The test may be used in an individualized medicine model of risk assessment of the patients, Dr. Lerman says.
EndoPAT, which received U.S. Food and Drug Administration approval in 2003, consists of digital recording equipment and two finger probes that look like large thimbles. For the test, which takes 15 minutes, probes are placed on each index finger and hooked up to a small machine to measure blood flow. A standard blood pressure cuff is placed on one arm; the arm without the cuff is the control. A reading of the fingers' blood flow rate begins, and then the blood pressure cuff on one arm is inflated for a few minutes and then deflated, allowing for three timed readings.
The role of the inflated blood pressure cuff is to occlude and then release blood flow to assess reactive hyperemia (RH), the normal blood flow response that occurs when occlusion is released. In the study, 49 percent of the patients who went on to have a cardiac event had a low RH score.
A low RH signal -- indicating a lower blood flow response -- is consistent with endothelial dysfunction and potentially impaired vascular health that may lead to or serve as a marker for future events, Dr. Lerman says.
Collaboration and Support
Other Mayo Clinic study team members are Ronen Rubinshtein, M.D.; Ryan Lennon; Rebecca Nelson; Geralyn Pumper; and Lilach Lerman, M.D., Ph.D. Team members from Tufts-New England Medical Center are Jeffrey Kuvin, M.D.; and Morgan Soffler, M.D.
Note: Dr. Lerman serves on an advisory board for Itamar Medical, EndoPAT's manufacturer, and, since completion of the study, has received consulting fees of less than the federal threshold for si
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