Relation of brachial artery flow-mediated vasodilation to significant coronary artery disease in patients with peripheral arterial disease

Pasquale Perrone-Filardi, Alberto Cuocolo, Gregorio Brevetti, Antonio Silvestro, Giovanni Storto, Santo Dellegrottaglie, Luigi Corrado, Maria Cafiero, Roberta Camerino, Michele Polimeno, Annamaria Zarrilli, Gianluca Caiazzo, Antonio Maglione, Andrea Petretta, Massimo Chiariello

Research output: Contribution to journalArticlepeer-review

Abstract

In patients at risk for coronary atherosclerosis, brachial artery flow-mediated dilation (FMD) rules out significant coronary artery disease (CAD). However, the value of this approach is unknown in patients with peripheral arterial disease who are at increased risk for CAD. This study assessed whether the noninvasive evaluation of endothelial function by brachial artery FMD rules out significant CAD by dipyridamole myocardial perfusion imaging (MPI) in patients with peripheral arterial disease who are asymptomatic for CAD. Forty-four patients with peripheral arterial disease who were asymptomatic for CAD underwent, in the same day, FMD evaluation and dipyridamole MPI using technetium-99m sestamibi single photon-emission computed tomography. MPI results were abnormal in 17 of 44 patients (39%). FMD was significantly less (6.0 ± 2.3%) in patients with abnormal MPI results compared with those with normal MPI results (7.3 ± 1.8%, p = 0.04). By multivariate analysis, FMD was the only significant predictor of abnormal MPI results (odds ratio 0.63, p = 0.02). Receiver-operating characteristic curve analysis assessing the ability of FMD to identify patients with summed stress scores 6% provided 92% negative predictive power to rule out abnormal MPI results, with sensitivity of 79% and specificity of 73%. In conclusion, the noninvasive evaluation of endothelial function by FMD has high negative predictive accuracy and good sensitivity and specificity to detect abnormal MPI results in patients with peripheral arterial disease. Thus, it may represent a valuable screening test to rule out significant CAD in these patients.

Original languageEnglish
Pages (from-to)1337-1341
Number of pages5
JournalThe American Journal of Cardiology
Volume96
Issue number9
DOIs
Publication statusPublished - Nov 1 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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