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Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery
Naser Ahmadi1, Fereshteh Hajsadeghi, Khawar Gul
1Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA.
Insights
Digital thermal monitoring (DTM) identifies vascular dysfunction in asymptomatic individuals. This method shows strong correlation with coronary artery calcium (CAC) and Framingham risk score (FRS), outperforming FRS alone in predicting significant CAC.
Area of Science:
- Cardiovascular diagnostics
- Vascular physiology
- Medical imaging analysis
Background:
- Digital thermal monitoring (DTM) correlates with known coronary artery disease (CAD).
- Assessing subclinical atherosclerosis in asymptomatic individuals is crucial for primary prevention.
- Current risk scores may not fully capture individual risk profiles.
Observation:
- DTM measurements, including temperature rebound (TR) and area under the curve (AUC), were taken during and after cuff occlusion.
- Two hundred thirty-three asymptomatic subjects underwent DTM, CAC scoring, and FRS calculation.
- DTM parameters were correlated with FRS and CAC scores.
Findings:
- Lower TR was observed in patients with higher FRS (>20%) and CAC scores (>=100).
- DTM parameters independently predicted elevated FRS and CAC, even after adjusting for traditional risk factors.
- The combination of DTM and FRS significantly improved the prediction of significant CAC (AUC 0.89) compared to FRS alone (AUC 0.66).
Implications:
- DTM offers a novel, non-invasive method to assess vascular dysfunction.
- DTM can identify at-risk asymptomatic individuals with subclinical atherosclerosis.
- DTM may enhance cardiovascular risk stratification beyond traditional risk scores.
Background:
Digital thermal monitoring (DTM) of vascular function was shown to correlate with the presence of known coronary artery disease (CAD).
Objective:
We evaluated whether DTM can identify at-risk, asymptomatic patients with significant coronary artery calcium (CAC) or increased Framingham risk score (FRS).
Methods:
Two hundred thirty-three consecutive asymptomatic subjects (58 +/- 11 years; 62% men) without known CAD underwent DTM, CAC, and FRS calculation. DTM measurements were obtained during and after a 5-minute suprasystolic arm-cuff occlusion. After cuff-deflation temperature rebound (TR) and area under the temperature curve (AUC) were measured and correlated with FRS and CAC.
Results:
TR was lower in patients with FRS > 20% and CAC >or= 100 as compared with FRS < 10% and CAC < 10, respectively (P < 0.05). After adjustment for age, sex, and traditional cardiac risk factors, the odds ratio of the lowest compared with the upper 2 tertiles of TR was 3.96 for FRS >or= 20% and 2.37 for CAC >or= 100 compared with low-risk cohorts. The area under the receiver operating characteristic (ROC) curve to predict CAC >or= 100 increased significantly from 0.66 for FRS to 0.79 for TR to 0.89 for TR + FRS.
Conclusions:
Vascular dysfunction measured by DTM strongly correlates with FRS and CAC independent of age, sex, and traditional cardiac risk factors and was superior to FRS for the prediction of significant CAC.
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