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Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease
M Esther Sanchez-Garcia1, Irene Ramirez-Lara1, Francisco Gomez-Delgado1
1Unidad de Lípidos y Arterosclerosis, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, España; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, España.
Insights
Patients with coronary heart disease show impaired microcirculation, including reduced capillary density at rest and after dynamic tests. This suggests both structural and functional microvascular disturbances in these individuals.
Area of Science:
- Cardiovascular Medicine
- Microcirculation Research
- Dermatology
Background:
- Microcirculation disturbances are linked to cardiovascular risk factors and inflammatory diseases.
- The specific impact on coronary heart disease (CHD) patients remains unclear.
- Investigating microvascular abnormalities in CHD is crucial for understanding disease mechanisms.
Purpose of the Study:
- To evaluate the relationship between coronary heart disease and capillary abnormalities.
- To assess functional and structural capillary changes in the cutaneous microcirculation.
- To utilize videocapillaroscopy for detailed microvascular analysis in CHD patients.
Main Methods:
- Videocapillaroscopy was performed on the dorsal skin of the third finger in 30 CHD patients and 30 matched controls.
- Basal and post-occlusion (arterial and venous) capillary density were measured to assess functionality.
- Capillary recruitment was also evaluated to understand microvascular response.
Main Results:
- Patients with CHD exhibited significantly lower resting microvascular capillary density compared to controls.
- Functional impairments were suggested by reduced capillary density even after dynamic tests.
- No significant difference in capillary recruitment was observed between the groups.
Conclusions:
- Coronary heart disease patients demonstrate both functional and structural microvascular disturbances.
- These preliminary findings highlight the importance of microvascular assessment in CHD.
- Further research is warranted to explore the link between microvascular function, treatment response, and prognosis in CHD.
Introduction And Objectives:
Microcirculation disturbances have been associated to most of the cardiovascular risk factors as well as to multiple inflammatory diseases. However, whether these abnormalities are specifically augmented in patients with coronary heart disease is still unknown. We aimed to evaluate if there is a relationship between the presence of coronary heart disease and the existence of functional and structural capillary abnormalities evaluated in the cutaneous microcirculation by videocapillaroscopy.
Material And Methods:
Two matched samples of 30 participants with and without coronary heart disease but with similar clinical and anthropometric characteristics were evaluated by videocapillaroscopy at the dorsal skin of the third finger of the non-dominant hand. We calculated basal capillary density as well as capillary density after a period of arterial and venous occlusion in order to evaluate functionality and maximum capillary density. We also measured capillary recruitment.
Results:
Microvascular capillary density at rest was significantly lower in patients suffering from coronary heart disease than in controls. This fact was also found after dynamic tests (arterial and venous occlusion), suggesting functional impairments. Capillary recruitment of the samples was not different in our sample.
Conclusions:
In our study, patients with coronary heart disease exhibit functional and structural microvascular disturbances. Although this is a very preliminary study, these findings open the door for further studying the microvascular functionality in coronary patients and how it relates to the response to treatment and/or the prognosis of the disease.
