Department of Medicine, Division of Cardiology, Pneumology, and Vascular Diseases, University Hospital, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
Microcirculation. 2010 Jul;17(5):358-66. doi: 10.1111/j.1549-8719.2010.00037.x.
Microcirculatory dysfunction contributes to morbidity and mortality in vascular diseases. Here, we aimed at establishing a sensitive and valid method to measure microvascular reactivity during post-occlusive reactive hyperemia (PORH) using scanning laser Doppler perfusion imaging (LDPI) of the forearm.
In a first series, LDPI was methodologically evaluated on the volar forearm of healthy volunteers (n = 10) before and after one to five minutes of upper arm occlusion. In a second series, readings were performed in 20 healthy subjects and 20 patients with coronary artery disease (CAD).
Three minutes of forearm occlusion were sufficient to induce maximal vasodilation during PORH as indicated by maximal increase in perfusion unit (PU) amplitude that did not further increase after five-minute occlusion. Five-minute occlusion led to a significant prolongation of PORH with greater area under curve (AUC) suggesting longer lasting vasodilation of microvessels. The five-minute occlusion was associated with lower variability as compared with three minutes (intraindividual variability: 9-17% vs. 12-21%; interindividual variability: 13-24% vs. 14-26%). CAD patients exhibited significantly reduced amplitude (105 +/- 49 vs. 164 +/- 35 PU; p < 0.001), ratio (4.7 +/- 1.8 vs. 7.1 +/- 1.8; p < 0.001), and AUC (1656 +/- 1070 vs. 2723 +/- 864 PU x minutes; p = 0.001).
Scanning LDPI is a feasible and reproducible method for non-invasive assessment of the cutaneous microcirculatory response during PORH.
微循环功能障碍导致血管疾病的发病率和死亡率。在这里，我们旨在建立一种敏感和有效的方法来测量前臂扫描激光多普勒灌注成像（LDPI）在闭塞后反应性充血（PORH）期间的微血管反应性。
在第一个系列中，在健康志愿者（n = 10）的前臂掌侧进行了 LDPI 的方法学评估，分别在 1 至 5 分钟的上臂闭塞之前和之后进行。在第二个系列中，在 20 名健康受试者和 20 名冠心病患者中进行了读数。
前臂闭塞 3 分钟足以诱导 PORH 期间的最大血管扩张，这表现为灌注单位（PU）幅度的最大增加，在 5 分钟闭塞后不再增加。5 分钟的闭塞导致 PORH 的持续时间延长，曲线下面积（AUC）更大，提示微血管的血管扩张持续时间更长。与 3 分钟相比，5 分钟的闭塞与较低的变异性相关（个体内变异性：9-17%对 12-21%；个体间变异性：13-24%对 14-26%）。冠心病患者的振幅明显降低（105 +/- 49 对 164 +/- 35 PU；p < 0.001），比率（4.7 +/- 1.8 对 7.1 +/- 1.8；p < 0.001）和 AUC（1656 +/- 1070 对 2723 +/- 864 PU x 分钟；p = 0.001）。
扫描 LDPI 是一种可行且可重复的方法，用于非侵入性评估 PORH 期间的皮肤微循环反应。
