title: Endothelial dysfunction in patients with coronary artery disease: a comparison of three frequently reported tests.
abstract: BACKGROUND
  Endothelial dysfunction is useful in predicting future cardiovascular disease. At present several tests are available to test endothelial function: coronary diameter response to acetylcholine, forearm bloodflow (FBF) response to acetylcholine, and brachial artery flow-mediated dilative (FMD) response to postischemic hyperemia. This study aimed to compare the three most frequently reported endothelial function tests.
  
  
  METHODS
  Twenty-eight patients (19 males and nine females, mean age 57 years) referred for diagnostic coronary angiography were considered for endothelial function measurement in the coronary artery as well as in the forearm by FBF and FMD.
  
  
  RESULTS
  Acetylcholine decreased the mean coronary diameter by 7.4% (SD 6.3%) and increased the mean FBF by 230% (SD 152%). Hyperemia increased the mean brachial diameter by 6.7% (SD 4.8%). The effect of acetylcholine on forearm resistance vessels was significantly related to the effect of acetylcholine on the coronary conduit vessels (P=0.039). Nonetheless, FMD was not related to FBF nor to the coronary response.
  
  
  CONCLUSIONS
  In patients with mild coronary endothelial dysfunction, forearm vasoreactivity is related to the coronary response, provided that the same stimulus is used.
authors.affiliation: Department of Cardiology, Thoraxcenter, University Hospital Groningen, The Netherlands.
authors.forename: Stefan H J
authors.initials: SH
authors.lastname: Monnink
authors.forename: Paul L
authors.initials: PL
authors.lastname: van Haelst
authors.forename: Ad J
authors.initials: AJ
authors.lastname: van Boven
authors.forename: Erik S G
authors.initials: ES
authors.lastname: Stroes
authors.forename: René A
authors.initials: RA
authors.lastname: Tio
authors.forename: Thijs W M
authors.initials: TW
authors.lastname: Plokker
authors.forename: Andries J
authors.initials: AJ
authors.lastname: Smit
authors.forename: Nic J G M
authors.initials: NJ
authors.lastname: Veeger
authors.forename: Harry J G M
authors.initials: HJ
authors.lastname: Crijns
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
mesh_terms: D000109:Acetylcholine; D000368:Aged; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D003331:Coronary Vessels / Q000187:drug effects / Q000503:physiopathology; D003935:Diagnostic Techniques, Cardiovascular; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
chemical_list: D000109:Acetylcholine