Peripheral Arterial Tone Reveals Heart Disease

According to a new study, patients with coronary artery disease show significantly different patterns, compared to healthy patients, in exercise-induced peripheral arterial tone (PAT). The study was published in the April 2001 issue of Circulation.

PAT is a physiologic signal that measures arterial pulsatile volume changes in the fingertip, which have been shown to mirror changes or anomalies in autonomic nervous system activity and related vascular events and can be independent of the patient's blood pressure, heart rate, or electrocardiogram changes. The study compared PAT signal patterns during exercise stress testing between 50 healthy volunteers and 57 patients with documented heart disease. The results showed that patients with heart disease had distinct and abnormal PAT response patterns. The PAT technology was developed by Itamar Medical (Caesarea, Israel; www.itamar-medical.com)

"Normal individuals maintain or increase PAT amplitude with exercise, reflecting relaxed sympathetic control of peripheral vasodilatation and subsequent heat loss,” said Alan Rozanski, M.D., professor of medicine at Columbia University College of Physicians and Surgeons (New York, NY, USA) and the lead author of the study. "However, in this study, patients with heart disease often showed one or more patterns of paradoxical vasoconstrictive responses or augmented sympathetic control, which may reflect peripheral vascular pathology even when evidence of obstructive coronary artery disease is not yet detectable by stress testing.”



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