Reproducibility and variability of digital thermal monitoring of vascular reactivity.

BACKGROUND: Previous studies demonstrated that digital thermal monitoring (DTM) of vascular reactivity, a new test for vascular function assessment, is well correlated with Framingham Risk Score, coronary calcium score and CT angiography. This study evaluates the variability and reproducibility of DTM measurements. We hypothesized that DTM is reproducible, and its variability falls within the accepted range of clinical diagnostic tests. METHOD: A fully automated DTM device (VENDYS, Endothelix Inc., Houston, TX, USA) was used for repeated measurement of vascular function in 18 healthy volunteers (age 35 ± 4 years, 74% men) after 24 h. All subjects underwent overnight fasting, and the test was preceded by 30-min rest in a supine position inside a dimmed room with temperature 22-24°C. The measurements were obtained during and after a 2-min supra systolic arm-cuff occlusion-induced reactive hyperaemia procedure. As a part of this study, the Doppler ultrasound hyperaemic, low-frequency, blood velocity of radial artery and a fingertip DTM of vascular function were compared simultaneously. Postcuff deflation temperature rebound and area under the curve, DTM indices of vascular function, were studied. RESULTS: Temperature rebound area under the curve correlated closely with Doppler hyperaemic, low-frequency, blood velocity (r = 0·97, P = 0·0001). Day-to-day intra-subject variability was 6·2% for baseline temperature, 8·7% for mean blood pressure and 11·4% for heart rate. The coefficient of repeatability of temperature rebound and area under the curve were 2·4% and 2·8%. CONCLUSION: In a controlled environment, the repeatability of DTM is excellent. DTM can be used as a reproducible and operator-independent test for non-invasive measurement of vascular function.

Digital thermal monitoring (DTM) of vascular reactivity closely correlates with Doppler flow velocity.

The noninvasive measurement of peripheral vascular reactivity, as an indicator of vascular function, provides a valuable tool for cardiovascular screening of at-risk populations. Practical and economical considerations demand that such a test be low-cost and simple to use. To this end, it is advantageous to substitute digital thermal monitoring (DTM) for the more costly and complex Doppler system commonly used for this measurement. A signal processing model was developed to establish the basis for the relationship between finger temperature reactivity and blood flow reactivity following a transient brachial artery occlusion and reperfusion protocol (reactive hyperemia). Flow velocity signals were acquired from the radial artery of human subjects via an 8 MHz Doppler probe while simultaneous DTM signals were acquired from a distal fingertip via DTM sensors. The model transforms the DTM temperature signals into normalized flow signals via a deconvolution method which employs an exponential impulse function. The DTM normalized flow signals were compared to simultaneous, low-frequency, normalized flow signals computed from Doppler sensors. The normalized flow signals, derived from DTM and Doppler sensors, were found to yield similar reactivity responses during reperfusion. The reactivity areas derived from DTM and Doppler sensors, indicative of hyperemic volumes, were found to be within +/- 15%. In conclusion, this signal processing model provides a means to measure vascular reactivity using DTM sensors, that is equivalent to that obtained by more complex Doppler systems.