PURPOSE: In diabetes, generalised microvascular disease and coronary artery disease (CAD) are likely to occur in parallel. We used a sidestream dark field (SDF) handheld imaging device to determine the relation between the labial microcirculation parameters and CAD in asymptomatic patients with diabetes. METHODS: SDF imaging was validated for assessment of labial capillary density and tortuosity. Thereafter, mean labial capillary density and tortuosity were evaluated and compared in non-diabetic controls, and in asymptomatic patients with type 1 and type 2 diabetes. In diabetic patients, mean capillary density and tortuosity were compared according to the presence of CAD. RESULTS: Both type 1 and type 2 diabetes were associated with increased capillary density and tortuosity. In diabetes, mean capillary density was an independent predictor of elevated coronary artery calcium (CAC) (p = 0.03) and obstructive CAD on computed tomography angiography (p = 0.01). Using a cut-off mean capillary density of 24.9 (per 0.63 mm(2)) the negative predictive value was 84% and 89% for elevated CAC and obstructive CAD. Likewise, capillary tortuosity was an independent predictor of increased CAC (p = 0.01) and obstructive CAD (p = 0.04). CONCLUSION: Assessment of labial microcirculation parameters using SDF imaging is feasible and conveys the potential to estimate vascular morbidity in patients with diabetes, at bedside.
PURPOSE: In diabetes, generalised microvascular disease and coronary artery disease (CAD) are likely to occur in parallel. We used a sidestream dark field (SDF) handheld imaging device to determine the relation between the labial microcirculation parameters and CAD in asymptomatic patients with diabetes. METHODS:SDF imaging was validated for assessment of labial capillary density and tortuosity. Thereafter, mean labial capillary density and tortuosity were evaluated and compared in non-diabetic controls, and in asymptomatic patients with type 1 and type 2 diabetes. In diabeticpatients, mean capillary density and tortuosity were compared according to the presence of CAD. RESULTS: Both type 1 and type 2 diabetes were associated with increased capillary density and tortuosity. In diabetes, mean capillary density was an independent predictor of elevated coronary artery calcium (CAC) (p = 0.03) and obstructive CAD on computed tomography angiography (p = 0.01). Using a cut-off mean capillary density of 24.9 (per 0.63 mm(2)) the negative predictive value was 84% and 89% for elevated CAC and obstructive CAD. Likewise, capillary tortuosity was an independent predictor of increased CAC (p = 0.01) and obstructive CAD (p = 0.04). CONCLUSION: Assessment of labial microcirculation parameters using SDF imaging is feasible and conveys the potential to estimate vascular morbidity in patients with diabetes, at bedside.
Authors: Can Ince; E Christiaan Boerma; Maurizio Cecconi; Daniel De Backer; Nathan I Shapiro; Jacques Duranteau; Michael R Pinsky; Antonio Artigas; Jean-Louis Teboul; Irwin K M Reiss; Cesar Aldecoa; Sam D Hutchings; Abele Donati; Marco Maggiorini; Fabio S Taccone; Glenn Hernandez; Didier Payen; Dick Tibboel; Daniel S Martin; Alexander Zarbock; Xavier Monnet; Arnaldo Dubin; Jan Bakker; Jean-Louis Vincent; Thomas W L Scheeren Journal: Intensive Care Med Date: 2018-02-06 Impact factor: 17.440
Authors: Meriem Khairoun; Mieke van den Heuvel; Bernard M van den Berg; Oana Sorop; Rients de Boer; Nienke S van Ditzhuijzen; Ingeborg M Bajema; Hans J Baelde; Malu Zandbergen; Dirk J Duncker; Ton J Rabelink; Marlies E J Reinders; Wim J van der Giessen; Joris I Rotmans Journal: PLoS One Date: 2015-04-24 Impact factor: 3.240
Authors: Roel Bijkerk; Barend W Florijn; Meriem Khairoun; Jacques M G J Duijs; Gurbey Ocak; Aiko P J de Vries; Alexander F Schaapherder; Marko J K Mallat; Johan W de Fijter; Ton J Rabelink; Anton Jan van Zonneveld; Marlies E J Reinders Journal: Transplant Direct Date: 2017-06-19