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Reduced systemic microvascular density and reactivity in individuals with early onset coronary artery disease

Eduardo Tibirica1, Elaine G Souza2, Andrea De Lorenzo2

  • 1National Institute of Cardiology (INC), Rio de Janeiro, Brazil; Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.

Microvascular Research
|December 3, 2014
PubMed

Insights

Patients with early-onset coronary artery disease exhibit reduced capillary density and impaired microvascular function. These findings suggest microvascular alterations may serve as an early marker for subclinical atherosclerosis in at-risk young adults.

Area of Science:

  • Cardiovascular Research
  • Microvascular Medicine
  • Atherosclerosis Studies

Background:

  • Early-onset coronary artery disease (EOCAD) affects young individuals, necessitating early detection of underlying pathologies.
  • Microvascular dysfunction and capillary rarefaction are increasingly recognized contributors to cardiovascular disease.
  • Assessing microvascular function may provide insights into subclinical atherosclerosis in EOCAD patients.

Purpose of the Study:

  • To investigate systemic microvascular rarefaction and endothelial dysfunction in patients with EOCAD.
  • To compare microvascular parameters between EOCAD patients and age-/sex-matched healthy controls.
  • To evaluate the potential of skin video-capillaroscopy in detecting early signs of atherosclerosis.

Main Methods:

  • Skin video-capillaroscopy was employed to assess functional capillary density (FCD) in EOCAD patients and controls.
  • High-resolution intra-vital color microscopy measured FCD in the dorsum of the middle phalanx.
  • Post-occlusive reactive hyperemia (PORH) was used to evaluate capillary recruitment and reserve.

Main Results:

  • EOCAD patients demonstrated significantly reduced mean capillary density at rest compared to controls (80±18 vs. 95±20 capillaries/mm²).
  • Capillary density remained markedly reduced in EOCAD patients during PORH (71±20 capillaries/mm²).
  • A significant reduction in capillary density was observed in EOCAD patients from rest to PORH (80±19 to 71±20 capillaries/mm²).

Conclusions:

  • Patients with EOCAD exhibit systemic capillary rarefaction and impaired microvascular endothelial function.
  • These microvascular alterations may serve as a surrogate marker for subclinical atherosclerosis.
  • Early detection of these changes in young adults at risk could aid in identifying subclinical atherosclerosis.
Abstract

Keywords:
Capillary rarefactionCardiovascular riskCoronary artery diseaseMicrovascular endothelial dysfunctionSkin microvascular reactivity

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