Impaired hyperemic response of forearm vessels in patients with coronary artery disease. A non-invasive evaluation.
The blood flow velocity of the right brachial artery was measured noninvasively by pulsed Doppler flowmetry in 50 patients with angina pectoris. Reactive hyperemia was induced by a 2-minute occlusion of the artery by a tourniquet. We assessed the peak velocity ratio (PVR) and 50% recovery time (RT) which were defined as the ratio of maximal to baseline systolic peak velocity and as the interval from the resumption of arterial flow to 50% decline of the increased systolic peak velocity, respectively. Multiple regression analysis for determinants of PVR and 50% RT was performed with 7 variables which were age, sex, hypertension, diabetes mellitus, smoking, total cholesterol level, and the number of diseased coronary arteries. Multiple R was 0.649 (p < .01) for PVR and 0.682 (p < .01) for 50% RT. There were significant inverse correlations between PVR and the number of diseased vessels (t-value; -3.34), hypertension (-2.43) and smoking (-2.38). The 50% RT was inversely correlated with the number of diseased vessels (t-value; -4.45), feminine gender (-2.75) or smoking (-2.12). Stepwise regression analysis revealed that the number of diseased vessels was the only significant variable for the determination of PVR or 50% RT. An impairment of reactive hyperemia at the forearm vessel correlated with the severity of coronary artery disease in patients with angina pectoris. This finding suggests the presence of some identical mechanisms which are detrimental to both vascular beds. Observation of the hyperemic response at the brachial artery will provide a clue for noninvasive estimation of the extent of coronary artery disease.
Hirono
O
O
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Kubota
I
I
Shiga
R
R
Abe
S
S
Terashita
K
K
Tomoike
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology; D003327:Coronary Disease / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D006937:Hypercholesterolemia / Q000503:physiopathology; D006940:Hyperemia / Q000503:physiopathology*; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012907:Smoking / Q000503:physiopathology