Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia

Piero O. Bonetti, Geralyn M. Pumper, Stuart T. Higano, David R. Holmes, Jeffrey T. Kuvin, Amir Lerman

Research output: Contribution to journalArticlepeer-review

683 Scopus citations


We investigated the value of reactive hyperemia peripheral arterial tonometry (RH-PAT) as a noninvasive tool to identify individuals with coronary microvascular endothelial dysfunction. Coronary endothelial dysfunction, a systemic disorder, represents an early stage of atherosclerosis; RH-PAT is a technique to assess peripheral microvascular endothelial function. Using RH-PAT, digital pulse volume changes during reactive hyperemia were assessed in 94 patients without obstructive coronary artery disease and either normal (n = 39) or abnormal (n = 55) coronary microvascular endothelial function; RH-PAT index, a measure of reactive hyperemia, was calculated as the ratio of the digital pulse volume during reactive hyperemia divided by that at baseline. Average RH-PAT index was lower in patients with coronary endothelial dysfunction compared with those with normal coronary endothelial function (1.27 ± 0.05 vs. 1.78 ± 0.08: p < 0.001). An RH-PAT index <1.35 was found to have a sensitivity of 80% and a specificity of 85% to identify patients with coronary endothelial dysfunction. Digital hyperemic response, as measured by RH-PAT, is attenuated in patients with coronary microvascular endothelial dysfunction, suggesting a role for RH-PAT as a noninvasive test to identify patients with this disorder.

Original languageEnglish (US)
Pages (from-to)2137-2141
Number of pages5
JournalJournal of the American College of Cardiology
Issue number11
StatePublished - Dec 7 2004

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia'. Together they form a unique fingerprint.

Cite this