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Juarez-Ramirez JC, Coyotl-Ocelotl B, Choi B, Ramos-Garcia R, Spezzia-Mazzocco T, Ramirez-San-Juan JC. Improved spatial speckle contrast model for tissue blood flow imaging: effects of spatial correlation among neighboring camera pixels. JOURNAL OF BIOMEDICAL OPTICS 2023; 28:125002. [PMID: 38074216 PMCID: PMC10704254 DOI: 10.1117/1.jbo.28.12.125002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023]
Abstract
Significance Speckle contrast analysis is the basis of laser speckle imaging (LSI), a simple, inexpensive, noninvasive technique used in various fields of medicine and engineering. A common application of LSI is the measurement of tissue blood flow. Accurate measurement of speckle contrast is essential to correctly measure blood flow. Variables, such as speckle grain size and camera pixel size, affect the speckle pattern and thus the speckle contrast. Aim We studied the effects of spatial correlation among adjacent camera pixels on the resulting speckle contrast values. Approach We derived a model that accounts for the potential correlation of intensity values in the common experimental situation where the speckle grain size is larger than the camera pixel size. In vitro phantom experiments were performed to test the model. Results Our spatial correlation model predicts that speckle contrast first increases, then decreases as the speckle grain size increases relative to the pixel size. This decreasing trend opposes what is observed with a standard speckle contrast model that does not consider spatial correlation. Experimental data are in good agreement with the predictions of our spatial correlation model. Conclusions We present a spatial correlation model that provides a more accurate measurement of speckle contrast, which should lead to improved accuracy in tissue blood flow measurements. The associated correlation factors only need to be calculated once, and open-source software is provided to assist with the calculation.
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Affiliation(s)
| | - Beatriz Coyotl-Ocelotl
- Instituto Nacional de Astrofisica, Optica y Electronica, Departamento de Optica, Tonantzintla, Mexico
| | - Bernard Choi
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, Department of Surgery, Irvine, California, United States
| | - Ruben Ramos-Garcia
- Instituto Nacional de Astrofisica, Optica y Electronica, Departamento de Optica, Tonantzintla, Mexico
| | - Teresita Spezzia-Mazzocco
- Instituto Nacional de Astrofisica, Optica y Electronica, Departamento de Optica, Tonantzintla, Mexico
| | - Julio C. Ramirez-San-Juan
- Instituto Nacional de Astrofisica, Optica y Electronica, Departamento de Optica, Tonantzintla, Mexico
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Laser speckle contrast imaging and laser Doppler flowmetry reproducibly assess reflex cutaneous vasoconstriction. Microvasc Res 2022; 142:104363. [DOI: 10.1016/j.mvr.2022.104363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/15/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022]
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Balasubramanian GV, Chockalingam N, Naemi R. The Role of Cutaneous Microcirculatory Responses in Tissue Injury, Inflammation and Repair at the Foot in Diabetes. Front Bioeng Biotechnol 2021; 9:732753. [PMID: 34595160 PMCID: PMC8476833 DOI: 10.3389/fbioe.2021.732753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/26/2021] [Indexed: 12/23/2022] Open
Abstract
Diabetic foot syndrome is one of the most costly complications of diabetes. Damage to the soft tissue structure is one of the primary causes of diabetic foot ulcers and most of the current literature focuses on factors such as neuropathy and excessive load. Although the role of blood supply has been reported in the context of macro-circulation, soft tissue damage and its healing in the context of skin microcirculation have not been adequately investigated. Previous research suggested that certain microcirculatory responses protect the skin and their impairment may contribute to increased risk for occlusive and ischemic injuries to the foot. The purpose of this narrative review was to explore and establish the possible link between impairment in skin perfusion and the chain of events that leads to ulceration, considering the interaction with other more established ulceration factors. This review highlights some of the key skin microcirculatory functions in response to various stimuli. The microcirculatory responses observed in the form of altered skin blood flow are divided into three categories based on the type of stimuli including occlusion, pressure and temperature. Studies on the three categories were reviewed including: the microcirculatory response to occlusive ischemia or Post-Occlusive Reactive Hyperaemia (PORH); the microcirculatory response to locally applied pressure such as Pressure-Induced Vasodilation (PIV); and the interplay between microcirculation and skin temperature and the microcirculatory responses to thermal stimuli such as reduced/increased blood flow due to cooling/heating. This review highlights how microcirculatory responses protect the skin and the plantar soft tissues and their plausible dysfunction in people with diabetes. Whilst discussing the link between impairment in skin perfusion as a result of altered microcirculatory response, the review describes the chain of events that leads to ulceration. A thorough understanding of the microcirculatory function and its impaired reactive mechanisms is provided, which allows an understanding of the interaction between functional disturbances of microcirculation and other more established factors for foot ulceration.
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Affiliation(s)
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, United Kingdom
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Balasubramanian G, Chockalingam N, Naemi R. A systematic evaluation of cutaneous microcirculation in the foot using post-occlusive reactive hyperemia. Microcirculation 2021; 28:e12692. [PMID: 33655651 DOI: 10.1111/micc.12692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Cutaneous microcirculatory impairments are associated with skin injury to the foot. Post-Occlusive reactive hyperemia (PORH) is one of the quick and easy methods to assess microcirculatory function. However, there are variations in the protocols currently used. Hence, this study aimed to systematically investigate the reproducibility of PORH protocols with minimal occlusion time in the foot. METHODS Post-Occlusive reactive hyperemia was measured using 12 different protocols (three occlusion times, two occlusion sites and with or without temperature control) in 25 healthy adults. Each of the 12 different protocols was repeated three times, and the intraclass correlation coefficient (ICC) was calculated. RESULTS Intraclass correlation coefficient showed that that ankle level occlusion produced moderate to excellent reproducibility for most PORH measures. In the right foot, 30- and 60-s ankle level occlusion without temperature control showed ICC of >0.40 for all parameters except the area of hyperemia (ICC = -0.36) and biological zero to peak flow percent change (ICC = -0.46). In the left foot, 30-s ankle level occlusion without temperature control showed ICC of >0.40 for all parameters except time to latency (ICC = 0.29), after hyperemia (ICC = 0.37), and max (ICC = -0.01), and area of hyperemia (ICC = -0.36). But the 60-s protocol showed ICC > 0.40 for all except time to max (ICC = 0.38). In the hallux protocols, all three 10-, 30-, and 60-s protocols without temperature control showed moderate to excellent reproducibility (ICC > 0.40). In most cases, the temporal and area under the perfusion-time curve parameters showed poor reproducibility. CONCLUSION Post-Occlusive reactive hyperemia can be tested efficiently with a minimal occlusion time of 10 s with hallux occlusion and 30 s with ankle occlusion in the foot. This can suggest that microcirculatory assessment is feasible in routine practice and can potentially be included for routine assessment of foot in people with diabetes.
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Affiliation(s)
- Gayathri Balasubramanian
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
| | - Nachiappan Chockalingam
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK.,Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Roozbeh Naemi
- Centre for Biomechanics and Rehabilitation Technologies, Staffordshire University, Stoke-on-Trent, UK
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Feng W, Liu S, Zhang C, Xia Q, Yu T, Zhu D. Comparison of cerebral and cutaneous microvascular dysfunction with the development of type 1 diabetes. Theranostics 2019; 9:5854-5868. [PMID: 31534524 PMCID: PMC6735377 DOI: 10.7150/thno.33738] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/19/2019] [Indexed: 02/07/2023] Open
Abstract
Rationale: Diabetes can lead to cerebral and cutaneous vascular dysfunction. However, it is still unclear how vascular function changes with the development of diabetes and what differences exist between cerebral and cutaneous vascular dysfunction. Thus, it is very important to monitor changes in cerebral and cutaneous vascular function responses in vivo and study their differences during diabetes development. Methods: With the assistance of newly developed skull and skin optical clearing techniques, we monitored the responses of sodium nitroprusside (SNP)- and acetyl choline (ACh)-induced cerebral and cutaneous vascular blood flow and blood oxygen in diabetic mice in vivo during the development of type 1 diabetes (T1D) by combining laser speckle contrast imaging with hyperspectral imaging. We then compared the differences between cerebral and cutaneous vascular responses and explored the reasons for abnormal changes induced in response to different vascular beds. Results: In the early stage of diabetes (T1D-1 week), there were abnormal changes in the cerebral vascular blood flow and blood oxygen responses to SNP and ACh as well as cutaneous vascular blood oxygen. The cutaneous vascular blood flow response also became abnormal from T1D-3 weeks. Additionally, the T1D-induced abnormal blood flow response was associated with changes in vascular myosin light chain phosphorylation and muscarinic acetylcholine receptor M3 levels, and the aberrant blood oxygen response was related to an increase in glycated hemoglobin levels. Conclusion: These results suggest that the abnormal cutaneous vascular blood oxygen response occurred earlier than the blood flow response and therefore has the potential to serve as a good assessment indicator for revealing cerebrovascular dysfunction in the early stage of diabetes.
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Affiliation(s)
- Wei Feng
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Shaojun Liu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Chao Zhang
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Qing Xia
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Tingting Yu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
| | - Dan Zhu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics-Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
- MoE Key Laboratory for Biomedical Photonics, Huazhong University of Science and Technology, Wuhan, Hubei 430074, China
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Atkinson CL, Carter HH, Thijssen DHJ, Birk GK, Cable NT, Low DA, Kerstens F, Meeuwis I, Dawson EA, Green DJ. Localised cutaneous microvascular adaptation to exercise training in humans. Eur J Appl Physiol 2018; 118:837-845. [DOI: 10.1007/s00421-018-3813-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/11/2017] [Indexed: 02/03/2023]
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Humeau-Heurtier A, Abraham P, Henni S. Bi-dimensional variational mode decomposition of laser speckle contrast imaging data: A clinical approach to critical limb ischemia? Comput Biol Med 2017; 86:107-112. [DOI: 10.1016/j.compbiomed.2017.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/11/2017] [Accepted: 05/11/2017] [Indexed: 10/19/2022]
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Cracowski JL, Roustit M. Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser-Based-Techniques. Microcirculation 2016; 23:337-44. [DOI: 10.1111/micc.12257] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 11/20/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Jean-Luc Cracowski
- Université Grenoble Alpes; Grenoble France
- INSERM; Grenoble France
- Clinical Pharmacology Unit; INSERM CIC1406; Grenoble University Hospital; Grenoble France
| | - Matthieu Roustit
- Université Grenoble Alpes; Grenoble France
- INSERM; Grenoble France
- Clinical Pharmacology Unit; INSERM CIC1406; Grenoble University Hospital; Grenoble France
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Arverud ED, Persson-Lindell O, Sundquist F, Labruto F, Edman G, Ackermann PW. Microcirculation in healing and healthy Achilles tendon assessed with invasive laser doppler flowmetry. Muscles Ligaments Tendons J 2016; 6:90-6. [PMID: 27331035 DOI: 10.11138/mltj/2016.6.1.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Achilles tendon (AT) rupture exhibits a prolonged healing process with varying clinical outcome. Reduced blood flow to the AT has been considered an underlying factor to AT rupture (ATR) and impaired healing. In vivo measurements using laser Doppler flowmetry (LDF) may be a viable method to assess blood flow in healthy and healing AT. METHODS 29 persons were included in the study; 9 being ATR patients and 20 healthy subjects without any prior symptoms from the AT. Invasive LDF was used to determine the post-occlusive reactive hyperemia (PORH) in the paratenon after 15 minutes of occlusion of the lower extremities. ATR patients were examined two weeks post-operatively. RESULTS LDF-assessments demonstrated a significantly different (p < 0.001) PORH response in the healing- versus intact- and control AT. In the healing AT, a slow, flattened PORH was observed compared to a fast, high peak PORH in intact, healthy AT. CONCLUSION in vivo LDF appears to be a feasible method to assess alterations in blood flow in healing and intact AT. The healing ATs capability to react to an ischemic period is clearly impaired, which may be due to the trauma at injury and/or surgery or degenerative changes in the tendon.
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Affiliation(s)
| | - Olof Persson-Lindell
- Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Fredrik Sundquist
- Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Fausto Labruto
- Section of Diagnostic Imaging, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar Edman
- Department of Neurobiology, Care Sciences, and Society, Centre of Family Medicine (CeFAM), Karolinska Institutet, Stockholm, Sweden
| | - Paul W Ackermann
- Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm, Sweden
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Hellmann M, Gaillard-Bigot F, Roustit M, Cracowski JL. Prostanoids are not involved in postocclusive reactive hyperaemia in human skin. Fundam Clin Pharmacol 2015; 29:510-6. [DOI: 10.1111/fcp.12135] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 07/02/2015] [Accepted: 07/15/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Marcin Hellmann
- Clinical Pharmacology Department; Inserm CIC3; University Hospital; Grenoble France
- Noninvasive Cardiac Diagnostics Department; Medical University; Gdansk Poland
| | | | - Matthieu Roustit
- Clinical Pharmacology Department; Inserm CIC3; University Hospital; Grenoble France
- Inserm U1042; Grenoble France
- University Grenoble-Alpes; Grenoble France
| | - Jean-Luc Cracowski
- Clinical Pharmacology Department; Inserm CIC3; University Hospital; Grenoble France
- Inserm U1042; Grenoble France
- University Grenoble-Alpes; Grenoble France
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Shi R, Chen M, Tuchin VV, Zhu D. Accessing to arteriovenous blood flow dynamics response using combined laser speckle contrast imaging and skin optical clearing. BIOMEDICAL OPTICS EXPRESS 2015; 6:1977-89. [PMID: 26114023 PMCID: PMC4473738 DOI: 10.1364/boe.6.001977] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/24/2015] [Accepted: 04/28/2015] [Indexed: 05/18/2023]
Abstract
Laser speckle contrast imaging (LSCI) shows a great potential for monitoring blood flow, but the spatial resolution suffers from the scattering of tissue. Here, we demonstrate the capability of a combination method of LSCI and skin optical clearing to describe in detail the dynamic response of cutaneous vasculature to vasoactive noradrenaline injection. Moreover, the superior resolution, contrast and sensitivity make it possible to rebuild arteries-veins separation and quantitatively assess the blood flow dynamical changes in terms of flow velocity and vascular diameter at single artery or vein level.
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Affiliation(s)
- Rui Shi
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
- MoE Key Laboratory of Biomedical Photonics, Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
- These authors contributed equally to this work
| | - Min Chen
- Affiliated Hospital, Huazhong University of Science and Technology, Wuhan 430074, China
- These authors contributed equally to this work
| | - Valery V. Tuchin
- Research-Educational Institute of Optics and Biophotonics, Saratov State University, Saratov 410012, Russia
- Institute of Precise Mechanics and Control RAS, Saratov 410028, Russia
| | - Dan Zhu
- Britton Chance Center for Biomedical Photonics, Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430074, China
- MoE Key Laboratory of Biomedical Photonics, Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
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The contribution of sensory nerves to cutaneous vasodilatation of the forearm and leg to local skin heating. Eur J Appl Physiol 2015; 115:2091-8. [PMID: 25998144 DOI: 10.1007/s00421-015-3188-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The initial cutaneous vasodilatory response to local skin heating is larger in the forearm than the leg. While the initial vasodilatation of the forearm to local heating is primarily dependent on sensory nerves, their role in the leg is unknown. We compared the contribution of sensory nerves in driving the cutaneous vasodilatory response of the forearm and leg to local heating using local anaesthetic (EMLA) cream. METHOD In seven participants, two skin sites were selected on both the dorsal forearm and anterolateral calf; one site on each region received EMLA, with the other an untreated control. All sites were controlled at 33 °C and then locally heated to 42 °C with integrated laser-Doppler local heating probes. RESULTS Cutaneous vascular conductance (CVC) during the initial vasodilatation to local heating was smaller in the leg (47 ± 9% max) compared to the forearm (62 ± 7 % max) (P = 0.012). EMLA reduced the initial vasodilatation at both the leg (27 ± 13 % max) (P = 0.02) and forearm (33 ± 14% max) (P < 0.001). The times to onset of vasodilatation, initial vasodilatory peak, and plateau phase were longer in the leg compared to the forearm (all P < 0.05), and EMLA increased these times in both regions (both P < 0.05). CVC during the plateau phase to sustained local skin heating was higher in the leg compared to the forearm at both the untreated (93 ± 6 vs. 85 ± 4% max) (P = 0.33) and EMLA-treated (94 ± 5 vs. 86 ± 6% max) (P = 0.001) sites; EMLA did not affect CVC (P > 0.05). CONCLUSION The differences in the initial vasodilatory peak to local skin heating between the forearm and the leg are due to the contribution of sensory nerves.
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Del Pozzi AT, Hodges GJ. Comparison of the noradrenergic sympathetic nerve contribution during local skin heating at forearm and leg sites in humans. Eur J Appl Physiol 2015; 115:1155-64. [DOI: 10.1007/s00421-014-3097-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/24/2014] [Indexed: 01/08/2023]
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Omarjee L, Signolet I, Humeau-Heutier A, Martin L, Henrion D, Abraham P. Optimisation of movement detection and artifact removal during laser speckle contrast imaging. Microvasc Res 2015; 97:75-80. [DOI: 10.1016/j.mvr.2014.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/16/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
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Johnson JM, Minson CT, Kellogg DL. Cutaneous vasodilator and vasoconstrictor mechanisms in temperature regulation. Compr Physiol 2014; 4:33-89. [PMID: 24692134 DOI: 10.1002/cphy.c130015] [Citation(s) in RCA: 233] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In this review, we focus on significant developments in our understanding of the mechanisms that control the cutaneous vasculature in humans, with emphasis on the literature of the last half-century. To provide a background for subsequent sections, we review methods of measurement and techniques of importance in elucidating control mechanisms for studying skin blood flow. In addition, the anatomy of the skin relevant to its thermoregulatory function is outlined. The mechanisms by which sympathetic nerves mediate cutaneous active vasodilation during whole body heating and cutaneous vasoconstriction during whole body cooling are reviewed, including discussions of mechanisms involving cotransmission, NO, and other effectors. Current concepts for the mechanisms that effect local cutaneous vascular responses to local skin warming and cooling are examined, including the roles of temperature sensitive afferent neurons as well as NO and other mediators. Factors that can modulate control mechanisms of the cutaneous vasculature, such as gender, aging, and clinical conditions, are discussed, as are nonthermoregulatory reflex modifiers of thermoregulatory cutaneous vascular responses.
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Affiliation(s)
- John M Johnson
- Department of Physiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Vionnet J, Calero-Romero I, Heim A, Rotaru C, Engelberger RP, Dischl B, Noël B, Liaudet L, Waeber B, Feihl F. No Major Impact of Skin Aging on the Response of Skin Blood Flow to a Submaximal Local Thermal Stimulus. Microcirculation 2014; 21:730-7. [DOI: 10.1111/micc.12154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 12/23/2022]
Affiliation(s)
- Julien Vionnet
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Irene Calero-Romero
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Abigaël Heim
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Corina Rotaru
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Rolf Peter Engelberger
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Benoît Dischl
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Bernard Noël
- Service de Dermatologie et Vénéréologie; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Lucas Liaudet
- Service de Médecine Intensive de l'Adulte; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - Bernard Waeber
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
| | - François Feihl
- Division de Physiopathologie Clinique; Centre Hospitalier Universitaire Vaudois and University of Lausanne; Lausanne Switzerland
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Puissant C, Abraham P, Durand S, Humeau-Heurtier A, Faure S, Leftheriotis G, Mahé G. Assessment of endothelial function by acetylcholine iontophoresis: Impact of inter-electrode distance and electrical cutaneous resistance. Microvasc Res 2014; 93:114-8. [DOI: 10.1016/j.mvr.2014.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 11/25/2022]
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Ramirez-San-Juan JC, Ramos-Garcia R, Martinez-Niconoff G, Choi B. Simple correction factor for laser speckle imaging of flow dynamics. OPTICS LETTERS 2014; 39:678-81. [PMID: 24487897 PMCID: PMC4030066 DOI: 10.1364/ol.39.000678] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
One of the major constraints facing laser speckle imaging for blood-flow measurement is reliable measurement of the correlation time (τ(C)) of the back-scattered light and, hence, the blood's speed in blood vessels. In this Letter, we present a new model expression for integrated speckle contrast, which accounts not only for temporal integration but spatial integration, too, due to the finite size of the pixel of the CCD camera; as a result, we find that a correction factor should be introduced to the measured speckle contrast to properly determine τ(C); otherwise, the measured blood's speed is overestimated. Experimental results support our theoretical model.
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Affiliation(s)
| | - R. Ramos-Garcia
- Optics Department, INAOE, Luis Enrique Erro No. 1, Tonantzintla, Puebla 72840, Mexico
| | - G. Martinez-Niconoff
- Optics Department, INAOE, Luis Enrique Erro No. 1, Tonantzintla, Puebla 72840, Mexico
| | - B. Choi
- Beckman Laser Institute and Medical Clinic, Department of Surgery, University of California, Irvine, 1002 Health Sciences Road East, Irvine, California 92612, USA
- Department of Biomedical Engineering, University of California, Irvine, 3120 Natural Sciences II, Irvine, California 92697, USA
- Edwards Life Sciences Center for Advanced Cardiovascular Technology, University of California, Irvine, 2400 Engineering Hall, Irvine, California 92697, USA
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Puissant C, Abraham P, Durand S, Humeau-Heurtier A, Faure S, Rousseau P, Mahé G. [Endothelial function: role, assessment and limits]. ACTA ACUST UNITED AC 2013; 39:47-56. [PMID: 24355615 DOI: 10.1016/j.jmv.2013.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 10/24/2013] [Indexed: 12/16/2022]
Abstract
For several years, detecting and preventing cardiovascular diseases have become a major issue. Different methods have been developed to evaluate endothelial function. Endothelial dysfunction is one of the first steps leading to atherosclerosis. This review presents an insight into endothelial function, the interests of its assessment and methods for studying endothelial function. To date, the vascular endothelium must be considered as a specific organ with its own functions that contribute to the homeostasis of the cardiovascular system. Endothelial dysfunction typically corresponds to a decrease of nitric oxide NO bioavailability. Biological or physico-chemical methods may be used to assess dysfunction. Biological methods allow measuring NO metabolites and pro-inflammatory and vasoconstrictor mediators released by the endothelium. The physico-chemical methods include intra-coronary injections, plethysmography, flow-mediated dilation (FMD), digital plethysmography and optical techniques using laser (laser Doppler single-point, laser Doppler imager, laser speckle contrast imaging) that can be coupled with provocation tests (iontophoresis, microdialysis, post-ischemic hyperemia, local heating). The principle of each technique and its use in clinical practice are discussed. Studying endothelial dysfunction is a particularly promising field because of new drugs being developed. Nevertheless, assessment methodology still needs further development to enable reliable, non-invasive, reproducible, and inexpensive ways to analyze endothelial dysfunction.
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Affiliation(s)
- C Puissant
- Service des explorations fonctionnelles vasculaires, centre hospitalier universitaire, 49933 Angers cedex 9, France
| | - P Abraham
- Service des explorations fonctionnelles vasculaires, centre hospitalier universitaire, 49933 Angers cedex 9, France; Biologie neurovasculaire et mitochondriale intégrée (BNMI) - unité mixte UMR CNRS 6214/Inserm U 1083, faculté de médecine, LUNAM université, 49045 Angers, France
| | - S Durand
- EA 4334 motricity, interactions, and performance, LUNAM université, université du Maine, 72085 Le Mans cedex 9, France
| | - A Humeau-Heurtier
- Laboratoire d'ingénierie des systèmes automatisés (LISA), LUNAM université, université d'Angers, 49000 Angers, France
| | - S Faure
- Stress oxydant et pathologies métaboliques (SOPAM), Inserm U1063, LUNAM université, université d'Angers, 40045 Angers, France
| | - P Rousseau
- Département de chirurgie plastique, centre hospitalier universitaire, 49933 Angers cedex 9, France
| | - G Mahé
- Biologie neurovasculaire et mitochondriale intégrée (BNMI) - unité mixte UMR CNRS 6214/Inserm U 1083, faculté de médecine, LUNAM université, 49045 Angers, France; Pôle imagerie médicale, centre hospitalier universitaire Pontchaillou, 2, avenue du Pr-Léon-Bernard, 35033 Rennes cedex 9, France.
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Humeau-Heurtier A, Abraham P, Mahe G. Linguistic Analysis of Laser Speckle Contrast Images Recorded at Rest and During Biological Zero: Comparison With Laser Doppler Flowmetry Data. IEEE TRANSACTIONS ON MEDICAL IMAGING 2013; 32:2311-2321. [PMID: 24058017 DOI: 10.1109/tmi.2013.2281620] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Laser speckle contrast imaging (LSCI) is a newly commercialized imaging modality to monitor microvascular blood flow. Contrary to the well-known laser Doppler flowmetry (LDF), LSCI has the advantage of giving a full-field image of surface blood flow using simple instrumentation. However, laser speckle contrast images are not fully understood yet and their link with LDF signals still has to be studied. To quantify the similarity between LSCI and LDF symbolic sequences, we propose to use, for the first time, the index adapted from linguistic analysis and information theory proposed by Yang For this purpose, LSCI and LDF data were recorded simultaneously on the forearm of healthy subjects, at rest and during a vascular occlusion (biological zero). We show that there are different dynamical patterns for LSCI and LDF data, and the distances between these patterns differ through the space scales explored. Moreover, our results suggest that these different dynamical patterns could be linked to blood flow. The quantitative metric used herein therefore provides new information on LSCI and brings knowledge on links between LSCI and LDF.
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Wenner MM, Taylor HS, Stachenfeld NS. Androgens influence microvascular dilation in PCOS through ET-A and ET-B receptors. Am J Physiol Endocrinol Metab 2013; 305:E818-25. [PMID: 23921139 PMCID: PMC3798701 DOI: 10.1152/ajpendo.00343.2013] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hyperandrogenism and vascular dysfunction often coexist in women with polycystic ovary syndrome (PCOS). We hypothesized that testosterone compromises cutaneous microvascular dilation in women with PCOS via the endothelin-1 ET-B subtype receptor. To control and isolate testosterone's effects on microvascular dilation, we administered a gonadotropin-releasing hormone antagonist (GnRHant) for 11 days in obese, otherwise healthy women [controls, 22.0 (4) yr, 36.0 (3.2) kg/m(2)] or women with PCOS [23 (4) yr, 35.4 (1.3) kg/m(2)], adding testosterone (T; 2.5 mg/day) on days 8-11. Using laser Doppler flowmetry and cutaneous microdialysis, we measured changes in skin microcirculatory responsiveness (ΔCVC) to local heating while perfusing ET-A (BQ-123) and ET-B (BQ-788) receptor antagonists under three experimental conditions: baseline (BL; prehormone intervention), GnRHant (day 4 of administration), and T administration. At BL, ET-A receptor inhibition enhanced heat-induced vasodilation in both groups [ΔCVC control 2.03 (0.65), PCOS 2.10 (0.25), AU/mmHg, P < 0.05]; ET-B receptor inhibition reduced vasodilation in controls only [ΔCVC 0.98 (0.39), 1.41 (0.45) AU/mmHg for controls, PCOS] compared with saline [ΔCVC controls 1.27 (0.48), PCOS 1.31 (0.13) AU/mmHg]. GnRHant enhanced vasodilation in PCOS [saline ΔCVC 1.69 (0.23) AU/mmHg vs. BL, P < 0.05] and abolished the ET-A effect in both groups, a response reasserted with T in controls. ET-B receptor inhibition reduced heat-induced vasodilation in both groups during GnRHant and T [ΔCVC, controls: 0.95 (0.21) vs. 0.51 (13); PCOS: 1.27 (0.23) vs. 0.84 (0.27); for GnRHant vs. T, P < 0.05]. These data demonstrate that androgen suppression improves microvascular dilation in PCOS via ET-A and ET-B receptors.
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Roustit M, Cracowski JL. Assessment of endothelial and neurovascular function in human skin microcirculation. Trends Pharmacol Sci 2013; 34:373-84. [DOI: 10.1016/j.tips.2013.05.007] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/03/2013] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
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Humeau-Heurtier A, Guerreschi E, Abraham P, Mahe G. Relevance of Laser Doppler and Laser Speckle Techniques for Assessing Vascular Function: State of the Art and Future Trends. IEEE Trans Biomed Eng 2013; 60:659-66. [DOI: 10.1109/tbme.2013.2243449] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Cracowski JL, Gaillard-Bigot F, Cracowski C, Sors C, Roustit M, Millet C. Involvement of cytochrome epoxygenase metabolites in cutaneous postocclusive hyperemia in humans. J Appl Physiol (1985) 2013; 114:245-51. [DOI: 10.1152/japplphysiol.01085.2012] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Several mediators contribute to postocclusive reactive hyperemia (PORH) of the skin, including sensory nerves and endothelium-derived hyperpolarizing factors. The main objective of our study was to investigate the specific contribution of epoxyeicosatrienoic acids in human skin PORH. Eight healthy volunteers were enrolled in two placebo-controlled experiments. In the first experiment we studied the separate and combined effects of 6.5 mM fluconazole, infused through microdialysis fibers, and lidocaine/prilocaine cream on skin PORH following 5 min arterial occlusion. In the second experiment we studied the separate and combined effects of 6.5 mM fluconazole and 10 mM NG-monomethyl-l-arginine (l-NMMA). Skin blood flux was recorded using two-dimensional laser speckle contrast imaging. Maximal cutaneous vascular conductance (CVCmax) was obtained following 29 mM sodium nitroprusside perfusion. The PORH peak at the placebo site averaged 66 ± 11%CVCmax. Compared with the placebo site, the peak was significantly lower at the fluconazole (47 ± 10%CVCmax; P < 0.001), lidocaine (29 ± 10%CVCmax; P < 0.001), and fluconazole + lidocaine (30 ± 10%CVCmax; P < 0.001) sites. The effect of fluconazole on the area under the curve was more pronounced. In the second experiment, the PORH peak was significantly lower at the fluconazole site, but not at the l-NMMA or combination site, compared with the placebo site. In addition to sensory nerves cytochrome epoxygenase metabolites, putatively epoxyeicosatrienoic acids, play a major role in healthy skin PORH, their role being more important in the time course rather than the peak.
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Affiliation(s)
- Jean-Luc Cracowski
- Clinical Pharmacology Department, Institut National de la Santé et de la Recherche Médicale CIC3, University Hospital, Grenoble, France
- Institut National de la Santé et de la Recherche Médicale U1042, Grenoble, France; and
- University Joseph Fourier, Grenoble, France
| | - Florence Gaillard-Bigot
- Clinical Pharmacology Department, Institut National de la Santé et de la Recherche Médicale CIC3, University Hospital, Grenoble, France
- Institut National de la Santé et de la Recherche Médicale U1042, Grenoble, France; and
| | - Claire Cracowski
- Clinical Pharmacology Department, Institut National de la Santé et de la Recherche Médicale CIC3, University Hospital, Grenoble, France
| | - Claire Sors
- Clinical Pharmacology Department, Institut National de la Santé et de la Recherche Médicale CIC3, University Hospital, Grenoble, France
- Institut National de la Santé et de la Recherche Médicale U1042, Grenoble, France; and
| | - Matthieu Roustit
- Clinical Pharmacology Department, Institut National de la Santé et de la Recherche Médicale CIC3, University Hospital, Grenoble, France
- Institut National de la Santé et de la Recherche Médicale U1042, Grenoble, France; and
- University Joseph Fourier, Grenoble, France
| | - Claire Millet
- Institut National de la Santé et de la Recherche Médicale U1042, Grenoble, France; and
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Folkesson KT, Samuelsson A, Tesselaar E, Dahlström B, Sjöberg F. A human vascular model based on microdialysis for the assessment of the vasoconstrictive dose-response effects of norepinephrine and vasopressin in skin. Microcirculation 2012; 19:352-9. [PMID: 22332827 DOI: 10.1111/j.1549-8719.2012.00170.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Microdialysis enables drug delivery in the skin and simultaneous measurement of their effects. The present study aimed to evaluate dose-dependent changes in blood flow and metabolism during microdialysis of norepinephrine and vasopressin. METHODS We investigated whether increasing concentrations of norepinephrine (NE, 1.8-59 μmol/L) and vasopressin (VP, 1-100 nmol/L), delivered sequentially in one catheter or simultaneously through four catheters, yield dose-dependent changes in blood flow (as measured using urea clearance) and metabolism (glucose and lactate). RESULTS We found a significant dose-dependent vasoconstriction with both drugs. Responses were characterized by a sigmoid dose response model. Urea in the dialysate increased from a baseline of 7.9 ± 1.7 to 10.9 ± 0.9 mmol/L for the highest concentration of NE (p < 0.001) and from 8.1 ± 1.4 to 10.0 ± 1.7 mmol/L for the highest concentration of VP (p = 0.037). Glucose decreased from 2.3 ± 0.7 to 0.41 ± 0.18 mmol/L for NE (p = 0.001) and from 2.7 ± 0.6 to 1.3 ± 0.5 mmol/L for VP (p < 0.001). Lactate increased from 1.1 ± 0.4 to 2.6 ± 0.5 mmol/L for NE (p = 0.005) and from 1.1 ± 0.4 to 2.6 ± 0.5 mmol/L for VP (p = 0.008). There were no significant differences between responses from a single catheter and from those obtained simultaneously using multiple catheters. CONCLUSIONS Microdialysis in the skin, either with a single catheter or using multiple catheters, offers a useful tool for studying dose response effects of vasoactive drugs on local blood flow and metabolism without inducing any systemic effects.
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Affiliation(s)
- Kim Tchou Folkesson
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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Humeau-Heurtier A, Abraham P, Durand S, Leftheriotis G, Henrion D, Mahé G. Clinical use of laser speckle techniques: beyond the sole mapping. Med Biol Eng Comput 2012; 50:1001-2. [DOI: 10.1007/s11517-012-0942-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 07/05/2012] [Indexed: 11/30/2022]
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Cordovil I, Huguenin G, Rosa G, Bello A, Köhler O, de Moraes R, Tibiriçá E. Evaluation of systemic microvascular endothelial function using laser speckle contrast imaging. Microvasc Res 2012; 83:376-9. [PMID: 22326551 DOI: 10.1016/j.mvr.2012.01.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/18/2012] [Accepted: 01/24/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to compare cutaneous microvascular function in young healthy subjects (n=50) with that of cardiometabolic diseased patients (n=50) using laser speckle contrast imaging (LSCI) coupled with transdermal iontophoretic delivery of acetylcholine (ACh) and post-occlusive reactive hyperemia (PORH). METHODS Cutaneous blood flow was assessed in the forearm using LSCI at rest, during PORH and during iontophoresis of ACh with increasing anodal currents of 30, 60, 90, 120, 150 and 180 μA during 10-second intervals spaced 1 min apart. RESULTS Endothelium-dependent skin microvascular vasodilator responses induced by both ACh and PORH were significantly reduced in cardiometabolic diseased patients compared to healthy subjects. Vasodilator responses induced by ACh were significantly higher in young women than in young men. Iontophoresis charges up to 1.5 mC do not induce nonspecific effects on skin microvascular flux. CONCLUSION LSCI appears to be a promising noninvasive technique for evaluating systemic microvascular endothelial function.
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Affiliation(s)
- Ivan Cordovil
- National Institute of Cardiology (INC), Rio de Janeiro, Brazil
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Mahé G, Humeau-Heurtier A, Durand S, Leftheriotis G, Abraham P. Assessment of Skin Microvascular Function and Dysfunction With Laser Speckle Contrast Imaging. Circ Cardiovasc Imaging 2012; 5:155-63. [DOI: 10.1161/circimaging.111.970418] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Guillaume Mahé
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Anne Humeau-Heurtier
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Sylvain Durand
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Georges Leftheriotis
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
| | - Pierre Abraham
- From the Laboratory of Vascular Investigations, University Hospital of Angers and Biologie Neurovasculaire et Mitochondriale Intégrée (BNMI)-Unité mixte UMR CNRS 6214/INSERM 771, Faculté de Médecine, Angers, France (G.M., G.L., P.A.); Laboratoire d'Ingénierie des Systèmes Automatisés (LISA), Université d'Angers, Angers, France (A.H.-H.); and Laboratory “Motricité, Interactions, Performance” EA 4334, University of Le Mans, Faculty of Sport Sciences, Le Mans, France (S.D.)
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