Abstract
Measurement of endothelial function using peripheral arterial tonometry (PAT) has been reported to be significantly correlated with coronary blood flow. Repetitive PAT measurements were performed in 22 healthy male subjects at test intervals of 1 hour (5 times within a day) and 0.5 hours (7 times within a day) to evaluate the variability of the reactive hyperemia index (RHI). A total of 10 subjects underwent additional repetitive PAT at 2 hour intervals (7 times within a day) for 3 consecutive days to evaluate the diurnal effects and day‐to‐day reproducibility. The RHI from each test was computed automatically based on a 15 minute recording of pulse wave amplitude changes of the fingers in response to reactive hyperemia induced by a 5 minute occlusion of the brachial artery. Intrasubject variability of RHI at different test intervals, defined as the coefficient of variation (CV) was 15.3% ± 5.3%, 16.1%± 7.8%, and 22.6% ± 3.9% for the tests at 0.5 hour, 1 hour, and 2 hour intervals, respectively. Reactive hyperemia indices measured at the same time points on each of the 3 days were not statistically significant. The interday reproducibility, presented as intraclass correlation coefficients (ICC) ranged from − 0.07 to 0.47. We conclude that repetitive PAT measurements have no carryover effect on RHI at 1 hour, and 2 hour intervals, and the RHI measured at 0.5 hour intervals is associated with a trend of increase. The interday reproducibility is relatively low and the intrasubject variability of RHI is similar to those observed in studies of flow‐mediated dilation using brachial artery ultrasound scanning. Copyright © 2009 Wiley Periodicals, Inc.
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References
- 1. Celermajer D. Endothelial function: does it matter? Is it reversible? J Am Coll Cardiol 1997; 30: 325–333. [DOI] [PubMed] [Google Scholar]
- 2. Vane J, Anggard E, Botting R. Regulatory function of the vascular endothelium. N Engl J Med 1990; 323: 27–36. [DOI] [PubMed] [Google Scholar]
- 3. Kuvin JT, Patel AR, Sliney KA, et al. Peripheral vascular endothelial function testing as a noninvasive indicator of coronary artery disease. J Am Coll Cardiol 2001; 38: 1843–1849. [DOI] [PubMed] [Google Scholar]
- 4. Bonetti PO, Pumper GM, Higano ST, Holmes DR Jr. Kuvin JT, Lerman A. Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol 2004; 44: 2137–2141. [DOI] [PubMed] [Google Scholar]
- 5.US Food and Drug Administration. 510(K) SUMMARY ITAMAR MEDICAL. 510(k) Number KO32519, November 12, 2003. http://www.fda.gov/cdrh/pdf3/k032519.pdf. Accessed December 12, 2007.
- 6. Kuvin JT, Patel AR, Sliney KA, et al. Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude. Am Heart J 2003; 146: 168–174. [DOI] [PubMed] [Google Scholar]
- 7. Bonetti PO, Barsness GW, Keelan PC, et al. Enhanced external counterpulsation improves endothelial function in patients with symptomatic coronary artery disease. J Am Coll Cardiol 2003; 41: 1761–1768. [DOI] [PubMed] [Google Scholar]
- 8. McGraw KO, Wong SP. Forming inferences about some intraclass correlation coefficients. Psychological Methods 1996; 1: 30–46. [Google Scholar]
- 9. Liang YL, Teede H, Kotsopoulos D, et al. Non‐invasive measurements of arterial structure and function: repeatability, interrelationships and trial sample size. Clin Sci 1998; 95: 669–679. [DOI] [PubMed] [Google Scholar]
- 10. Herrington DM, Fan L, Drum M, et al. Brachial flow‐mediated vasodilator responses in population‐based research: methods, reproducibility and effects of age, gender and baseline diameter. J Cardiovasc Risk 2001. 8: 319–328. [DOI] [PubMed] [Google Scholar]
- 11. De Roos NM, Bots ML, Schouten EG, Katan MB. Within‐subject variability of flow‐mediated vasodilation of the brachial artery in healthy men and women: implications for experimental studies. Ultrasound Med Bio 2003; 29: 401–406. [DOI] [PubMed] [Google Scholar]
- 12. Malik J, Wichterle D, Haas T, et al. Repeatability of noninvasive surrogates of endothelial function. Am J Cardiol 2004; 94: 693–696. [DOI] [PubMed] [Google Scholar]
- 13. Brook R, Grau M, Kehrer C, et al. Intrasubject variability of radial artery flow‐mediated dilatation in healthy subjects and implications for use in prospective clinical trials. Am J Cardiol 2005; 96: 1345–1348. [DOI] [PubMed] [Google Scholar]
- 14. Harris RA, Padilla J, Rink LD, et al. Variability of flow‐mediated dilation measurements with repetitive reactive hyperemia. Vasc Med 2006; 11: 1–6. [DOI] [PubMed] [Google Scholar]
- 15. Etsuda H, Takase B, Uehata A, et al. Morning attenuation of endothelium‐dependent, flow‐mediated dilation in healthy young men: possible connection to morning peak of cardiac events? Clin Cardiol 1999; 22: 417–421. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 16. Otto ME, Svatikova A, Barretto RB, et al. Early morning attenuation of endothelial function in healthy humans. Circulation 2004; 109: 2507–2510. [DOI] [PubMed] [Google Scholar]