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Patients with chronic hypoparathyroidism (cHypoPT) are prone to intracranial-calcification, cataract and nephrocalcinosis. In this study, we systematically investigated the possibility of increased coronary artery calcification (CAC) and coronary artery disease (CAD) in them.Cross-sectional.Ninety-four nonsurgical cHypoPT (M:F = 50:44; age = 45 ± 15 years) with 18.6 ± 9.3 years of illness were assessed. Those with dyspnoea, angina, syncope, abnormal electrocardiogram, echocardiography or significant CAC underwent coronary angiography or myocardial-perfusion-stress imaging. Their lipid parameters and high-sensitivity C-reactive protein (hsCRP) were compared with age-matched healthy controls (Group A, n = 101). The prevalence of CAC in cHypoPT was compared with that of subjects referred from cardiology-clinics (Group B, n = 148, age = 52 ± 11 years).One of 94 cHypoPT had known CAD. On screening, 17 cHypoPT required evaluation for CAD. Two of 17 had severe coronary stenosis, and 12 showed subclinical CAD. CAC and aortic-valve calcification occurred in 21.5% and 11.8%. Clinical and subclinical CAD, CAC and aortic-valve calcification in cHypoPT ≥50 years of age was 8.1%, 27.0%, 52.8% and 27.8%, respectively. Frequency of age-adjusted CAC was comparable between cHypoPT and control Group B (30.2% vs. 30.7%, p = .93). Elevated hsCRP was higher in cHypoPT than in controls A (52% vs. 32%, p .01). Factors associated with CAD in cHypoPT were CAC and hypertension. However, CAD and CAC showed no association with long-term calcemic or phosphatemic control and intracranial-calcification in cHypoPT.Clinical and subclinical CAD was observed in 3.2% and 12.8% of cHypoPT patients. The increased prevalence of CAD, CAC and aortic-valve calcification in cHypoPT above 50 years of age suggested their careful cardiac evaluation during follow-up.

Low-flow-mediated constriction (LFMC) has been used to assess resting endothelial function in peripheral conduit arteries. The literature describes discrepancies in the behaviour of radial versus brachial artery in response to low-flow state, the reasons for which were not addressed in a systematic and scientific way. Moreover, the influence of handedness on observed LFMC responses has not been investigated. The present study aimed at systematic measurement and comparison of the LFMC responses in radial and brachial arteries of both dominant and non-dominant arms of healthy human volunteers. We also investigated the physiological factors associated with differential LFMC response of radial versus brachial artery in the same group of subjects. Longitudinal B mode ultrasonographic cine loops of radial and brachial arteries were acquired at baseline and after producing distal circulatory arrest. Cine loops were screen grabbed and analyzed later using automated edge detection algorithms to measure end-diastolic diameters. Distal circulatory arrest was produced over the proximal forearm (for the brachial artery) and over the wrist (for the radial artery) at 250 mm Hg for 5 min after baseline measurements. Results suggested that arterial location (p = 0.0001) and baseline diameter (p0.0021) emerged as independent predictors of LFMC response. Differences in the LFMC responses are handedness independent and could be attributed to the arterial location along with the differences in their baseline diameters.

Background: Ultrasonographic imaging to record changes in peripheral arterial diameter associated with Flow mediated dilatation or Low flow mediated constriction is routinely used to assess various facets of vascular endothelial function. Imaging poses many challenges including requirement of costly ultrasound machines, trained manpower to perform imaging and effort-intensive steps to analyse the images subsequently using manual or automated methods. We tested the feasibility and validity of using an imaging-free technology to record resting arterial diameters of brachial and radial arteries. Methods: Eight healthy volunteers initially underwent ultrasonographic imaging (M7, Mindray; Shenzhen, P.R. China) of brachial artery and proximal radial artery. The brachial and radial artery ‘zones’ thereby identified through imaging were surface marked on subject’s arm. Imaging-free ARTSENS® Pen device [1] (Healthcare Technology Innovation Centre, IIT Madras, India) consisting of highly integrated hardware for operating a single element broadband ultrasound transducer (centre-frequency = 5 MHz, spatial half angle

Background: Literature describes differences in Low flow mediated constriction (LFMC) of radial versus brachial artery [1,2]. We investigated whether differences in occlusion induced changes in luminal flow and shear rates could explain the observed radial vs brachial differences in LFMC responses. Methods: Twenty Healthy volunteers (Age 23.50 ± 2.06 years) underwent examination of Brachial and radial arteries of both the arms. Arteries were visualized in Pulsed wave doppler in duplex mode (Vivid-e; GE Healthcare) using a 12 MHz probe at baseline and during low flow state produced using an occluding cuff placed around the forearm (for brachial artery) and over the wrist joint (for radial artery) inflated to supra-systolic pressures. Results: LFMC in Radial artery was significantly higher than that of Brachial artery [delta LFMC of −0.58 mm (−0.24––0.76) in radial artery vs 0.03 mm (0.21––0.13) in brachial artery; p < 0.0001). Occlusion induced reduction in anterograde shear rate was comparatively higher in radial artery than brachial artery [−67.9% (−43––77) in radial vs −56.7% (−40.9––65.4) in brachial; p = 0.0098] whereas, the rise in retrograde shear rate and changes in oscillatory shear index were comparable between both. Percentage changes in anterograde shear rate and anterograde flow velocities emerged as independent predictors in the regression model that explained 86% of the variance in LFMC responses of brachial artery. Conclusion: Discrepancies in the LFMC responses of radial vs brachial artery could be attributed to the occlusion induced differences in the anterograde shear rate and anterograde flow velocities.