Endothelial Function In Stroke Subtypes Using EndoPAT Technology.

Caballero, Pedro Enrique Jiménez; Espuela, Fidel López; Portilla-Cuenca, Juan Carlos; Marrero, José Antonio Fermin; Naranjo, I. Casado

doi:10.14302/issn.2470-5020.jnrt-14-558

Cited by 2 publications

(4 citation statements)

References 27 publications

(20 reference statements)

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“…A prior cross-sectional study showed lower PAT ratio in patients who had an atherothrombotic compared with cardioembolic stroke. 16 Also, lower FMD has been associated with vascular events in patients with prior stroke. 44 Although stroke has been included in the composite outcome measures of several prior longitudinal studies of FMD and PAT response, 32 stroke was not separated as an individual outcome.…”

Section: Pat Ratio and Stroke Riskmentioning

confidence: 99%

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Digital Peripheral Arterial Tonometry and Cardiovascular Disease Events: The Framingham Heart Study

Cooper

Wang

Beiser

et al. 2021

Stroke

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Background and Purpose: Novel noninvasive measures of vascular function are emerging as subclinical markers for cardiovascular disease (CVD) and may be useful to predict CVD events. The purpose of our prospective study was to assess associations between digital peripheral arterial tonometry (PAT) measures and first-onset major CVD events in a sample of FHS (Framingham Heart Study) participants. Methods: Using a fingertip PAT device, we assessed pulse amplitude in Framingham Offspring and Third Generation participants (n=3865; mean age, 55±14 years; 52% women) at baseline and in 30-second intervals for 4 minutes during reactive hyperemia. The PAT ratio (relative hyperemia index) was calculated as the post-to-pre occlusion pulse signal ratio in the occluded arm, relative to the same ratio in the control (nonoccluded) arm, and corrected for baseline vascular tone. Baseline pulse amplitude and PAT ratio during hyperemia are measures of pressure pulsatility and microvascular function in the finger, respectively. We used Cox proportional hazards regression to relate PAT measures in the fingertip to incident CVD events. Results: During follow-up (median, 9.2 years; range, 0.04–10.0 years), 270 participants (7%) experienced new-onset CVD events (n=270). In multivariable models adjusted for cardiovascular risk factors, baseline pulse amplitude (hazard ratio [HR] per 1 SD, 1.04 [95% CI, 0.90–1.21]; P =0.57) and PAT ratio (HR, 0.95 [95% CI, 0.84–1.08]; P =0.43) were not significantly related to incident composite CVD events, including myocardial infarction or heart failure. However, higher PAT ratio (HR, 0.76 [95% CI, 0.61–0.94]; P =0.013), but not baseline pulse amplitude (HR, 1.15 [95% CI, 0.89–1.49]; P =0.29), was related to lower risk for incident stroke. In a sensitivity analysis by stroke subtype, higher PAT ratio was related to lower risk of incident ischemic stroke events (HR, 0.68 [95% CI, 0.53–0.86]; P =0.001). Conclusions: Novel digital PAT measures may represent a marker of stroke risk in the community.

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Section: Pat Ratio and Stroke Riskmentioning

confidence: 99%

“…Prior studies suggest the presence of abnormal endothelial function, including PAT responses in patients who have had strokes or in the presence of cerebrovascular disease. [14][15][16] Thus, we assessed associations between PAT measures and first-onset major CVD events, including stroke, in a sample of FHS (Framingham Heart Study) participants.…”

mentioning

confidence: 99%

Digital Peripheral Arterial Tonometry and Cardiovascular Disease Events: The Framingham Heart Study

Cooper

Wang

Beiser

et al. 2021

Stroke

View full text Add to dashboard Cite

show abstract

“…It is mandatory to apply this technique on larger cohorts of stroke patients to assess the relation between endothelial dysfunction and risk factors for stroke. In addition, studies investigating the association of this EF score with stroke subtypes are needed as this has only been investigated by studies with small sample sizes (23, 35). …”

Section: Discussionmentioning

confidence: 99%

“…Hence, FMD and EndoPAT probably reflect different aspects of vascular function in selected vascular beds and vessel size (5, 21). A study investigating the relationship of digital EF and stroke subtypes according to the TOAST classification (22) found variations in EF according to stroke subtypes with best EF in patients with cardioembolic stroke and worst in lacunar and large artery stroke (23). …”

Section: Introductionmentioning

confidence: 99%

Validation of Repeated Endothelial Function Measurements Using EndoPAT in Stroke

et al. 2017

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BackgroundDecreased endothelial function (EF) may be a prognostic marker for stroke. Measuring pharmacological effects on EF may be of interest in the development of personalized medicine for stroke prevention. In this study, we assessed the reliability of repeated EF measurements using a pulse amplitude tonometry technology in acute stroke patients. Similarly, reliability was tested in healthy subjects devoid of vascular disease to estimate reactivity and reliability in a younger non-stroke population.Materials and methodsEF was assessed using the EndoPAT2000 in 20 healthy volunteers (men 50%, mean age 35.85 ± 3.47 years) and 21 stroke patients (men 52%, mean age 66.38 ± 2.85 years, and mean NIHSS 4.09 ± 0.53) under standardized conditions. EF was measured as the reactive hyperemia index (RHI), logarithm of RHI (lnRHI), and Framingham RHI (fRHI). Measurements were separated by 1.5 and 24 h to assess same-day and day-to-day reliability, respectively.ResultsFair to moderate correlations of measurements [intraclass correlation coefficient (ICC)same-day 0.29 and ICCday-to-day 0.52] were detected in healthy subjects. In stroke patients, we found moderate to substantial correlation of both same-day and day-to-day repeated measurements (ICCsame-day 0.40 and ICCday-to-day 0.62). fRHI compared with RHI and lnRHI showed best reliability.ConclusionRepeated measurements of fRHI in stroke patients show moderate reliability on same-day and substantial on day-to-day measurements. Likewise, in healthy subjects there was substantial reliability on day-to-day measurement, but only moderate on same-day measurements. In general, day-to-day correlation of repeated EF measurements was far better than that of same-day measurements, which ranged from poor to moderate depending on the specific outcome measure of EF. A possible carryover effect should be considered if same-day repeated testing of drug effects is applied in future studies.

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Endothelial Function In Stroke Subtypes Using EndoPAT Technology.

Cited by 2 publications

References 27 publications

Digital Peripheral Arterial Tonometry and Cardiovascular Disease Events: The Framingham Heart Study

Digital Peripheral Arterial Tonometry and Cardiovascular Disease Events: The Framingham Heart Study

Validation of Repeated Endothelial Function Measurements Using EndoPAT in Stroke

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