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Non-invasive assessment of microcirculation by sidestream dark field imaging as a marker of coronary artery disease in diabetes
Djaberi, Roxana; Schuijf, Joanne D.; Koning, Eelco J. De; Wijewickrama, D. C.; Pereira, Alberto M.; Smit, Johannes W.; Kroft, Lucia J.; De Roos, Albert; Bax, Jeroen J.; Rabelink, Ton J.; Jukema, J. Wouter
Citation:Djaberi R, Schuijf JD, de Koning EJ, Wijewickrama DC, Pereira AM, Smit JW, Kroft LJ, Roos Ad, Bax JJ, Rabelink TJ, Jukema JW. Non-invasive assessment of microcirculation by sidestream dark field imaging as a marker of coronary artery disease in diabetes. Diab Vasc Dis Res. 2013 Mar;10(2):123-34. doi: 10.1177/1479164112446302. Epub 2012 May 23. PMID: 22621919.
Date:2023-12-05
Abstract:
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 mm2) 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.