The Correlation Between Rewarming Time Of The Finger Cooling Test And The Degree Of Coronary Stenosis Of Patients Who Underwent Coronary Angiography

Background:Coronary heart disease(CHD)is a heart disease caused by myocardial ischemia,hypoxia or necrosis due to coronary stenosis or obstruction.Its main pathophysiological basis is coronary atherosclerosis.In the past,people’s attention to coronary heart disease mainly diagnosed by coronary angiography has been paid to the epicardial artery.The primary purpose of treatment is to open the blocked blood vessels and restore blood perfusion.However,with the development of percutaneous interventional therapy,the phenomenon of "no reflow" or "slow blood flow" has increased,and people gradually recognize the important role of microcirculation in the development of coronary artery disease.A large body of evidence suggests that coronary atherosclerosis is not confined to the coronary artery,and it is closely related to the peripheral microcirculation.Some researchers think that microvascular dysfunction may occur earlier than macrovascular disease,and that it seems possible to identify coronary arteriosclerosis early by evaluating microcirculation function.Peripheral microcirculation and coronary microcirculation both belong to the circulatory system,so peripheral blood vessels must be involved in the process of coronary atherosclerosis.Therefore,some people have explored the relationship between peripheral microcirculation function and coronary atherosclerosis.Up to now,a variety of methods for assessing peripheral microcirculation have been developed,including peripheral artery tonometry(PAT),laser Doppler imaging(LDI),and digital thermal monitoring(DTM).Compared with the former two,the finger cooling test is simple and non-invasive,and has been used to evaluate the circulation of peripheral vascular diseases such as Raynaud’s syndrome.Although several studies have shown that peripheral microcirculatory disorders are associated with cardiovascular risk factors and poor prognosis,there is no study to investigate whether peripheral microcirculation is associated with coronary stenosis.To this end,this study explored the correlation between peripheral microcirculation assessing by the finger cooling test(FCT)and coronary stenosis degree assessing by the Gensini score after coronary angiography.We aim at providing evidence for early identification of coronary artery disease in the clinical practice.Objective:The goal of this study was to assess whether rewarming time(RT)of the finger cooling test(FCT)is associated with the severity of coronary artery stenosis in patients who underwent coronary angiography.Method:This study included 113 in-patients who were suspected of having coronary heart disease(80 males and 33 females,62.6 ± 10.5 years old).According to the results of coronary angiography,three groups were created: 21 in normal,27 in Non-CHD group(stenosis <50%)and 65 in coronary heart disease(CHD)group(stenosis ≥ 50% at least in one coronary artery).After taking the basic temperature(baseline-T),the index finger was immersed into water at 10 °C for 60-seconds.After cooling stimulus withdrawal,the duration of finger temperature returned to the baseline-T was noted as the RT.The severity of coronary artery stenosis was estimated with the Gensini score.Result:There were differences in gender,age,previous history of hypertension,history of smoking,and aspartate aminotransferase among the three groups while no significant difference was found in other indicators.The RT gradually increased from normal(248±116 s),Non-CHD(344±238 s)and to CHD(371±261s),and a significant difference was found between the normal and the CHD group(P=0.004).Unfortunately,there was no significant difference between the normal group and the non-CHD group,the non-CHD group and the CHD group.In addition,T0 gradually decreased in the three groups,while DA had no statistically significant difference in the three groups.Spearman’s correlation analysis showed a positive correlation between RT and Gensini scores and HDL(r = 0.209,P = 0.026;r = 0.203,P = 0.031)and a negative correlation with BMI(r =-0.206,P = 0.028).Meanwhile,multivariate regression analysis showed Gensini scores was an independent positive factor(β = 0.249,p = 0.007)for RT and BMI was an independent negative predictor for RT(β =-0.208,p = 0.023).Conclusion:The positive association between RT and Gensini scores suggests that more obvious microvascular dysfunction in the CHD patients with more severe coronary artery stenosis.