P1.08 Comparing Proximal and Distal Occlusion for Testing Endothelial Function Using Forearm Ischemia Hyperaemia

Abstract

Introduction

There are several approaches to assess endothelial function using forearm ischemia - hyperaemia (FMD). The principal difference is whether flow is stopped in the root of the arm (proximal or P) or the wrist (distal or D). P induces “non pulsatile ischemia”, and D, “pulsatile ischemia”, and the choice based on tolerance.

Aim:

Compare the efficacy and tolerability of two different FMD methods.

Methods:

Seventeen pts., between 30 and 50 y.o, males, without CV disease or CV drugs were evaluated in the Vascular Lab. FMD was performed at the beginning and at the end of the vascular study (>30 minutes apart each one) in a randomized sequence using P or D occlusion and were recorded to be read blinded. Pts. were asked about the tolerance of each method.

Results:

Mean age 39 + 7 y.o, BP 133,4 + 17 and 82,5 + 11 mmHg, normal IMT, Plaques (5 subjects, 29%), PWV 10,26 + 1,8 m/seg Aix b −25,7%, Aix Ao 20 %, Vascular score 2,53. Basal diameters humeral artery (mm): P: 3,44 + 0,5 D: 3,51 + 0,5 (pNS) Post ischemia diameters (mm): P: 3,63 + 0,4 D: 3,67 + 0,4 (p NS). Delta of diameter (%): P: 5,7% + 4,8 D: 4,7% + 5 (p. NS) (r 0,49 p.01, concordant according Bland & Altmann test). About 60% of FMDs were in the same sense and degree and P better tolerated than D.

Conclusions:

Although P is better tolerated, there seems to be no significative differences between both methods.