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J Appl Physiol (May 15, 2008). doi:10.1152/japplphysiol.90431.2008
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Submitted on March 20, 2008
Revised on May 13, 2008
Accepted on May 13, 2008

Inter-relationships Among Noninvasive Measures of Postischemic Macro- and Micro-Vascular Reactivity

Mandeep Dhindsa, Shawn M Sommerlad, Allison E DeVan M. A.1, Jill N Barnes, Jun Sugawara PhD2, Obdulia Ley3, and Hirofumi Tanaka2*

1 The University of Texas at Austin
2 University of Texas at Austin
3 Texas A&M University

* To whom correspondence should be addressed. E-mail: htanaka{at}mail.utexas.edu.

The clinical importance of vascular reactivity as an early marker of atherosclerosis has been well established, and a number of established and emerging techniques have been employed to provide measurements of peripheral vascular reactivity. However, relations between these methodologies are unclear as each technique evaluates different physiological aspects related to micro- and macro-vascular reactive hyperemia. To address this question, a total of 40 apparently healthy normotensive adults aged 19-68 years underwent 5 minutes of forearm suprasystolic cuff-induced ischemia followed by post-ischemic measurements. Measurements of vascular reactivity included a) flow-mediated dilatation (FMD), b) changes in pulse wave velocity between the brachial and radial artery ({Delta}PWV), c) hyperemic shear stress, d) reactive hyperemic flow, e) reactive hyperemia index (RHI) assessed by fingertip arterial tonometry, f) fingertip temperature rebound (TR), and g) skin reactive hyperemia. FMD was significantly and positively associated with RHI (r=0.47) and TR (r=0.45) (both P<0.01), but not with reactive hyperemic flow or hyperemic shear stress. There was no correlation between two measures of macrovascular reactivity (FMD and PWV). Skin reactive hyperemia was significantly associated with RHI (r=0.55) and reactive hyperemic flow (r=0.35) (both P<0.05). There was a significant association between reactive hyperemia and RHI (r=0.30; P<0.05). In more than 75% of cases, vascular reactivity measures were not significantly associated. We concluded that associations among different measures of peripheral micro- and macro-vascular reactivity were modest at best. These results suggest that different physiological mechanisms may be involved in changing different measures of vascular reactivity.




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Measures of vascular reactivity: prognostic crystal ball or Pandora's box?
J Appl Physiol, August 1, 2008; 105(2): 398 - 399.
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