Cutaneous microvascular responses to physiological stimuli are currently being investigated as indices of vascular function and to monitor responses to therapy. We attempted to systematically assess various microvascular cutaneous flow indices in response to reactive hyperaemia in control subjects and in patients with coronary artery disease (CAD), and to correlate these with brachial artery flow-mediated dilation (FMD). Groups of 24 healthy controls and 24 subjects with CAD underwent sequential brachial FMD determination in the dominant arm, and laser Doppler imaging to assess skin blood flow in the contralateral arm in response to reactive hyperaemia induced by cuff inflation and release. Laser Doppler values were expressed as: (a) AUC5min (area under the curve over 5min of release), (b) time to peak response, (c) % reactive hyperaemia, and (d) peak perfusion ratio. As expected, FMD was attenuated in CAD patients compared with controls (1.85±4.29% compared with 4.30±4.00%; P = 0.05). Percentage reactive hyperaemia (CAD, 294±290%; controls, 501±344%; P = 0.04) and the time to peak response as measured by laser Doppler imaging (CAD, 16.84±9.61s; controls, 9.13±4.43s; P = 0.001) were significantly different between the CAD and control groups, while AUC5min and the peak perfusion ratio did not show significant differences. Receiver operator curves for sensitivity/specificity analysis suggested that the time to peak response derived by laser Doppler imaging was superior to FMD for the diagnosis of CAD, with an overall specificity of 91.3% (positive predictive value of 89.4%) and a sensitivity of 73.7% (negative predictive value of 77.6%). In conclusion, laser Doppler-derived indices of microvascular flow do not correlate with conduit vessel responses. However, a time to peak response of >10s as measured by laser Doppler imaging offers superior specificity for the diagnosis of CAD compared with brachial FMD.
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Research Article|
August 13 2002
Altered cutaneous microvascular responses to reactive hyperaemia in coronary artery disease: a comparative study with conduit vessel responses
Qurratul Aine SHAMIM-UZZAMAN;
Qurratul Aine SHAMIM-UZZAMAN
1
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Dana PFENNINGER;
Dana PFENNINGER
1
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Christine KEHRER;
Christine KEHRER
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Anjan CHAKRABARTI;
Anjan CHAKRABARTI
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Nico KACIROTTI;
Nico KACIROTTI
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Melvyn RUBENFIRE;
Melvyn RUBENFIRE
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Robert BROOK;
Robert BROOK
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
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Sanjay RAJAGOPALAN
1Department of Internal Medicine, and Section of Vascular Medicine, University of Michigan School of Medicine, Ann Arbor, MI, U.S.A.
Correspondence: Dr Sanjay Rajagopalan, Section of Vascular Medicine, Division of Cardiology, L3119 Women's Hospital, 1500E. Medical Center Drive, Ann Arbor, MI 48109-0273, U.S.A. (e-mail [email protected]).
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Publisher: Portland Press Ltd
Received:
December 13 2001
Revision Received:
March 25 2002
Accepted:
June 11 2002
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2002
2002
Clin Sci (Lond) (2002) 103 (3): 267–273.
Article history
Received:
December 13 2001
Revision Received:
March 25 2002
Accepted:
June 11 2002
Citation
Qurratul Aine SHAMIM-UZZAMAN, Dana PFENNINGER, Christine KEHRER, Anjan CHAKRABARTI, Nico KACIROTTI, Melvyn RUBENFIRE, Robert BROOK, Sanjay RAJAGOPALAN; Altered cutaneous microvascular responses to reactive hyperaemia in coronary artery disease: a comparative study with conduit vessel responses. Clin Sci (Lond) 1 September 2002; 103 (3): 267–273. doi: https://doi.org/10.1042/cs1030267
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