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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
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Observational Study of Sublingual Microcirculation in Patients With Chronic Cardiovascular Disease
Jacob Niculcea1, James W Schurr1, Fatima M Talebi2
1Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Microcirculation (New York, N.Y. : 1994)
|October 13, 2025
Summary
Sublingual microcirculation in cardiovascular disease (CVD) patients is largely normal, except for diabetic individuals who show reduced microvascular heterogeneity. This study quantizes key microvascular metrics in a large CVD cohort.
Area of Science:
- Cardiovascular Science
- Microcirculation Research
- Medical Imaging
Background:
- Sublingual video microscopy is a valuable tool for assessing microcirculation, particularly in acute conditions.
- The microcirculation in patients with chronic cardiovascular diseases (CVD) remains understudied.
- This study aims to fill this knowledge gap by quantifying sublingual microcirculatory parameters in a large CVD cohort.
Purpose of the Study:
- To quantify key sublingual microcirculatory parameters in a cohort of patients with chronic cardiovascular diseases (CVD).
- To investigate the influence of age, comorbidities, and systemic hemodynamics on sublingual microcirculation in CVD patients.
Main Methods:
- One hundred thirteen patients with CVD were enrolled in the study.
- Incident dark-field handheld video microscopy (IDF-HVM) was employed to measure microvascular flow index (MFI), microvascular heterogeneity index (MHI), proportion of perfused vessels (PPV), perfused vessel density (PVD), and total vessel density (TVD).
- Data were stratified by age, cardiovascular comorbidities (hypertension, diabetes, CKD, CAD, HF), and hemodynamics (MAP, PP).
Main Results:
- Overall MFI was 2.86 ± 0.20, MHI was 0.15 ± 0.20, PPV was 94.3% ± 4.9%, PVD was 23.1 ± 4.7 mm/mm², and TVD was 24.5 ± 4.8 mm/mm².
- Diabetic patients exhibited a significantly lower mean MHI (0.10) compared to non-diabetic patients (0.17; p=0.046).
- No significant differences in sublingual microcirculatory parameters were observed based on other CVDs, age groups, or systemic hemodynamics.
Conclusions:
- Sublingual microvascular parameters in patients with stable cardiovascular disease are generally consistent across different age groups, blood pressure levels, and comorbidities.
- Diabetes mellitus is identified as a significant factor associated with altered sublingual microcirculation, specifically reduced microvascular heterogeneity (MHI).
- These findings highlight the potential impact of diabetes on the microvasculature in CVD patients and suggest MHI as a sensitive indicator.
