Background: Development of instruments capable of detecting early stage vascular disease has increased interest\nin employing arterial stiffness (e.g. pulse wave velocity (PWV), augmentation index (AIx)) and endothelial dysfunction\n(e.g. reactive hyperemia index (RHI)) to diagnose atherosclerotic disease before occurrence of a cardiovascular event.\nHowever, amongst the equipment designed for this purpose, there is insufficient information regarding each of these\nparameters to establish appropriate cutoffs to distinguish between healthy and unhealthy blood vessels. To address\nthese limitations, the study was designed to establish the upper arterial stiffness and endothelial function thresholds\nin a healthy population, by comparing the outputs from different instruments capable of measuring PWV, AIx and RHI.\nMethods: A systematic comparison of PWV, AIx and RHI was conducted to determine the inter-relationships between\nthese parameters of vascular functionality. Outputs were obtained non-invasively using three instruments, the VP-1000\n(VP), SphygmoCor (SC), and EndoPAT (EP), in 40 apparently healthy males and females.\nResults: Correlations were found between the brachial-ankle PWV and radial-ankle PWV (by VP and SC), and PWV (VP)\nwith AIx (SC). The interchangeability of these outputs was demonstrated by the Bland Altman test, making\nit feasible to extrapolate cut-offs for radial-ankle PWV and AIx equivalent to brachial-ankle PWV that signify\nhealthy vessels. In contrast, RHI showed no association with AIx, suggesting these endothelial and arterial\nparameters are functionally distinct.\nConclusions: It was concluded that it is possible to compare the vascular function outputs of different instruments\nand identify healthy from unhealthy vessels, even though the approaches for quantifying the underlying physiological\nprocesses may differ. In this way, non-invasive determination of arterial function could be a new paradigm for detecting\nexisting early stage asymptomatic atherosclerotic disease in individuals using techniques that are amenable to the\nclinical setting.
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