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. 2022 Feb 4:39:100960.
doi: 10.1016/j.ijcha.2022.100960. eCollection 2022 Apr.

A novel operator-independent noninvasive device for assessing arterial reactivity

Kellen A Knowles  1 , Kerry J Stewart  2 , Joseph Tejan  1 , Pamela Ouyang  2 , Elizabeth V Ratchford  2 , Laura Sullam  2 , Kathy Magliato  3 , Michael D Whitt  4 , Harry A Silber  2
Affiliations

A novel operator-independent noninvasive device for assessing arterial reactivity

Kellen A Knowles et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Endothelial dysfunction is associated with increased risk of cardiovascular disease (CVD). Currently available noninvasive methods of measuring endothelial function have limitations. We tested a novel device that provides an automated measurement of the difference between baseline and post-ischemic, hyperemia-induced, brachial arterial compliance, a phenomenon known to be endothelium-dependent. The association between the calculated index, Flow-mediated Compliance Response (FCR), and established CVD risk indices was determined.

Methods: Adults with CVD risk factors or known coronary artery disease (CAD) were enrolled. Framingham Risk Score (FRS) was calculated and presence of metabolic syndrome (MetSyn) was assessed. Carotid artery plaques were identified by ultrasound. Cardiorespiratory fitness was assessed by 6-minute walk test (6MWT). FCR was measured using the device.

Results: Among 135 participants, mean age 49.3 +/- 17.9 years, characteristics included: 48% female, 7% smokers, 7% CAD, 10% type 2 diabetes, 34% MetSyn, and 38% with carotid plaque. Those with MetSyn had 24% lower FCR than those without (p < 0.001). Lower FCR was associated with higher FRS percentile (r = -0.29, p < 0.001), more MetSyn factors (r = -0.30, p < 0.001), more carotid plaques (r = -0.22, p = 0.01), and lower 6MWT (r = 0.34, p < 0.0001).

Conclusion: FCR, an index of arterial reactivity obtained automatically using a novel, operator-independent device, was inversely associated with established CVD risk indices, increased number of carotid plaques, and lower cardiorespiratory fitness. Whether measuring FCR could play a role in screening for CVD risk and assessing whether endothelial function changes in response to treatments aimed at CVD risk reduction, warrants further study.

Keywords: 6MWT, 6-minute walk test; ANOVA, analysis of variance; Arterial compliance; CAD, coronary artery disease; CVD, cardiovascular disease; Cardiovascular disease; Cardiovascular risk factors; Endothelial dysfunction; Endothelium; FCR, flow-mediated compliance response; FMD, flow-mediated dilation; FRS, Framingham risk score; MetSyn, metabolic syndrome; PWA, pulse wave amplitude; SD, standard deviation.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Cordex SmartCuff™ System which includes a standardized blood pressure cuff, pulse oximeter, and main control unit.
Fig. 2
Fig. 2
Baseline and hyperemia arterial compliance curves. The area in gold color between the two curves in the positive arterial transmural pressure range represents the FCR.
Fig. 3
Fig. 3
Relationship between Flow-mediated Compliance Response score and Framingham Risk Score Percentile (r = -0.29, p < 0.001, N = 125).
Fig. 4
Fig. 4
Relationship between Flow-mediated Compliance Response score and number of metabolic syndrome factors (r = -0.30, p < 0.001, N = 134).
Fig. 5
Fig. 5
Relationship between Flow-mediated Compliance Response score and carotid plaque count (r = -0.22, p = 0.01, N = 132).
See this image and copyright information in PMC

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