High Frequency of Microvascular Dysfunction in US Outpatient Clinics: A Sign of High Residual Risk? Data from 7,105 Patients.

IF 2.5 Q2 PERIPHERAL VASCULAR DISEASE International Journal of Vascular Medicine Pub Date : 2022-01-06 eCollection Date: 2022-01-01 DOI:10.1155/2022/4224975
Morteza Naghavi, Stanley Kleis, Hirofumi Tanaka, Albert A Yen, Ruoyu Zhuang, Ahmed Gul, Yasamin Naghavi, Ralph Metcalfe
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Abstract

Previous studies have linked peripheral microvascular dysfunction measured by arterial tonometry to high residual risk in on-statin patients. Digital thermal monitoring (DTM) of microvascular function is a new and simplified technique based on fingertip temperature measurements that has been correlated with the burden of atherosclerosis and its risk factors. Here, we report analyses of DTM data from two large US registries: Registry-I (6,084 cases) and Registry-II (1,021 cases) across 49 US outpatient clinics. DTM tests were performed using a VENDYS device during a 5-minute arm-cuff reactive hyperemia. Fingertip temperature falls during cuff inflation and rebounds after deflation. Adjusted maximum temperature rebound was reported as vascular reactivity index (VRI). VRI distributions were similar in both registries, with mean ± SD of 1.58 ± 0.53 in Registry-I and 1.52 ± 0.43 in Registry-II. In the combined dataset, only 18% had optimal VRI (≥2.0) and 82% were either poor (<1.0) or intermediate (1.0-2.0). Women had slightly higher VRI than men (1.62 ± 0.56 vs. 1.54 ± 0.47, p < 0.001). VRI was inversely but mildly correlated with age (r = -0.19, p < 0.001). Suboptimal VRI was found in 72% of patients <50 years, 82% of 50-70 years, and 86% of ≥70 years. Blood pressure was not correlated with VRI. In this largest registry of peripheral microvascular function measurements, suboptimal scores were highly frequent among on-treatment patients, possibly suggesting a significant residual risk. Prospective studies are warranted to validate microvascular dysfunction as an indicator of residual risk.

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美国门诊微血管功能障碍的高频率:高残留风险的标志?数据来自7105名患者。
先前的研究已经将动脉血压计测量的外周微血管功能障碍与服用他汀类药物患者的高残留风险联系起来。微血管功能数字热监测(DTM)是一种基于指尖温度测量的新型简化技术,与动脉粥样硬化负担及其危险因素相关。在这里,我们报告了来自美国两个大型登记处的DTM数据的分析:登记处- i(6084例)和登记处- ii(1021例),横跨49个美国门诊诊所。在5分钟的臂袖反应性充血期间,使用VENDYS设备进行DTM测试。袖口膨胀时指尖温度下降,收缩后又反弹。调整后的最高温度回弹作为血管反应性指数(VRI)。两个注册中心的VRI分布相似,注册中心i的平均±SD为1.58±0.53,注册中心ii的平均±SD为1.52±0.43。在合并的数据集中,只有18%的VRI达到最佳(≥2.0),82%的VRI较差(p < 0.001)。VRI与年龄呈负相关但轻度相关(r = -0.19, p < 0.001)。72%的患者VRI不理想
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来源期刊
International Journal of Vascular Medicine
International Journal of Vascular Medicine PERIPHERAL VASCULAR DISEASE-
CiteScore
3.50
自引率
0.00%
发文量
7
审稿时长
16 weeks
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