemia  Index (RHI) in an actual population with multiple atherosclerotic risk factors or coronary artery disease (CAD). A total of 417 patients from the Seoul National University Boramae Medical Center RHI registry were enrolled in this study. Patients were enrolled from January, 2013 to July, 2016. RHI was measured using the EndoPAT2000 system (Itamiar Medical Inc. Israel). The mean value of RHI was 1.67 ± 0.48 in total study population. Among various atherosclerotic risk factors, RHI was significantly lower in older (> 60 years) patients, diabetics, smokers’ patients on statin therapy, and those with coronary or cerebrovascular disease. Most of these findings were consistent after adjustment with multiple regression analysis. RHI was significantly associated with CAD, with a hazard ratio of 1.80 (95% confidence interval 1.15-2.80, p = 0.010). In the subgroup with CAD, current smoking was the only finding showing a lower RHI. Brachial-ankle pulse wave velocity, which is a surrogate marker of arterial atherosclerotic change, was not correlated with RHI in patients with clinically significant atherosclerotic disease. RHI was significantly reduced by major atherosclerotic risk factors and in clinical atherosclerotic disease. RHI may reflect a composite effect of risk factors pertaining to the endothelial function.

KEYWORDS:

Atherosclerosis; Coronary artery disease; Endothelial dysfunction; Reactive Hyperemia Index                     

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