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Title: Assessment of endothelial function in the dermal circulation in people with coronary artery disease
Author: Agarwal, Sharad Chander
ISNI:       0000 0004 2744 6141
Awarding Body: University of Newcastle Upon Tyne
Current Institution: University of Newcastle upon Tyne
Date of Award: 2011
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Introduction The studies in this thesis address the use of laser Doppler flowmetry (LDF) and pulse photoplethysmography (PPG) in assessing the endothelial function in the dermal microcirculation in people with coronary artery disease (CAD). Measurements included assessment of endothelial function, lipid profile, inflammatory markers and asymmetric dimethylarginine (ADMA). Methods Forty-eight people with coronary artery disease (24 with stable angina and 24 people with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) were compared with 25 healthy controls. Endothelial function was assessed using LDF and PPG. Circulating markers of inflammation, serum lipids and ADMA were measured by standard laboratory methods. People with CAD were treated with statins. Ten healthy controls had repeat measurements by LDF to assess reproducibility of the measurements and 34 people with CAD had repeat LDF measurements three months after PCI. Results 1. The people with CAD and healthy controls were matched for age and gender. The body mass index (BMI) and systolic blood pressure was significantly higher in people with CAD. The serum total cholesterol, low density lipoprotein cholesterol (LDL cholesterol), high density lipoprotein cholesterol (HDL cholesterol) and apolipoprotein A 1 were significantly lower in people with CAD. Serum highly sensitive CRP (hsCRP), triglyceride and ADMA levels were significantly higher in people with CAD. People with ACS had higher BMI, hsCRP and lower apolipoprotein A 1 levels compared to people with stable angina. 2. Perfusion changes measured by LDF in response to acetylcholine (ACh) iontophoresis, local heating and reactive hyperaemia had good reproducibility with coefficients of variation (CV) less than 25%. The CV for perfusion changes in response to heating was better than the changes in response to ACh iontophoresis and reactive hyperaemia. 3. Endothelial function measured by LDF and PPG was significantly impaired in people with CAD (p
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available