Fingertip reactive hyperemia-peripheral artery tonometry (RH-PAT) is an emerging novel non-invasive method for evaluating endothelial function. We aimed to evaluate endothelial function with fingertip reactive hyperemia by RH-PAT in symptomatic patients undergoing elective coronary angiography and assess the relationship between degree of endothelial dysfunction (ED) and the presence and the severity of coronary artery disease (CAD).
We assessed 92 patients. Before coronary angiography, the endothelial function was measured by RH-PAT and reactive hyperemia index (RHI) was obtained. For each patient, Gensini score was calculated according to the coronary angiographic findings to evaluate the severity of CAD.
In CAD (+) group, RHI (1.35±0.57 vs. 1.74±0.46, p=0.001) mean values were lower than CAD (-) group. In multivariate logistic regression analysis: age, HDL and RHI were found to be an independent parameter predicting the presence of CAD. In multivariate linear regression analysis, RHI was found to be an independent predictor associated with the severity of CAD. In ROC (Receiver Operating Curve) analysis, RHI achieved an AUC of 0,763 (95% confidence interval 0.663-0.846 p=0.001) for the ability to predict the presence of CAD. A cut-off value of 1.49 for RHI predicted the presence of coronary artery disease with a sensitivity of 75% and a specificity of 72,9 %.
RH-PAT is an objective and highly reproducible test with superior diagnostic accuracy for the evaluation of ED. We found significant correlations between ED and the presence and the severity of CAD.

The Author(s). Published by S. Karger AG, Basel.