Introduction: Current microvascular assessments may not be practical or accessible requiring experienced personnel and/or ongoing equipment costs. Piezoelectric transducers can reliably obtain finger blood pressure waves, similar to peripheral arterial tonometry devices; thus, they could be used to estimate microvascular function. We aimed to validate piezoelectric transducers as an alternative measure of microvascular function compared to EndoPAT. Methods: Twenty-five adults (aged 20–64 years) completed reactive hyperemia (5 min forearm circulatory occlusion and 3 min recovery) with piezoelectric transducers on the middle fingers and EndoPAT probes on the index fingers. Average area under the curve (AUC) of the pulse wave signal for the occluded and control arms was determined at baseline, every 30 s post-occlusion, and 10 s around the peak response. Microvascular function index (MFI) was calculated as the ratio of AUC post-occlusion to AUC baseline in the test arm, then normalized to the same ratio in the control arm. MFI at each time point was correlated with the reactive hyperemia index (RHI) from the EndoPAT. Results: The greatest significance was found between RHI and MFI at 10 s around the peak response (Spearman’s r = 0.67, p = 0.0002; Pearson’s r = 0.76, p = 0.00001). Conclusion: MFI is a reusable and user-friendly microvascular function assessment that could provide better access to vascular health screening.

1.
Furchgott
RF
,
Zawadzki
JV
.
The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine
.
Nature
.
1980
;
288
(
5789
):
373
6
.
2.
Rubanyi
GM
,
Romero
JC
,
Vanhoutte
PM
.
Flow-induced release of endothelium-derived relaxing factor
.
Am J Physiol
.
1986
;
250
(
6 Pt 2
):
H1145
9
.
3.
Frame
MDS
,
Sarelius
IH
.
Endothelial cell dilatory pathways link flow and wall shear stress in an intact arteriolar network
.
J Appl Physiol
.
1996
;
81
(
5
):
2105
14
.
4.
Palmer
RMJ
,
Ferrige
AG
,
Moncada
S
.
Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor
.
Nature
.
1987
;
327
(
6122
):
524
6
.
5.
Alexander
Y
,
Osto
E
,
Schmidt-Trucksäss
A
,
Shechter
M
,
Trifunovic
D
,
Duncker
DJ
, et al
.
Endothelial function in cardiovascular medicine: a consensus paper of the European society of cardiology working groups on atherosclerosis and vascular biology, aorta and peripheral vascular diseases, coronary pathophysiology and microcirculation, and thrombosis
.
Cardiovasc Res
.
2021
;
117
(
1
):
29
42
.
6.
Sorensen
KE
,
Celermajer
DS
,
Georgakopoulos
D
,
Hatcher
G
,
Betteridge
DJ
,
Deanfield
JE
.
Impairment of endothelium-dependent dilation is an early event in children with familial hypercholesterolemia and is related to the lipoprotein(a) level
.
J Clin Invest
.
1994
;
93
(
1
):
50
5
.
7.
Kinlay
S
,
Ganz
P
.
Role of endothelial dysfunction in coronary artery disease and implications for therapy
.
Am J Cardiol
.
1997
;
80
(
9A
):
11I
16I
.
8.
Gokce
N
,
Keaney
JF
,
Hunter
LM
,
Watkins
MT
,
Menzoian
JO
,
Vita
JA
.
Risk stratification for postoperative cardiovascular events via noninvasive assessment of endothelial function: a prospective study
.
Circulation
.
2002
;
105
(
13
):
1567
72
.
9.
Hasdai
D
,
Lerman
A
.
The assessment of endothelial function in the cardiac catheterization laboratory in patients with risk factors for atherosclerotic coronary artery disease
.
Herz
.
1999
;
24
(
7
):
544
7
.
10.
Reriani
MK
,
Lerman
LO
,
Lerman
A
.
Endothelial function as a functional expression of cardiovascular risk factors
.
Biomark Med
.
2010
;
4
(
3
):
351
60
.
11.
Corretti
MC
,
Anderson
TJ
,
Benjamin
EJ
,
Celermajer
D
,
Charbonneau
F
,
Creager
MA
, et al
.
Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force
.
J Am Coll Cardiol
.
2002
;
39
(
2
):
257
65
.
12.
Takase
B
,
Uehata
A
,
Akima
T
,
Nagai
T
,
Nishioka
T
,
Hamabe
A
, et al
.
Endothelium-dependent flow-mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease
.
Am J Cardiol
.
1998
;
82
(
12
):
1535
9
, A7–8.
13.
Kuvin
JT
,
Patel
AR
,
Sliney
KA
,
Pandian
NG
,
Sheffy
J
,
Schnall
RP
, et al
.
Assessment of peripheral vascular endothelial function with finger arterial pulse wave amplitude
.
Am Heart J
.
2003
;
146
(
1
):
168
74
.
14.
Hamburg
NM
,
Benjamin
EJ
.
Assessment of endothelial function using digital pulse amplitude tonometry
.
Trends Cardiovasc Med
.
2009
;
19
(
1
):
6
11
.
15.
Moerland
M
,
Kales
AJ
,
Schrier
L
,
van Dongen
MGJ
,
Bradnock
D
,
Burggraaf
J
.
Evaluation of the EndoPAT as a tool to assess endothelial function
.
Int J Vasc Med
.
2012
;
2012
:
904141
8
.
16.
Bonetti
PO
,
Pumper
GM
,
Higano
ST
,
Holmes
DR
,
Kuvin
JT
,
Lerman
A
.
Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia
.
J Am Coll Cardiol
.
2004
;
44
(
11
):
2137
41
.
17.
Nohria
A
,
Gerhard-Herman
M
,
Creager
MA
,
Hurley
S
,
Mitra
D
,
Ganz
P
.
Role of nitric oxide in the regulation of digital pulse volume amplitude in humans
.
J Appl Physiol
.
2006
;
101
(
2
):
545
8
.
18.
Foo
JYA
,
Lim
CS
.
Pulse transit time based on piezoelectric technique at the radial artery
.
J Clin Monit Comput
.
2006
;
20
(
3
):
185
92
.
19.
Edgell
H
,
Stickland
MK
,
MacLean
JE
.
A simplified measurement of pulse wave velocity is not inferior to standard measurement in young adults and children
.
Blood Press Monit
.
2016
;
21
(
3
):
192
5
.
20.
Qananwah
Q
,
Dagamseh
A
,
Alquran
H
,
Ibrahim
KS
,
Alodat
M
,
Hayden
O
.
A comparative study of photoplethysmogram and piezoelectric plethysmogram signals
.
Phys Eng Sci Med
.
2020
;
43
(
4
):
1207
17
.
21.
Nardone
M
,
Miner
S
,
McCarthy
M
,
Ardern
CI
,
Edgell
H
.
Noninvasive microvascular indices reveal peripheral vascular abnormalities in patients with suspected coronary microvascular dysfunction
.
Can J Cardiol
.
2020
;
36
(
8
):
1289
97
.
22.
Zou
KH
,
O’Malley
AJ
,
Mauri
L
.
Receiver-operating characteristic analysis for evaluating diagnostic tests and predictive models
.
Circulation
.
2007
;
115
(
5
):
654
7
.
23.
Black
MA
,
Cable
NT
,
Thijssen
DHJ
,
Green
DJ
.
Importance of measuring the time course of flow-mediated dilatation in humans
.
Hypertension
.
2008
;
51
(
2
):
203
10
.
24.
Jujic
A
,
Kennebäck
C
,
Johansson
M
,
Nilsson
PM
,
Holm
H
.
The impact of age on endothelial dysfunction measured by peripheral arterial tonometry in a healthy population-based cohort – the Malmö offspring study
.
Blood Press
.
2023
;
32
(
1
):
2234059
.
25.
Habib
K
,
Fallah
B
,
Edgell
H
.
Effect of upright posture on endothelial function in women and men
.
Front Physiol
.
2022
;
13
:
846229
.
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