title: Influence of transradial versus transfemoral diagnostic heart catheterisation on peripheral vascular endothelial function.
abstract: OBJECTIVE
  Endothelium dysfunction has been reported in patients (pts) undergoing transradial catheterisation. Alterations of the hand microcirculation possibly associated with systemic inflammation have never previously been reported. We aimed at investigating possible alteration of hand endothelial microcirculation secondary to transradial heart catheterisation.
  
  
  RESULTS
  We randomised 40 pts with stable angina undergoing coronary angiography to either transradial (TR, n=20) or transfemoral (TF, n=20) approach. At baseline (BL), 24 hours (24 hrs) and 30 days (FU: follow-up) after catheterisation we assessed: a) peripheral endothelial function (EndoScore [ES]) by peripheral arterial tonometry (EndoPAT); b) biomarkers of endothelial turnover (sE-Selectin) and inflammation (hs-CRP). No clinical or angiographic differences were observed between the two groups. At 24 hours, ES (BL: 0.42±0.27 vs. 24 hours: 0.27±0.19, p<0.05) significantly decreased in the TR group, but not in the TF group (BL: 0.44±0.34 vs. 24 hours: 0.45±0.39, n.s.). Both sE-Selectin and hs-CRP increased significantly at 24 hours in all pts. At 30 days, we observed in the TR group a restoration of ES (FU: 0.44±0.34, n.s. vs. BL; p<0.05 vs. 24 hours), while no difference was observed in the TF group. A reduction towards baseline was observed in both groups of sE-Selectin and hs-CRP.
  
  
  CONCLUSIONS
  A transient impairment of the digital microcirculatory endothelial function is observed in patients undergoing transradial diagnostic catheterisation, beyond local mechanical injury at the arterial access and on top of the systemic inflammatory response associated with heart catheterisation.
authors.affiliation: Cardiovascular Center Aalst OLV Clinic, Aalst, Belgium. emanuele.barbato@olvz-aalst.be
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Serafino
authors.forename: Stylianos A
authors.initials: SA
authors.lastname: Pyxaras
authors.forename: Fabio
authors.initials: F
authors.lastname: Mangiacapra
authors.forename: Karen
authors.initials: K
authors.lastname: Dierickx
authors.forename: Gabor
authors.initials: G
authors.lastname: Toth
authors.forename: Jozef
authors.initials: J
authors.lastname: Bartunek
authors.forename: Bernard
authors.initials: B
authors.lastname: De Bruyne
authors.forename: Carlos
authors.initials: C
authors.lastname: Van Mieghem
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.forename: Emanuele
authors.initials: E
authors.lastname: Barbato
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D060050:Angina, Stable / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001530:Belgium; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000276:immunology / Q000503:physiopathology*; D005260:Female; D005263:Femoral Artery; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008365:Manometry; D008833:Microcirculation; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011677:Punctures; D017534:Radial Artery / Q000276:immunology / Q000293:injuries / Q000503:physiopathology*; D013997:Time Factors; D057772:Vascular System Injuries / Q000097:blood / Q000276:immunology / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D019040:E-Selectin; D018836:Inflammation Mediators; C546936:SELE protein, human; D002097:C-Reactive Protein