指端反应性充血评估早期冠脉粥样硬化.pdfVIP

ARTICLE IN PRESS Journal of the American College of Cardiology Vol. 44, No. 11, 2004 © 2004 by the American College of Cardiology Foundation ISSN 0735-1097/04/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2004.08.062 Coronary Artery Disease Noninvasive Identification of Patients With Early Coronary Atherosclerosis by Assessment of Digital Reactive Hyperemia Piero O. Bonetti, MD,* Geralyn M. Pumper, RN,* Stuart T. Higano, MD, FACC,* David R. Holmes, JR, MD, FACC,* Jeffrey T. Kuvin, MD, FACC,† Amir Lerman, MD, FACC* Rochester, Minnesota; and Boston, Massachusetts OBJECTIVES We investigated the value of reactive hyperemia peripheral arterial tonometry (RH-PAT) as a noninvasive tool to identify individuals with coronary microvascular endothelial dysfunction. BACKGROUND Coronary endothelial dysfunction, a systemic disorder, represents an early stage of athero- sclerosis; RH-PAT is a technique to assess peripheral microvascular endothelial function. METHODS Using RH-PAT, digital pulse volume changes during reactive hyperemia were assessed in 94 patients without obstructive coronary artery disease and either normal (n 39) or abnormal (n 55) coronary microvascular endothelial function; RH-PAT index, a measure of reactive hyperemia, was calculated as the ratio of the digital pulse volume during reactive hyperemia divid