Endothelial Peripheral Arterial Tonometry (Endo-PAT 2000) use in paediatric patients: a systematic review

Abstract

ObjectivesEndo Peripheral Artery Tonometry (EndoPAT-2000) is a non-invasive technology for measuring endothelial dysfunction (ED). The reactive hyperaemia index (RHI) is resulted and is low when ED is present. We aim to synthesise the literature on paediatric ED that used Endo-PAT analysis.DesignA comprehensive systematic review was conducted from January 2015 to March 2021. The databases included Cochrane, MEDLINE EBSCO, EMBASE (Ovid), PUBMED and CINAHL EBSCO. Exclusion criteria were: (1) If a study used a different device, for example, (2) If the study had no results. Inclusion criteria were: (1) Published in the English, (2) more than 50% of study subjects were in the paediatric age range, (3) data relevant to paediatric age range children could be extrapolated from all data, where not all study subjects were children.ResultsFollowing the removal of duplicates, 156 articles were initially identified. Following exclusion, 50 articles were included for review. We have subdivided these papers into different systems for ease of reference and have reported our findings in six tables: patients with type 1/2 diabetes, obesity, cardiovascular, respiratory, psychiatric conditions and miscellaneous diseases. For each, the study design, population, control group (if available), RHI results and conclusions were reported.ConclusionsA number of papers using Endo-PAT for children with various chronic diseases have evidence of ED. However, in many cases, there has only been a single cohort study using Endo-PAT. Further studies are required to validate these findings and to help characterise the cardiovascular risk profile of children with chronic disease. Further studies are also required that will characterise more completely the cardiovascular risk profile of these children.Consensus on other vascular risk markers that could be included in future studies is ideal and if accomplished, this would facilitate meta-analyses of studies of relatively rare conditions.

Toward Patient Centricity: Why Do Patients With Inflammatory Bowel Disease Participate in Pharmaceutical Clinical Trials? A Mixed-Methods Exploration of Study Participants

“…Other methods include the use of external control arms as an alternative to placebo. 21 , 22 However, establishing historical control groups is challenging in this field due to the frequent introduction of new treatments, and increasing inclusion of patients who have failed multiple therapies into clinical trials. 23 …”

Endothelial Dysfunction in Diabetes Mellitus: New Insights

“…The first option to assess ED is flow-mediated dilatation (FMD), where ED is characterized by less vasodilatation (reduced FMD) in the brachial artery. FMD is assessed using ultrasound to measure changes in brachial artery diameter in response to increased flow after a period of vascular occlusion caused by a blood pressure cuff and is highly dependent on NO bioavailability [ 23 ]. Endo-PAT 2000 is a newer, non-invasive technology for measuring ED.…”

“…Hayden et al, in their recent study, reported that Endo-PAT was an easy test to conduct and well-tolerated by children and adolescents with T1DM, and it could be performed at the point of care [ 23 ]. Two studies reported lower RHI results in T1DM [ 26 , 27 ].…”

Dedicated devices for non-invasive cardiovascular risk assessment — the future of cardiovascular prevention

“…AI correct values are between -30% and -10% with a mean intra-individual variability of 37%. EndoPat could be useful in recognizing patients at the earliest stage of CVD, showing vascular disfunction in patients with DM, familiar hypercholesterolemia, obesity, inflammatory bowel disease, Fontan survivors, and could monitor the effects of metformin and sulfonylurea treatment [2,5]. Despite many advantages, availability of the equipment is limited.…”

“…Evaluation of endothelial function is also possible using the non-invasive, fast (15 minutes), and non-operator-dependent EndoPat, which enables detection of endothelial dysfunction based on the registration of changes occurring in the digital pulse wave (peripheral arterial tone, PAT), measured using a pair of plethysmographic probes placed on the index fingers of each hand. Endothelial-mediated alterations in the PAT signal are induced by generating a downstream hyperemic response [ 2 , 5 ].…”