Relationship between peripheral and coronary function using laser doppler imaging and transthoracic echocardiography
Résumé
Vascular dysfunction in the coronary and peripheral circulations is an early prognostic marker of future cardiovascular events. Measurements of coronary and peripheral vascular function in resistance vessels can be made but rely on invasive procedures, which make them unsuitable for routine application. Aa assessment of the direct correlation between vascular responses in skin and coronary vessels has not been made previously. In 27 normal, healthy subjects (18 to 55 years old), we examined the relationship between peripheral and coronary vascular function. Cutaneous perfusion was measured using the non-invasive technique of laser Doppler imaging during iontophoresis of acetylcholine and sodium nitroprusside, and cutaneous vascular conductance was calculated (laser Doppler perfusion/mean arterial pressure). Coronary flow reserve was measured using transthoracic echocardiography during intravenous adenosine infusion. Mean diastolic velocities were measured at baseline and at peak hyperaemic conditions from the Doppler signal recordings. Coronary velocity reserve (CVR) was defined as the ratio of hyperaemic to basal mean diastolic velocities. There were significant positive correlations between coronary velocity reserve and cutaneous vascular conductance for acetylcholine (r=0.399, P=0.039) and for sodium nitroprusside (r=0.446, P=0.020). These results support the idea that peripheral measurements of skin blood flow are representative of generalised microvascular function including that of the coronary circulation in normal healthy subjects.
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