Parallel Oral Presentation 1a Vascular Surgery O15 Endothelial Dysfunction in Intermittent Claudication

O15 ENDOTHELIAL DYSFUNCTION IN INTERMITTENT CLAUDICATION R Sarvanandan, RA Lane, IC Chetter Academic Vascular Unit, Hull Royal Infirmary/Hull York Medical School Introduction Endothelial dysfunction is integral to the development of atherosclerosis and subsequent plaque progression. In coronary disease, there is an association between disease severity and arterial stiffness and endothelial dysfunction. We aimed to determine the association between disease severity, cardiovascular risk factors and endothelial dysfunction in patients with intermittent claudication (IC). Methods A prospective observational study of consecutive patients with IC was performed. Patients underwent a constant load treadmill assessment along with pre and post exercise ABPIs and were graded according to Rutherford’s criteria. Arterial stiffness and endothelial function were measured with the ‘Endopat2000’ (Itamar, Israel). Both are measured at the capillary bed; the reactive hyperaemia index (RHI) measures endothelial function, and pulse waveform analysis measures the augmentation index(AI), which is a marker of arterial stiffness. Spearman’s correlation coefficient was used (SPSS, v19), a p<0.05 was deemed significant. Results 92 patients with IC were recruited; n=71 (77%) were male, and median age was 66 (IQR 60 to 72) years. AI was moderately associated with pre (r=0.354, p=0.001), and post (r=0.324, p=0.002) exercise ABPI, and weakly associated with smoking (r=0.301, p=0.004), and Rutherford severity (r=0.208, p=0.049). A moderate correlation between RHI and diabetes (r=0.327, P=0.001) was present. There was no association between measures of lower limb ischaemia (ABPI, walking distance or Rutherford grade) and RHI. Conclusions The severity of lower limb ischaemia in claudication demonstrates mild correlation with arterial stiffness but not with endothelial function Disease severity cannot predict underlying endothelial function, and independent assessment should be undertaken. Take-home message Endothelial dysfunction as measured by Endopat2000 device does not correlate with disease severity in intermittent claudication, and independent assessment should be undertaken.