A novel effective method for the assessment of microvascular function in male patients with coronary artery disease: a pilot study using laser speckle contrast imaging.

J.P Borges,P.M.C Nascimento,G.O Lopes,M.P Coelho,V Verri,E Tibirica,D.A Kopiler

doi:10.1590/1414-431x20165541

Abstract

Evaluation of microvascular endothelial function is essential for investigating the pathophysiology and treatment of cardiovascular and metabolic diseases. Although laser speckle contrast imaging technology is well accepted as a noninvasive methodology for assessing microvascular endothelial function, it has never been used to compare male patients with coronary artery disease with male age-matched healthy controls. Thus, the aim of this study was to determine whether laser speckle contrast imaging could be used to detect differences in the systemic microvascular functions of patients with established cardiovascular disease (n=61) and healthy age-matched subjects (n=24). Cutaneous blood flow was assessed in the skin of the forearm using laser speckle contrast imaging coupled with the transdermal iontophoretic delivery of acetylcholine and post-occlusive reactive hyperemia. The maximum increase in skin blood flow induced by acetylcholine was significantly reduced in the cardiovascular disease patients compared with the control subjects (74 vs 116%; P<0.01). With regard to post-occlusive reactive hyperemia-induced vasodilation, the patients also presented reduced responses compared to the controls (0.42±0.15 vs 0.50±0.13 APU/mmHg; P=0.04). In conclusion, laser speckle contrast imaging can identify endothelial and microvascular dysfunctions in male individuals with cardiovascular disease. Thus, this technology appears to be an efficient non-invasive technique for evaluating systemic microvascular and endothelial functions, which could be valuable as a peripheral marker of atherothrombotic diseases in men.

Highlights

Cardiovascular diseases are among the leading causes of morbidity and mortality worldwide [1]
The evaluation of microvascular endothelial function is essential for investigating the pathophysiology of cardiometabolic diseases, including arterial hypertension, diabetes, dyslipidemia and obesity [4]
The main finding of this study is that laser speckle contrast imaging (LSCI) is capable of identifying the reduced endothelium-dependent skin microvascular vasodilator responses in patients with coronary artery disease (CAD) compared with healthy subjects

Summary

Introduction

Cardiovascular diseases are among the leading causes of morbidity and mortality worldwide [1]. The evaluation of microvascular endothelial function is essential for investigating the pathophysiology of cardiometabolic diseases, including arterial hypertension, diabetes, dyslipidemia and obesity [4]. From a clinical perspective, the development of an easy-to-perform and noninvasive test for routinely assessing microvascular endothelial function is still required. An optimal tool for routine use should, among other factors, be non-invasive, specific, and able to detect diseased patients [3]. In this sense, the more common non-invasive methods that have been developed in clinical microvascular laboratories are based on laser technology, such as laser Doppler imaging and

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