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Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia

Piero O. Bonetti, MD^*, Geralyn M. Pumper, RN^*, Stuart T. Higano, MD, FACC^*, David R. Holmes, Jr, MD, FACC^*, Jeffrey T. Kuvin, MD, FACC and Amir Lerman, MD, FACC^*,*

^* Center for Coronary Physiology and Imaging, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
Division of Cardiology, New England Medical Center Hospitals, Tufts University School of Medicine, Boston, Massachusetts

View larger version (29K): [in a new window]   Figure 1 Representative reactive hyperemia peripheral arterial tonometry recordings of subjects with normal and abnormal reactive hyperemic response. Normal response is characterized by a distinct increase in the signal amplitude after cuff release compared with baseline.

View larger version (22K): [in a new window]   Figure 2 Receiver operating characteristic curve for the reactive hyperemia peripheral arterial tonometry (RH-PAT) index to identify patients with normal coronary endothelial function. An RH-PAT index of 1.35 discriminates best between presence/absence of coronary endothelial dysfunction. AUC = area under the curve.