DOC News February 1, 2005
Volume 2 Number 2 p. 22
© 2005 American Diabetes Association
Digital Diagnosis of Coronary Artery Disease
A simple noninvasive test of blood flow may serve as a means to screen for
early coronary atherosclerosis, according to a group of researchers from Mayo
Clinic in Rochester, Minn., and Tufts University Medical Center in Boston.
Investigators evaluated the utility of reactive hyperemia–peripheral
arterial tonometry (RH-PAT), a study of blood vessels in which circulation has
been stopped and restored. Endothelial dysfunction is an early stage of
coronary artery disease. Normally, when blood flow is disrupted and restored
to a limb there is a particular "signature" that is indicative of
vascular health.
The RH-PAT device was tested on 94 consecutive patients who were referred
for coronary angiography. A blood pressure cuff was placed on one upper arm,
while the other arm served as a control. Peripheral arterial tonometry probes
were placed on one finger of each hand. The blood pressure cuff was inflated
above systolic pressure for 5 minutes, then slowly deflated over a 10-minute
period of time while the RH-PAT probe measured the amplitude of the pulse
signals.
The average RH-PAT index was significantly higher among patients with
normal coronary artery endothelial function. "This study demonstrates
that patients with coronary microvascular endothelial dysfunction have a lower
peripheral hyperemic endothelial response," the authors report.
Bonetti PO, Pumper GM, Higano ST, et al.: Noninvasive
identification of patients with early coronary atherosclerosis by assessment
of digital reactive hyperemia. J Am Coll Cardiol 44: 2137–2141, 2004.[Abstract/Free Full Text]
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