[Changes in pulse wave velocity in the reactive hyperemia as a method of evaluation of endothelial vasomotor function in hypertensive patients].

Aim: To assess the method of pulse wave velocity (PWV) measurement in reactive postocclusion hyperemia test for investigation of vasomotor endothelial function (VEF) in hypertension patients.

Material And Methods: A total of 50 hypertensive patients participated in the study: 40 patients (age 20-72 years, 19 females, 21 males) with arterial hypertension of degree I-III with moderate and high risk and 2-30 year duration of the disease and 10 healthy normotensive 20-50 year old males (a control group). VEF was evaluated by two methods: ultrasound test with reactive hyperemia according to D.S. Celermajer (Vivid 7 unit) and measurement of PWV in the test of reactive postocclusive hyperemia on the arteries of the upper limbs (VaSera VS-1000 device).

Results: According to the ultrasound method, flow-dependent vasodilatation (FDVD%) in hypertensive patients was 15.0 to 5.8% (mean 3.8 +/- 0.9%) and was lower than in healthy persons (16.0 to 8.0, mean 11.6 +/- 0.8%, p < 0.001). Endothelial dysfunction (FDVD < 6%) was found in 20 (67%) hypertensive patients. In reactive postocclusion hyperemia control group demonstrated PWV lowering and its relative changes (delta PWV%) was 124 to 5.3% (mean 8.8 +/- 0.9%). In hypertensive patients delta PWV% ranged from 11.8 to 5.9% (mean 4.9 +/- 0.8%) that is lower than in healthy subjects (p = 0.001). The linear regression analysis has revealed a positive correlation between FDVD and delta PWV (r = 0.54; p = 0.0003). In delta PWV = 5.1% sensitivity and specificity of the method for detection of VEF disturbance were 65 and 90%, respectively.

Conclusion: The technique of PWV measurement in the reactive postocclusion hyperemia test with satisfactory sensitivity and specificity can be used in hypertensive patients for detection of VEF defects in the arteries of the upper limbs.