| Digital assessment of endothelial function and ischemic heart disease in women. | |
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MedLine Citation:
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PMID: 20394872 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We investigated the utility of digital reactive hyperemia peripheral arterial tonometry (RH-PAT) in predicting ischemic heart disease (IHD), including obstructive coronary artery disease (CAD) and nonobstructive coronary artery disease (NOCAD), in women. BACKGROUND: IHD is the leading cause of mortality, and its pathogenesis is diverse in women. Fingertip RH-PAT is a new device that provides noninvasive, automatic, and quantitative evaluation of endothelial dysfunction. METHODS: RH-PAT was measured using Endo-PAT2000 (Itamar Medical, Caesarea, Israel) before cardiac catheterization in 140 stable women scheduled for hospitalization to examine chest pain. NOCAD was diagnosed by angiography with measurement of coronary blood flow and cardiac lactate production during intracoronary acetylcholine provocation test and cardiac scintigraphy with stress tests. RESULTS: Sixty-eight women (49%) had obstructive CAD and 42 women (30%) had NOCAD. RH-PAT indexes were significantly attenuated in both obstructive CAD and NOCAD as compared with non-IHD (n = 30) (obstructive CAD: median 1.57, interquartile range [IQR] 1.42 to 1.76; NOCAD: median 1.58, IQR 1.41 to 1.78; non-IHD: median 2.15, IQR 1.85 to 2.48, p < 0.001). By multivariate logistic regression analysis, only RH-PAT index was significantly associated with IHD, including obstructive CAD and NOCAD (odds ratio 0.51; 95% confidence interval: 0.38 to 0.68; p < 0.001). In receiver-operating characteristic analysis, RH-PAT index was a significant predictor of IHD (area under the curve 0.86; p < 0.001). Furthermore, only RH-PAT was useful for the prediction of NOCAD after excluding obstructive CAD (area under the curve 0.85; p < 0.001; RH-PAT index of <1.82 had 81% sensitivity and 80% specificity). CONCLUSIONS: RH-PAT indexes were significantly attenuated in women with IHD. Digital RH-PAT can predict patients with IHD, especially NOCAD before angiography. RH-PAT is potentially useful for identifying high-risk women for IHD. (Endothelial Dysfunction and Coronary Artery Spasm; NCT00619294). |
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Authors:
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Yasushi Matsuzawa; Seigo Sugiyama; Koichi Sugamura; Toshimitsu Nozaki; Keisuke Ohba; Masaaki Konishi; Junichi Matsubara; Hitoshi Sumida; Koichi Kaikita; Sunao Kojima; Yasuhiro Nagayoshi; Megumi Yamamuro; Yasuhiro Izumiya; Satomi Iwashita; Kunihiko Matsui; Hideaki Jinnouchi; Kazuo Kimura; Satoshi Umemura; Hisao Ogawa |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 55 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-16 Completed Date: 2010-06-15 Revised Date: 2012-06-27 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1688-96 Citation Subset: AIM; IM |
Copyright Information:
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Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00619294 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acetylcholine
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diagnostic use Aged Automatic Data Processing / methods* Cholinergic Agents / diagnostic use Coronary Angiography Electrocardiography Endothelium, Vascular / physiopathology* Female Fingers / blood supply* Heart Catheterization Humans Hyperemia / chemically induced, physiopathology* Manometry / methods* Middle Aged Myocardial Ischemia / diagnosis, physiopathology* Predictive Value of Tests Tomography, Emission-Computed, Single-Photon Vasodilation / physiology* |
| Chemical | |
Reg. No./Substance:
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0/Cholinergic Agents; 51-84-3/Acetylcholine |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2010 Apr 20;55(16):1697-9
[PMID:
20394873
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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