Microvascular rarefaction in patients with cerebrovascular events
Patricia P Wadowski1, Christian Schörgenhofer2, Thomas Rieder2
1Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Vienna, Austria.
Microvascular Research
|December 26, 2021
Summary
Acute cerebrovascular events, like stroke, are linked to reduced microvascular density and impaired blood flow. Sublingual videomicroscopy revealed systemic microcirculatory changes in patients, indicating altered perfusion.
Area of Science:
- Neurology
- Cardiovascular Science
- Microcirculation Research
Background:
- Chronic hypoperfusion and endothelial dysfunction are hallmarks of cerebral small vessel disease.
- Animal studies suggest microvascular remodeling plays a role in post-stroke brain reorganization.
- This study investigates if microcirculatory changes during acute cerebrovascular events are detectable systemically.
Purpose of the Study:
- To determine if acute cerebrovascular events alter systemic microcirculation.
- To explore the utility of sublingual videomicroscopy in assessing microcirculatory changes.
- To correlate microvascular parameters with clinical outcomes and laboratory findings.
Main Methods:
- Prospective observational trial involving 21 patients with acute stroke or transient ischemic attacks (TIAs) within 24 hours of admission.
- Comparison with an age- and sex-matched control group.
- In vivo sublingual sidestream darkfield videomicroscopy performed at admission, day 3, and day 7.
- Analysis of functional and perfused capillary density, perfused boundary region (PBR), and red blood cell (RBC) filling percentage.
- Assessment of platelet count and aggregation.
Main Results:
- Patients exhibited rarefied functional and perfused capillary density compared to controls (p < 0.001).
- A strong inverse correlation was found between PBR (glycocalyx indicator) and RBC filling percentage (microvessel perfusion) in patients and controls (r = -0.843, p < 0.001).
- Significant associations were observed between platelet parameters and microvascular alterations in stroke patients.
Conclusions:
- Acute cerebrovascular events are associated with systemic alterations in microvascular perfusion.
- Sublingual videomicroscopy can visualize these systemic microcirculatory changes.
- Microvascular dysfunction, including glycocalyx integrity and platelet activity, may contribute to stroke pathophysiology.
Keywords:
CapillariesIschemic strokeMicrocirculationSidestream darkfield videomicroscopyStrokeTransient ischemic attackMore Related Videos
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