Cutaneous microvascular reactivity and aortic elasticity in coronary artery disease: Comparison of the laser Doppler flowmetry and echocardiography

Abstract

Background and aim: Decreased vascular reactivity in atherosclerosis was previously shown. In our study, it was aimed to demonstrate the decreased vascular functions in both microvascular and macrovascular tissues and to estimate any correlation between them. Methods: Twenty-five control outpatients with no coronary artery disease (CAD) history and 26 outpatients with CAD history were enrolled in the study. Local cutaneous post-occlusive reactive hyperemia (PORH) responses after three minutes of brachial occlusion with a pneumatic cuff were recorded noninvasively by a Perimed Periflux 5010 laser Doppler flow system. Aortic distensibility and stiffness indexes were recorded noninvasively by a two-dimensional Doppler echocardiography machine (Vivid S6 GE Medical System, Horten, Norway). Results: Except for the medication history of subjects, there were no significant demographic differences between the CAD and control groups. Peak flow (PF), resting flow (RF) and biological zero(BZ) laser Doppler measurements were not decreased, but PF-RF/RF (%), PF-BZ/BF (%), hyperemia repayment and PORH indexes were significantly decreased in the CAD group (P = 0.005, P = 0.024, P = 0.017, P = 0.006, respectively) with laser Doppler measurements. Aortic strain (%) and aortic distensibility (cm3/dyn-1) measurements were significantly decreased in the CAD group (P = 0.005, P = 0.013). However, there was no correlation between microvascular indexes (hyperemia repayment index, PORH index) and macrovascular indexes (aortic strain and aortic distensibility). Discussion: Different corrupted vascular tonus regulator systems in arteries of varying diameter, different major reactive responses to the stimuli or, finally, the lack of a number of subjects to obtain a significant level may be responsible for the irrelevant correlation analysis. Conclusion: The differences in arterial beds (both aorta and microcirculation) may be examined to assess the cardiovascular risk in patients with history of CAD. (C) 2016 Elsevier Inc All rights reserved.