gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Endothelium-dependent vasodilation in forearm skin microcirculation is a surrogate for coronary vasomotion in CAD

Die Endothel-abhängige Vasodilatation in der Unterarm-Hautmikrozirkulation ist ein Surrogat für die koronare Vasomotion bei KHK-Patienten

Meeting Abstract (Hypertonie 2003)

  • presenting/speaker H. Bruck - Universitätsklinikum Essen (Essen, D)
  • C. Naber - Universitätsklinikum Essen (Essen, D)
  • D. Baumgart - Universitätsklinikum Essen (Essen, D)
  • R.F. Schäfers - Universitätsklinikum Essen (Essen, D)
  • R. Erbel - Universitätsklinikum Essen (Essen, D)
  • T. Philipp - Universitätsklinikum Essen (Essen, D)
  • R.R. Wenzel - Universitätsklinikum Essen (Essen, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP58

The electronic version of this article is the complete one and can be found online at:

Published: November 11, 2004

© 2004 Bruck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




In coronary artery disease (CAD) endothelial function may be disturbed in an early phase of the disease; endothelial dysfunction can be quantified by assessing coronary dilatation to acetylcholine (Ach).

The study aimed to investigate whether in patients with CAD endothelium-dependent vasomotion measured invasively by quantitative coronary angiography is related to vasomotion in skin microcirculation.


7 patients (2 female, 5 male, mean age 54±4 years, BMI 26±2 kg/m2) with CAD underwent invasive coronary angiography and were intracoronary infused with Ach (10-6 to 10-8 mol). Ach-effects were measured by quantitative coronary angiography (in APV) and were correlated with changes in blood flow assessed with double-injection-technique and laser-Doppler flowmetry in the forearm skin microcirculation (in arbitrary perfusion units, PU) after intradermal injection of Ach (10-6 to 10-8 mol) [Fig. 1].


In 6 patients Ach induced a dose-dependent vasodilatation of the coronary artery (delta APV for Ach 10-6: 7,5±2,3; Ach10-7: 0,83±0,8 and Ach10-8: -0,98±1,9) and in skin microcirculation (delta PU: Ach 10-6: 1396±331; Ach10-7: 1232±515 and Ach10-8: 582±358); in 1 patient Ach induced paradox vasoconstriction of the coronary artery and in skin microcirculation. Ach-induced changes in coronary artery perfusion significantly correlated with changes in skin microcirculation perfusion (p=0.04, r2=0,2, see figure). Furthermore, there was a positive correlation between serum LDL-levels with Ach-induced changes (p=0,02; r2=0,68 for the coronary artery and p=0,01; r2=0,76 for skin microcirculation).


In patients with CAD assessment of endothelium-dependent vasodilatation in the forearm skin microcirculation by double-injection technique and laser-Doppler-flowmetry is a minimal invasive test that predicts coronary endothelial function and correlates with serum LDL-cholesterol.