Digital thermal monitoring (DTM) of vascular function was shown to correlate with the presence of known coronary artery disease (CAD).
We evaluated whether DTM can identify at-risk, asymptomatic patients with significant coronary artery calcium (CAC) or increased Framingham risk score (FRS).
Two hundred thirty-three consecutive asymptomatic subjects (58 ± 11 years; 62% men) without known CAD underwent DTM, CAC, and FRS calculation. DTM measurements were obtained during and after a 5-minute suprasystolic arm-cuff occlusion. After cuff-deflation temperature rebound (TR) and area under the temperature curve (AUC) were measured and correlated with FRS and CAC.
TR was lower in patients with FRS > 20% and CAC ≥ 100 as compared with FRS < 10% and CAC < 10, respectively (P < 0.05). After adjustment for age, sex, and traditional cardiac risk factors, the odds ratio of the lowest compared with the upper 2 tertiles of TR was 3.96 for FRS ≥ 20% and 2.37 for CAC ≥ 100 compared with low-risk cohorts. The area under the receiver operating characteristic (ROC) curve to predict CAC ≥ 100 increased significantly from 0.66 for FRS to 0.79 for TR to 0.89 for TR + FRS.
Vascular dysfunction measured by DTM strongly correlates with FRS and CAC independent of age, sex, and traditional cardiac risk factors and was superior to FRS for the prediction of significant CAC.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
Full access to the journal is a member benefit for SCCT Members, Login via the SCCT website to access all journal content.
Subscribe:Subscribe to Journal of Cardiovascular Computed Tomography
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Endothelial function and dysfunction: testing and clinical relevance.Circulation. 2007; 115: 1285-1295
- The pathogenesis of atherosclerosis: a prospective for the 1990s.Nature. 1993; 362: 801-809
- Short duration of reactive hyperemia in the forearm of subjects with multiple cardiovascular risk factors.Circ J. 2006; 70: 115-123
- Cardiovascular risk factor as determinants of endothelium dependent and endothelium independent vascular reactivity in the general population.J Am Coll Cardiol. 2001; 38: 1814-1820
- Flow mediated change of finger-tip-temperature in patients with high cardiovascular risk.Cardiologia Hungarica. 2005; 35: 11-16
- Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia.J Am Coll Cardiol. 2004; 44: 2137-2141
- Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area: a histopathologic correlative study.Circulation. 1995; 92: 2157-2162
- Prediction of coronary heart disease using risk factor categories.Circulation. 1998; 97: 1837-1847
- Detection and quantification of coronary artery calcification with electron-beam and conventional CT.Eur Radiol. 1999; 9: 620-624
- Coronary vasodilator reserve and Framingham risk scores in subjects at risk for coronary artery disease.J Nucl Cardiol. 2006; 13: 761-767
- Is the association between flow-mediated dilation and cardiovascular risk limited to low-risk populations?.J Am Coll Cardiol. 2005; 45: 1987-1993
- Stehouwer CD.Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin.Eur J Clin Invest. 2003; 33: 536-542
- Evaluation of coronary calcium score by multidetector computed tomography in relation to endothelial function and inflammatory markers in asymptomatic individuals.Circ J. 2008; 72: 778-785
- Assessment of peripheral vascular endothelial function in the ambulatory setting.Vasc Med. 2007; 12: 13-16
- Biological correlates of day-to-day variation in flow-mediated dilation in individuals with type 2 diabetes: a study of test-retest reliability.Diabetologia. 2004; 47: 1625-1631
- Cross-sectional relations of digital vascular function to cardiovascular risk factors in the Framingham Heart Study.Circulation. 2008; 117: 3126-3133
- Peripheral artery tonometry demonstrates altered endothelial function in children with type 1 diabetes.Pediatr Diabetes. 2007; 8: 193-198
- Coronary calcium as a predictor of coronary events in four racial or ethnic groups.N Engl J Med. 2008; 358: 1336-1345
- Coronary calcium coverage score: determination, correlates, and predictive accuracy in the multi-ethnic study of atherosclerosis.Radiology. 2008; 247: 669-675
Published online: September 29, 2008
Accepted: September 18, 2008
Received: July 8, 2008
Conflict of interest: Dr. Matthew Budoff is on the speakers bureau for Coeneral Electric.
© 2008 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.