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Comparative Study
. 2018 May 4;18(1):81.
doi: 10.1186/s12872-018-0821-5.

A new method for the assessment of endothelial function with peripheral arterial volume

Affiliations
Comparative Study

A new method for the assessment of endothelial function with peripheral arterial volume

Daoyuan Si et al. BMC Cardiovasc Disord. .

Abstract

Background: Currently, many methodological approaches have been developed to assess peripheral endothelial function. However, a development of the noninvasive and automated technique for routinely assessing endothelial function is still required. We evaluated the potential value of a new method to measure peripheral endothelial function with reactive hyperemia peripheral arterial volume (RH-PAV) in patients with chest pain.

Methods: We used a novel oximeter-like probe to detect the peripheral arterial volume (PAV) of the finger and compared it with brachial flow-mediated dilation (FMD) performed in 93 consecutive patients with chest pain. The RH-PAV index was defined as the ratio of the digital pulse volume during reactive hyperemia relative to the baseline.

Results: Ninety-three patients (53 men, 58 ± 5 years) completed the study, and 53 patients demonstrated coronary artery disease (CAD) following scheduled coronary angiography. There was a moderate linear relationship between PAV and FMD (r = 0.69, p < 0.01). Similar to FMD, PAV was more impaired in patients who have more cardiovascular risk factors (CRFs). The subjects with CAD had lower PAV and FMD, compared with those without CAD (1.05 ± 0.23 VS. 1.41 ± 0.37, p < 0.01; 6.7% ± 2.9% VS. 10.4% ± 2.9%, p < 0.01, respectively), and the relationships between FMD and PAV were also significant in both CAD (r = 0.54, p < 0.01) and non-CAD (r = 0.62, p < 0.01) patients.

Conclusions: Endothelial function of digital artery assessed with the novel PAV method demonstrated a profile similar to that of brachial artery measured with FMD. The hyperemia PAV was decreased by factors which were considered to impair endothelial function, suggesting that PAV has the potential to be a novel method to study endothelial function.

Keywords: Endothelial function; Flow mediated dilation; Noninvasive measurement; Peripheral arterial volume; Photoplethysmography.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the ethical review board of China-Japan Union Hospital of Jilin University (2017040603). All individuals signed the written informed consents to the use of their clinical data for the purpose of research in the study.

Competing interests

Author Ping Yang has been a consultant for Saintyear Medical Ltd., which owns patent rights to PAV technique. Other authors have nothing to disclose.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a setup of PAV testing, b and c, from the side undergoing hyperemia. d from the contralateral side. b Individual with non-CAD and fewer CRFs showing an increased PAV signal during hyperemia. C, Individual with CAD and more CRFs showing a blunted PAV response during hyperemia. D, PAV recording from the same patient with CAD and more CRFs in contralateral side
Fig. 2
Fig. 2
a Linear regression evaluation of the relation between PAV index and FMD of the brachial artery in all patients (r = 0.69, P < 0.01). b Linear regression evaluation of relation between PAV index and FMD in CAD(r = 0.54, P < 0.01, n = 53) and non-CAD (r = 0.62, P < 0.01, n = 40) population
Fig. 3
Fig. 3
Similar to brachial artery FMD, the PAV index generally correlated with the numbers of CRFs (r = 0.53, P < 0.01 for FMD, r = 0.45, P < 0.01 for PAV). Values are expressed as the mean ± SD
Fig. 4
Fig. 4
ROCs of FMD and PAV for the prediction of coronary heart disease

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