Assessment of Endothelial Function Using Digital Pulse Amplitude Tonometry

Abstract

The significance of endothelial dysfunction in cardiovascular disease is well established (Widlansky et al. 2003). In the healthy state, the endothelium produces a number of factors including nitric oxide that are essential for maintaining vascular homeostasis. Systemic risk factors damage endothelial cells lowering nitric oxide (NO) bioavailability. Endothelial dysfunction facilitates atherogenesis by promoting inflammation, thrombosis and cellular adhesion. Recent studies demonstrate higher risk of cardiovascular events in individuals with impaired endothelial function (Yeboah et al. 2007). Since the initial identification of NO, several techniques have been employed to investigate endothelial vasomotor function in humans (McMackin and Vita 2005). Endothelial function assessment has not yet been incorporated into routine risk stratification in part owing to technical and logistical limitations. The use of a novel digital pulse amplitude tonometry (PAT) device to measure endothelial function offers the possibility of an easily performed, rapid assessment of vascular function (Celermajer 2008). The current article reviews the use of digital PAT as an indicator of endothelial function.