短阵房性心动过速发生规律探讨

目的 了解短阵房性心动过速(PAT)发生规律。方法 应用24h动态心电图(DCG)连续监测心脏节律的变化。结果 564例中发生PAT 127例，检出率22．5％。PAT发生时间规律为夜间少，白天多，中午迭高峰。集中趋势在中午12时30分左右。非卧床状态下发生阵数量是卧床休息状态下的2.2倍。检出率随年龄而增加。结论 PAT的发生可能与植物神经如交感神经及副交感神经能力变化的影响有关。     

阵发性房性心动过速动态心电图临床分析

目的 探讨短阵房性心动过速(PAT)的临床意义.方法 对146例PAT的动态心电图进行分析.结果 确诊为心血管疾病者(A组)PAT的检出率随年龄而增加,且其发生频率明显高于健康检查或仅有胸闷、心悸、乏力以及心脏以外其他疾病者(B组).差异有统计学意义(P<0.01).结论 动态心电图对PAT的诊断和治疗具有临床意义.     

舒适护理在急性心肌梗死病人绝对卧床期间的应用

目的分析舒适护理在急性心肌梗死患者绝对卧床期间的应用效果及体会。方法收集整理30例急性心肌梗死患者的临床资料,按照随机数字表法将其分为观察组与对照组各15例,其中对照组以功能性常规护理为主,观察组则采用舒适护理模式,比较治疗结束后两组患者的平均住院时间及卧床时间。结果:观察组平均卧床时间为(47.07±4.22)h,对照组平均卧床时间为(71.33±4.51)h,观察组卧床时间显著短于对照组,差异具统计学意义(t=5.7803,P0.05);对照组平均住院时间为(10.94±1.64)天,观察组平均住院时间为(8.14±2.43)天,观察组住院时间显著短于对照组,差异具统计学意义(t=5.8562,P0.05)。结论针对急性心肌梗死患者绝对卧床期间进行舒适护理可显著提高其舒适程度,缩短卧床时间及住院时间,从而改善治疗效果。     

冠脉支架术后Perclose缝合与手工压迫止血的对比研究

目的评价老年冠状动脉(以下称冠脉)支架术后Perclose缝合止血与手工压迫止血的优缺点,为老年冠脉支架术后处理穿刺血管提供参考。方法324例老年冠脉支架术后病人,165例Perclose缝合止血(缝合组),159例手工压迫止血(手工组)。比较止血时间、下肢制动时间、血管并发症、因卧床引起的不适发生率和止血后护理时间。结果两种止血方法同样安全有效。但是,缝合成功者止血时间、下肢制动时间和止血后护理时间明显较手工止血短,血管并发症及因卧床所致不适的发生率较手工止血低。缝合失败者上述时间明显延长,血管并发症及因卧床所致的不适程度增加。结论Perclose缝合止血的优点:(1)与手工止血同样安全有效;(2)止血、下肢制动和护理时间明显缩短,因卧床引起的不适和血管并发症发生率低。缺点:(1)费用昂贵;(2)一旦缝合失败,被迫在肝素化状态下压迫止血,导致血管并发症发生率增高,加重病人的经济和心理负担。     

Disopyramide phosphate治疗心律失常

美国加利福尼亚大学医学院Kalmansohn最近报导10家医院11名研究者的一项对照研究用Disopyramide phosphate治疗120例心律失常患者,89例获得良好至极好的疗效。 120例中,48例为多灶性室性期前收缩(PVC’S);29例为单灶性PVC’S;18例为PVC’S加房性期前收缩(PAC);4例为PVC’S加房性阵发性心动过速(PAT);1例PAT;18例PVC’S加PAC加PAT;2例PAC加PAT。判断疗效的标准为治疗期间每一动态心电图记录显示异位搏动比最佳安慰剂反应至     

12导联动态心电图对室性心动过速起源点的定位分析

目的:观察室性心动过速(VT)在自然状态下的发作情况,研究VT起源位点的分布规律。方法:对2934例心悸等不适症状患者行12导联动态心电图,连续记录24h或48h。对VT病例按其QRS波形态和持续时间进行分类,记录各部位发作例次和发作比例。对检出的VT病例依据体表心电图的VT起源点定位规律进行初步定位。结果:检出VT102例,总检出率3·74%。单形VT78例,占VT病例的76·4%,检出率2·65%,多形VT23例占22·55%,检出率0·78%,同一患者有2种或2种以上形态单形VT13例占12·6%,检出率0·44%,心室颤动1例占0·98%,检出率0·03%。单形VT初步定位右心室流出道1600例次占50·9%,前乳头肌50例次占1·6%,左心室流出道204例次占6·5%,前分支472例次占15·0%,中分支330例次占10·5%,后分支487例次占15·5%。结论:自然状态下的VT发作以单形为主,其次为多形VT,或同一患者有2种或2种以上形态的单形VT,较少检出心室颤动。VT起源部位为非随机分布,主要分布区域,依次为右心室流出道、左后分支、左前分支部位。对VT患者应用12导联动态心电图检查较3导联动态心电图检查可有效指导临床治疗。     

临床护理路径在心肌梗死患者护理中的应用

目的 探讨临床护理路径的实施对心肌梗死患者的影响。方法 选取2019年1月到2021年9月之间我院收治的心肌梗死患者60例,以抽签法进行分组研究,对照组30例患者采取常规护理,实验组30例患者采取临床护理路径。对比两组患者在不同护理模式下的卧床时间、住院时间、护理满意度评分以及健康教育内容的掌握程度。结果 实验组患者卧床所用时间和住院所用时间短于对照组,护理满意程度评分高于对照组,差异有统计学意义（P<0.05）;实验组健康教育内容掌握率高于对照组患者掌握率,差异有统计学意义（P<0.05）。结论 对心肌梗死患者实施临床护理路径能缩短其卧床和住院时间,护理效果显著,可推广与应用。     

食道超声引导下经胸微创外科封堵治疗先天性心脏病观察

目的探究先天性心脏病患者在食道超声引导下经胸微创外科封堵治疗的临床成效。方法选取我院2015年8月~2016年4月收治的先天性心脏病患者40例作为研究对象,按照随机分组法分为观察组和对照组,各20例。对照组给予传统手术治疗,观察组给予食道超声引导下经胸微创外科封堵治疗。对两组不良反应发生率、住院治疗及卧床恢复时间进行对比。结果观察组患者不良反应发生率为15%,对照组为30%,观察组明显低于对照组(P0.05);观察组患者住院治疗及卧床恢复时间显著低于对照组(P0.05)。结论先天性心脏病患者在食道超声引导下经胸微创外科封堵治疗的临床成效显著,能有效降低不良反应发生率,缩短患者住院治疗及卧床恢复时间,值得临床推广应用。     

双源CT心周脂肪定量与冠状动脉病变特点及斑块类型的关系

目的本研究通过64排双源CT测定心周脂肪组织（PAT）体积,分析PAT体积与冠状动脉病变支数、病变部位、病变狭窄程度以及斑块类型之间的关系,以期探讨PAT体积对冠状动脉粥样硬化病变程度的预测价值。方法同期行64排双源CT和经皮冠状动脉造影检查的310例患者入选,进行腰围、体质指数（BMI）、空腹血生化测定。使用64排双源CT测定PAT体积、钙化积分和斑块类型。通过经皮冠状动脉造影检查明确冠心病诊断、病变支数、病变部位,并采用Gensini积分量化冠状动脉狭窄的严重程度。结果 （1）冠心病患者的PAT体积明显大于非冠心病患者（P=0.004）;急性冠脉综合征患者的PAT体积明显大于稳定性心绞痛患者（P=0.009）。（2）双支和三支病变患者PAT体积与单支病变患者相比,PAT体积明显增加（P〈0.001）。（3）Gensini积分随着PAT体积增大而增加。（4）多元线性逐步回归分析显示PAT体积、BMI、空腹血糖是影响Gensini积分的独立危险因素。（5）PAT体积与钙化积分具有明显正相关性（r=0.31,P〈0.001）。（6）混合型斑块的PAT体积最大,其病变节段积分明显高于其他类型（P〈0.01）。结论 PAT体积与冠心病的发生、冠心病分型、冠状动脉病变支数、钙化积分存在强的相关性,是影响Gensini积分的独立危险因素。     

冠心病患者多层螺旋CT测量对心周脂肪的临床意义

目的探讨冠心病患者多层螺旋CT测量心周脂肪组织(PAT)体积评估冠心病的临床意义。方法将确诊的132例冠心病患者作为试验组,100例非冠心病组作为对照组。采用多层螺旋CT测量两组的PAT含量,分析其与冠心病之间的关系。结果试验组高密度脂蛋白水平低于对照组,低密度脂蛋白、PAT水平高于对照组(P0.001);Logistic回归分析,PAT体积进入回归方程(P=0.012),OR=3.52,高密度脂蛋白、低密度脂蛋白未进入回归方程(P0.05);不同狭窄组的PAT体积差异有统计学意义(F=15.532,P=0.000),轻度组到闭塞组呈递增趋势,Gensini积分差异有统计学意义(F=18.375,P=0.000),轻度组到闭塞组逐渐呈递增趋势,闭塞组最高。结论冠心病发病与心周脂肪组织体积存在高度的相关性,可作为预测冠心病的一个重要指标。     

Peripheral arterial tonometry: a diagnostic method for detection of myocardial ischemia induced during mental stress tests: a pilot study

BACKGROUND: Mental stress testing is considered a reliable method for diagnosing patients with coronary heart disease (CHD) who may be at risk for future events. It has been shown recently that myocardial ischemia induced during mental stress tests is specifically associated with peripheral arterial vasoconstriction. HYPOTHESIS: The study was undertaken to test the diagnostic capability of peripheral arterial tonometry (PAT) to detect peripheral arterial vasomotor changes. METHODS: We monitored pulsatile finger blood volume changes using a specially designed finger plethysmograph, PAT that can detect peripheral arterial vasomotor changes. Equilibrium radionuclide angiography (ERNA) was simultaneously performed in 18 male patients at rest and during a mental arithmetic stress test with harassment. All patients had previously diagnosed coronary disease and positive exercise tests. Myocardial ischemia was diagnosed by ERNA when global ejection fraction fell > or = 8% during mental stress or new (or worsened) focal wall motion abnormalities occurred. Peripheral arterial tonometry tracings were considered abnormal when the pulse wave amplitude decreased by > or = 20% from baseline. RESULTS: In 18 patients there were 16 usable studies. In eight patients, both ERNA and PAT were abnormal, and in six patients the tests were negative by both methods. In two cases, the results were discordant. Therefore, when considering an abnormal PAT tracing as indicative of mental stress-driven myocardial ischemia, concordance of the two methods was 88%. CONCLUSION: The use of PAT may facilitate both clinical testing and research during mental stress.     

Comparison of peripheral arterial response to mental stress in men versus women with coronary artery disease

There are profound gender-related differences in the incidence, presentation, and outcomes of coronary artery disease (CAD). These differences are not entirely explained by traditional cardiovascular risk factors. Nontraditional risk factors, such as psychological traits, have increasingly been recognized as important contributors to the genesis and outcomes of CAD. Mental stress induces significant peripheral arterial vasoconstriction, with consequent increases in heart rate and blood pressure. These changes are thought to underlie the development of myocardial ischemia and other mental stress-induced adverse cardiac events in patients with CAD. This study examined for gender-related differences in peripheral arterial response to mental stress in a cohort of patients with CAD using a novel peripheral arterial tonometric (PAT) technique. There were 211 patients (77 women; 37%) with a documented history of CAD and a mean age of 64 +/- 9 years. Patients were enrolled from August 18, 2004, to February 21, 2007. Mental stress was induced using a public speaking task. Hemodynamic and PAT measurements were recorded during rest and mental stress. The PAT response was calculated as a ratio of pulse wave amplitude during stress to at rest. PAT responses were compared between men and women. The PAT ratio (during stress to at rest) was significantly higher in women compared with men. Mean PAT ratio was 0.80 +/- 0.72 in women compared with 0.59 +/- 0.48 in men (p = 0.032). This finding remained significant after controlling for possible confounding factors (p = 0.037). In conclusion, peripheral vasoconstrictive response to mental stress was more pronounced in men compared with women. This finding may suggest that men have higher susceptibility to mental stress-related adverse effects. Additional studies are needed to determine the significance of this finding.     

Resolution of Primary Aortic Thrombosis after Dabigatran therapy—A New Hope for the Rare and Old Disease

The primary aortic thrombosis (PAT) is an uncommon noncardiac cause of distal peripheral embolization to lower extremities. Also, this condition develops in the absence of extensive atherosclerosis of aorta or abnormal dilatation like aneurysm of the aorta. In most of the cases, there was either no or minimal atherosclerosis of the aorta. The disease can involve any part of the aorta, but in most of the cases, the thoracic aorta below the origin of the left subclavian artery followed by the infrarenal portion of the abdominal aorta was the most common site of involvement. In our case, there was extensive thrombosis starting from the lower part of the thoracic aorta extending across both the renal arteries up to the aortic bifurcation without any underlying aortic pathology or hypercoagulable disease. There are no guidelines for the management of the PAT, but our experience is based on few case series, case reports, and meta-analysis where there are variable success rate using conservative medical management, endovascular procedure, or surgical thrombectomy. Vitamin K antagonist was the drug of choice in all the cases as a part of conservative medical management or used to prevent recurrence after the endovascular or surgical procedure. We present a case of PAT where the use of dabigatran leads to complete resolution and prevented the recurrence of the disease during two-year follow-up, which is the first and unique case report of the literature.     

Age-dependent likelihood of in situ thrombosis in secondary pulmonary hypertension.

Pulmonary arterial thrombosis (PAT) may complicate the clinical course of pulmonary hypertension associated with congenital heart disease (so-called Eisenmenger syndrome, ES). In this study, variables were sought that could represent risk factors for the occurrence of this complication. Twenty patients aged 11 to 53 (median, 33) years were studied. The presence of PAT (spiral computed tomography angiography) was correlated with age, gender group, PAP, hematocrit, peripheral oxygen saturation (SpO(2)), and plasma levels of endothelial and coagulation dysfunction markers: von Willebrand factor antigen (vWF:Ag), tissue plasminogen activator (t-PA), and D-dimer (enzyme immunoassay). Patients were classified according to the presence (group 1, N=7), or absence (group 2, N=13) of PAT. Group 1 patients were older (42+/-8 vs. 27+/-10 years in group 2, p=0.0051), had lower SpO(2) (82+/-7% vs. 89+/-6% in group 2, p=0.0462) and increased D-dimer levels (637 vs. 149 ng/mL in group 2, median values, p=0.0235). A trend was observed toward an increase in vWF:Ag (125+/-29 vs. 103+/-18 U/dL in group 2, p=0.0789) and t-PA (15.7 vs. 9.4 ng/mL in group 2, median values, p=0.0689). Age was the main variable influencing the occurrence of PAT in multivariate analysis (p=0.0026), with odds ratio of 1.204 per year. The age of 35 years was 86% sensitive and 85% specific for occurrence of PAT. Age correlated positively with t-PA (r=0.57, p=0.0111). Thus, PAT is highly prevalent in ES as an age-dependent event, probably associated with endothelial dysfunction. Prophylactic anticoagulation should be considered before the age of 30 years, in particular in subjects with low SpO(2) and increased D-dimer levels.     

Clinical and electrophysiologic features of fetal and neonatal paroxysmal atrial tachycardia resulting in congestive heart failure

Those clinical and electrophysiologic features of paroxysmal atrial tachycardia (PAT) that appeared to be the cause of prenatal congestive heart failure (CHF) (hydrops fetalis) were evaluated in 12 neonates, ages 1 to 14 days, and compared with those occurring in 12 neonates, ages 2 to 34 days, who developed CHF from PAT diagnosed postnatally. Transesophageal electrophysiologic evaluation was performed after birth or at the time of PAT occurrence in the prenatal CHF group and at the time of CHF diagnosis in the postnatal CHF group. Before the electrophysiologic study, spontaneous PAT onset and termination were observed in all prenatal CHF neonates. In the postnatal CHF neonates, however, a single, prolonged episode of PAT was observed. During PAT, all neonates were observed to have a regular heart rate, normal QRS morphology and ventriculoatrial interval exceeding 80 ms. These findings suggested an orthodromic reciprocating tachycardia using an accessory atrioventricular connection as the tachycardia mechanism. In the 12 neonates with prenatal CHF, the PAT cycle length measured 243 +/- 30 ms, whereas in the 12 neonates with postnatal CHF it measured 208 +/- 19 ms (p less than 0.003). Neonates with prenatal CHF secondary to PAT appear to develop CHF from multiple PATs recurring at relatively long cycle lengths (slow heart rates), whereas postnatal CHF neonates develop heart failure symptoms during a sustained tachycardia episode with relatively short cycle lengths (fast heart rates).     

Determination of Pericardial Adipose Tissue Increases the Prognostic Accuracy of Coronary Artery Calcification for Future Cardiovascular Events

Objectives: Pericardial adipose tissue (PAT) is associated with coronary artery plaque accumulation and the incidence of coronary heart disease. We evaluated the possible incremental prognostic value of PAT for future cardiovascular events. Methods: 145 patients (94 males, age 60 ± 10 years) with stable coronary artery disease underwent coronary artery calcification (CAC) scanning in a multislice CT scanner, and the volume of pericardial fat was measured. Mean observation time was 5.4 years. Results: 34 patients experienced a severe cardiac event. They had a significantly higher CAC score (1,708 ± 2,269 vs. 538 ± 1,150, p < 0.01), and the CAC score was highly correlated with the relative risk of a future cardiac event: 2.4 (1.8-3.7; p = 0.01) for scores >400, 3.5 (1.9-5.4; p = 0.007) for scores >800 and 5.9 (3.7-7.8; p = 0.005) for scores >1,600. When additionally a PAT volume >200 cm(3) was determined, there was a significant increase in the event rate and relative risk. We calculated a relative risk of 2.9 (1.9-4.2; p = 0.01) for scores >400, 4.0 (2.1-5.0; p = 0.006) for scores >800 and 7.1 (4.1-10.2; p = 0.005) for scores >1,600. Conclusions: The additional determination of PAT increases the predictive power of CAC for future cardiovascular events. PAT might therefore be used as a further parameter for risk stratification.     

Pulmonary artery involvement and associated lung disease in Behçet disease: a series of 47 patients

Pulmonary artery aneurysms (PAAs) are well known causes of mortality and morbidity in Beh?et disease (BD). However, pulmonary artery involvement in BD is not limited to PAA; the other main type of pulmonary artery involvement is pulmonary artery thrombus (PAT), with or without associated PAA. In addition, other types of lung disease like nodules and cavities in the lung parenchyma are frequently associated with pulmonary artery involvement, and can be misinterpreted as being due to infection. We surveyed the clinical, radiologic, and laboratory characteristics and outcome of 47 BD patients with pulmonary artery involvement and the associated findings, all seen and followed at a single dedicated tertiary care center.We identified 47 (41 male, 6 female) patients in whom pulmonary artery involvement was diagnosed, who were registered in the multidisciplinary clinic at Cerrahpasa Medical Faculty between January 2000 and December 2007. Mean age at diagnosis was 29 ± 8 years, and mean disease duration to the onset of pulmonary artery involvement was 3.6 ± 4.8 years. Hemoptysis was the most common presenting symptom (79%) followed by cough, fever, dyspnea, and pleuritic chest pain. Thirty-four of 47 patients (72%) presented with PAA, including 8 with associated PAT. The remaining 13 patients (28%) had isolated PAT. Patients with isolated PAT in general have clinical features similar to patients with PAA. However, hemoptysis was less frequent and voluminous in patients with isolated PAT. Most (91%) of the patients had active disease outside the lungs when they presented with pulmonary artery involvement.Forty (85%) patients had nodules and 6 (13%) had cavities when first seen. Peripheral venous thrombosis was present in 36 of 47 (77%) patients, and intracardiac thrombi in 12 of the 36 (33%) patients. Nodules, cavities, and intracardiac thrombi were mainly present in the acute stages of pulmonary artery involvement.Pulmonary artery involvement is usually multiple, and involves mostly descending branches of the pulmonary artery. Pulmonary artery involvement may disappear, but arterial stenosis or occlusions usually develop at the same location. After a mean follow-up of 7 years, 12 of 47 (26%) patients were dead; patients with larger aneurysms were more likely to die. Sixteen of 47 (34%) patients were symptom free, and the remaining 40% had mild dyspnea (13/47) and/or small bouts of hemoptysis (8/47).Pulmonary artery pressure may be elevated, and may indicate a poor prognosis. Mediastinal lymphadenopathy and mild pleural and pericardial effusions may also be observed. Corticosteroids and immunosuppressive agents are the mainstays of treatment; however, refractory cases may require embolization, lobectomy, cavitectomy, and decortication.     

Platelet antithrombin defect in malignancy: platelet protein alterations

Sixty-eight patients with malignant disease were divided into two groups based on the results of the platelet antithrombin test (PAT). The normal group had a PAT clotting time ranging from 21.4 to 29.8 seconds, which was equivalent to 25% to 65% inactivation of the 2 U of thrombin added to the test system. The other group showed abnormal PAT clotting time, less than 21.4 seconds or less than 25% thrombin inactivation. The polypeptide composition of platelets from the two patient groups was analyzed by sodium dodecyl sulfate (SDS)- electrophoresis on 7.5% polyacrylamide gels. A polypeptide of 180,000 apparent mol wt was decreased or absent in both Coomassie blue- and Alcian blue-stained gels of the platelets from patients whose PAT was abnormal; this polypeptide comigrated with purified platelet thrombospondin. Tritium labeling of platelet surface glycoproteins by the periodate-borohydride method followed by two-dimensional electrophoresis was performed on platelets of seven patients with abnormal PAT. When they were compared with ten patients with normal PAT, a glycoprotein of 140,000 apparent mol wt with a pl of 4.5 to 5.2 was decreased in platelets of all seven patients with abnormal PAT. Nitrocellulose replicas of one-dimensional gels of platelets from 13 of 14 patients with abnormal PAT showed decreased reaction with an anti- human platelet glycocalicin antiserum. Platelets of these same patients also showed a decreased or absent platelet agglutination induced by ristocetin. Patients with normal PAT had a mean agglutination slope of 1.25 +/- 0.6 (n = 26) as compared with 0.37 +/- 0.34 (n = 26) for the abnormal PAT group (P less than .001). Results indicate that platelets from a subpopulation of tumor patients characterized by decreased platelet antithrombin activity have alterations in two platelet glycoproteins, identified as GPIb and thrombospondin.     

双源CT心周脂肪定量与冠状动脉粥样硬化病变程度的相关性

目的 分析心周脂肪体积与心血管危险因素、冠心病的发生和冠状动脉狭窄程度之间的关系.方法 221例同期行64排双源CT和经皮冠状动脉造影检查的患者入选,进行腰围、体质指数和空腹血生物化学指标测定.使用64排双源CT测定心周脂肪体积,通过经皮冠状动脉造影检查明确患者的冠心病诊断和冠状动脉病变支数,并采用Gensini积分量化冠状动脉狭窄的严重程度.结果 入选患者男性占71.04%.男性心周脂肪体积明显大于女性(241.44±78.08 cm~3比216.46±64.36 cm~3,P=0.025).年龄≥70岁的患者心周脂肪体积明显大于年龄<70岁的同性别患者(P<0.05).冠心病患者的心周脂肪体积明显大于非冠心病患者(242.10±75.80 cm~3比189.23±52.26 cm~3,P<0.001).Logistic回归分析显示心周脂肪体积(OR=1.11,P<0.001)和体质指数(OR=1.01,P=0.001)是影响冠心病发生的独立危险因子.心周脂肪体积随着冠状动脉病变支数的增加而增加,并且与Gensini积分呈正相关.结论 64排双源CT可对心周脂肪组织进行准确定量,心周脂肪体积与心血管危险因素和冠心痛的发生以及冠状动脉病变程度存在较强的相关性,可作为一个新的评估冠心病风险和病变程度的指标.     

Relation between digital peripheral arterial tonometry and brachial artery ultrasound measures of vascular function in patients with coronary artery disease and in healthy volunteers

Digital peripheral arterial tonometry (PAT) is an emerging, noninvasive method to assess vascular function. The physiology underlying this phenotype, however, remains unclear. Therefore, we evaluated the relation between digital PAT and established brachial artery ultrasound measures of vascular function under basal conditions and after reactive hyperemia. Using a cross-sectional study design, digital PAT and brachial artery ultrasonography with pulsed wave Doppler were simultaneously completed at baseline and after reactive hyperemia in both those with established coronary artery disease (n = 99) and healthy volunteers with low cardiovascular disease risk (n = 40). Under basal conditions, the digital pulse volume amplitude demonstrated a significant positive correlation with the brachial artery velocity-time integral that was independent of the arterial diameter, in both the healthy volunteer (r(s) = 0.64, p <0.001) and coronary artery disease (r(s) = 0.63, p <0.001) cohorts. Similar positive relations were observed with the baseline brachial artery blood flow velocity and blood flow. In contrast, no relation between the reactive hyperemia-evoked digital PAT ratio and either brachial artery flow-mediated dilation or shear stress was observed in either cohort (p = NS). In conclusion, these findings demonstrate that the digital PAT measures of vascular function more closely reflect basal blood flow in the brachial artery than reactive hyperemia-induced changes in the arterial diameter or flow velocity, and the presence of vascular disease does not modify the physiology underlying the digital PAT phenotype.