Endothelial Function Assessed by Peripheral Arterial Tonometry is not related to Cardiovascular Risk Score in Healthy Subjects

Abstract

Background: The majority of first cases of myocardial infarction stem from those classified as intermediate- or low-risk in CV risk prediction calculators. Risk prediction models need to be refined in their capacity to discriminate high-risk from low-risk. Peripheral arterial tonometry (PAT) is a non-invasive method to assess peripheral endothelial function that could potentially improve primary prevention of CVD. Design We investigated the relation of PAT results to CV risk factors and risk score in a healthy cohort. Methods PAT measurements were performed on 102 individuals, with no previous history of CAD, attending a Risk Preventive Clinic. Traditional CV risk factors were evaluated and integrated into a CV risk score calculator. Outcome was expressed as absolute and relative 10- year risk of developing CVD. Results PAT results of reactive hyperemia index (RHI) and augmentation index (AI) had no statistically significant relation to risk score while baseline pulse amplitude was positively correlated with both absolute (p = 0.02) and relative (p = 0.02) 10-year risk of developing CVD. Among CV risk factors only heart rate was significantly associated with RHI (r = - 0.24, R2 = 0.06, p = 0.01). AI and baseline pulse amplitude both correlated with several risk factors. Conclusions Endothelial dysfunction, measured by PAT, was not associated with an increased 10-year risk of developing CVD. The relation between endothelial dysfunction and established CV risk factors was limited. Further clinical end point studies are needed to fully comprehend the diagnostic and predictive value of PAT measurements in healthy subjects.

Keywords

• Primary prevention
• Endothelial function
• Peripheral arterial tonometry
• Reactive hyperemia index
• Augmentation index
• Baseline pulse amplitude
• CV risk factors
• CV risk score