3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
2nd Propedeutic Department of Internal Medicine, Hippokrateio Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Clin Physiol Funct Imaging. 2023 Jul;43(4):211-222. doi: 10.1111/cpf.12819. Epub 2023 Apr 14.
Skin tissue holds a prominent role in microcirculatory research as an easily accessible vascular bed for the noninvasive evaluation of microvascular function. Skin microvascular changes have been associated to alterations in distinct target organs and vascular beds, reinforcing the hypothesis that skin microcirculation can be used as a model of generalized microvascular function. In addition, skin microvascular dysfunction has been documented in cardiovascular disease and patients of increased cardiovascular risk where it has been associated with multiple cardiovascular risk factors, rendering it a candidate surrogate marker of vascular damage. Laser speckle contrast imaging (LSCI) is a noninvasive, dynamic laser technique that allows assessment of skin microvascular function (SMF) by obtaining two-dimensional maps of the skin perfusion in real time with high spatial and temporal resolution and, most importantly, with the highest reproducibility compared to other laser methods. An ever-increasing number of studies using LSCI is confirming evidence of impaired SMF in several cardiovascular risk groups, therefore expanding its application in microvascular research and showing its potential clinical utility. This review attempts to present the growing importance of SMF in cardiovascular research and the emergence of LSCI technique as a robust imaging modality with a promising role to explore skin microvascular physiology. After a short description of the relevant technique and its main principle of function, we have also opted to present the most up to date studies using LSCI for the investigation of SMF in patients with cardiovascular disease as well as various groups of increased cardiovascular risk.
皮肤组织在微循环研究中具有重要作用，它是一个可用于非侵入性评估微血管功能的易于接近的血管床。皮肤微血管的变化与不同靶器官和血管床的改变有关，这加强了皮肤微循环可以作为广义微血管功能模型的假说。此外，皮肤微血管功能障碍已在心血管疾病和心血管风险增加的患者中得到证实，它与多种心血管危险因素有关，使其成为血管损伤的候选替代标志物。激光散斑对比成像（LSCI）是一种非侵入性、动态激光技术，通过实时获得皮肤灌注的二维图谱，以高空间和时间分辨率评估皮肤微血管功能（SMF），最重要的是，与其他激光方法相比，具有最高的可重复性。越来越多的使用 LSCI 的研究证实了几种心血管风险组中 SMF 受损的证据，因此扩展了其在微血管研究中的应用，并显示了其潜在的临床应用价值。这篇综述试图介绍 SMF 在心血管研究中的重要性日益增加，以及 LSCI 技术作为一种强大的成像方式的出现，具有探索皮肤微血管生理学的广阔前景。在简短描述相关技术及其主要功能原理后，我们还选择介绍了使用 LSCI 研究心血管疾病患者以及各种心血管风险增加组的 SMF 的最新研究。
