Key result
Forearm vasoreactivity to acetylcholine was significantly related to the coronary response to acetylcholine (P=0.039), whereas flow-mediated dilation was not related to either.
Why the study?
Does forearm vasoreactivity correlate with coronary endothelial response in patients referred for diagnostic coronary angiography?
Observational (n=28)
Does forearm vasoreactivity correlate with coronary endothelial response in patients referred for diagnostic coronary angiography?
p-value: p=0.039
Forearm vasoreactivity to acetylcholine correlates with coronary endothelial response, whereas flow-mediated dilation does not, suggesting the stimulus type is critical when assessing endothelial dysfunction.
Forearm acetylcholine response may indicate coronary endothelial function; leaves open validation against FMD in prospective cohorts.
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. CONCLUSION: In patients with mild coronary endothelial dysfunction, forearm vasoreactivity is related to the coronary response, provided that the same stimulus is used.
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Monnink et al. (2002) conducted an observational in Coronary Artery Disease (n=28). Endothelial function tests (coronary diameter response to acetylcholine, FBF, FMD) was evaluated on Relationship between the effect of acetylcholine on forearm resistance vessels and coronary conduit vessels (p=0.039). Forearm vasoreactivity to acetylcholine was significantly related to the coronary response to acetylcholine (P=0.039), whereas flow-mediated dilation was not related to either.
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