Peripheral Blood Perfusion Correlates with Microvascular Abnormalities in Systemic Sclerosis: A Laser-Doppler and Nailfold Videocapillaroscopy Study

2010 ◽  
Vol 37 (6) ◽  
pp. 1174-1180 ◽  
Author(s):  
MAURIZIO CUTOLO ◽  
CARMELA FERRONE ◽  
CARMEN PIZZORNI ◽  
STEFANO SOLDANO ◽  
BRUNO SERIOLO ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Negative Correlation ◽  
Healthy Subjects ◽  
Blood Perfusion ◽  
Laser Doppler ◽  
Nailfold Videocapillaroscopy ◽  
Microvascular Damage ◽  
Local Skin ◽  
Doppler Flowmetry ◽  
Prostacyclin Analog

Objective.To investigate possible correlations between fingertip blood perfusion (FBP) status, assessed by laser Doppler flowmetry (LDF), and morphological microvascular abnormalities, detected by nailfold videocapillaroscopy (NVC), in patients with systemic sclerosis (SSc). The effects on FBP of intravenous (IV) treatment with the prostacyclin analog iloprost were also investigated.Methods.Thirty-four consecutive patients with SSc and 16 healthy subjects were evaluated. LDF was performed by analyzing blood perfusion at the fingertips in both hands. Patients with SSc were distributed into the appropriate NVC pattern of microangiopathy (early, active, and late). Iloprost was administered to inpatients with SSc by 24-hour IV infusion for 7 consecutive days (4 μg/h).Results.FBP was significantly lower in patients with SSc (p < 0.05) compared to controls. Heating of the LDF probe at 36°C induced a significant increase of FBP in all subjects (p < 0.001), but the slope of variation was significantly lower in patients with SSc compared to controls (p < 0.05). Patients with SSc showing the late NVC pattern of microangiopathy had significantly lower FBP than patients with the active and early NVC patterns (p < 0.05). A negative correlation was observed between FBP and NVC rating of the microvascular damage (p < 0.05). After iloprost treatment, a significant increase of FBP was observed in patients with SSc (p < 0.05).Conclusion.Patients with SSc show a decreased FBP partially reversible by local skin heating. The FBP correlated negatively with the extent of nailfold microvascular damage, and IV iloprost treatment increased the FBP.

scholarly journals Microvascular damage evaluation in systemic sclerosis: the role of nailfold videocapillaroscopy and laser techniques

Reumatismo ◽  
2017 ◽  
Vol 69 (4) ◽  
pp. 147 ◽  
Author(s):  
B. Ruaro ◽  
A. Sulli ◽  
V. Smith ◽  
C. Pizzorni ◽  
S. Paolino ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Peripheral Blood ◽  
Imaging Technique ◽  
Blood Perfusion ◽  
Clinical Aspects ◽  
Damage Evaluation ◽  
Nailfold Videocapillaroscopy ◽  
Microvascular Damage ◽  
Laser Technologies

Microvascular damage and a decrease in peripheral blood perfusion are typical features of systemic sclerosis (SSc) with serious clinical implications, not only for a very early diagnosis, but also for disease progression. Nailfold videocapillaroscopy is a validated and safe imaging technique able to detect peripheral capillary morphology, as well as to classify and to score any nailfold abnormalities into different microangiopathy patterns. Capillaroscopic analysis is now included in the ACR/EULAR classification criteria for SSc. The decrease in peripheral blood perfusion is usually associated with microvascular damage in SSc, which may be studied by different methods. Several of these make use of safe laser technologies. This paper focuses on these new clinical aspects to assess SSc microvascular impairment.

Longterm Treatment with Endothelin Receptor Antagonist Bosentan and Iloprost Improves Fingertip Blood Perfusion in Systemic Sclerosis

2014 ◽  
Vol 41 (5) ◽  
pp. 881-886 ◽  
Author(s):  
Maurizio Cutolo ◽  
Barbara Ruaro ◽  
Carmen Pizzorni ◽  
Francesca Ravera ◽  
Vanessa Smith ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Blood Perfusion ◽  
Progressive Increase ◽  
Digital Ulcers ◽  
Endothelin Receptor ◽  
Nailfold Videocapillaroscopy ◽  
Raynaud Phenomenon ◽  
Doppler Flowmetry ◽  
Longterm Treatment ◽  
Capillary Dilation

Objective.To evaluate the longterm effects of endothelin-1 (ET-1) antagonism on peripheral blood perfusion (PBP) in patients with systemic sclerosis (SSc).Methods.Twenty-six patients with SSc already receiving cyclic intravenous iloprost (ILO) for severe Raynaud phenomenon were enrolled. Thirteen patients continued the treatment for a further 3 years (ILO group) and 13 patients, because of the appearance of digital ulcers, received in addition bosentan (BOS; 125 mg twice/day) for 3 years (ILO + BOS group). Both PBP at fingertips and nailfold microangiopathy were evaluated yearly by laser Doppler flowmetry and nailfold videocapillaroscopy, respectively.Results.A progressive significant increase of PBP was observed in the ILO + BOS group during the 3 followup years (p = 0.0007, p = 0.0002, p = 0.01, respectively). In contrast, an insignificant progressive decrease of PBP was observed in the ILO group. Difference of perfusion between the PBP evaluations at basal temperature and at 36°C (to test capillary dilation capacity), was found progressively decreased during the 3-year followup only in the ILO group (p = 0.05, p = 0.26, p = 0.09, respectively). A progressive increase of nailfold capillary number was observed only in the ILO + BOS group after 2 and 3 years of followup (p = 0.05).Conclusion.Longterm treatment of SSc patients with ET-1 antagonism, in combination with ILO, seems to increase fingertip blood perfusion, as well as both capillary dilation capacity and number.

scholarly journals Laser Doppler Flowmetry versatile acquisition system with low quantization error

2018 ◽  
Vol 4 (1) ◽  
pp. 25
Author(s):  
Francesco Marrazzi ◽  
Frederic Truffer ◽  
Martial Geiser
Keyword(s):  
Laser Doppler Flowmetry ◽  
Analog Circuit ◽  
Scattered Light ◽  
Blood Perfusion ◽  
Electrical Signal ◽  
Laser Doppler ◽  
Physical Models ◽  
Acquisition System ◽  
Invasive Technique ◽  
Doppler Flowmetry

The Laser Doppler Flowmetry (LDF) is a non-invasive technique used to evaluate blood perfusion of various human tissues like the skin or the fundus of the eye. It is based on the scattering of light on moving red blood cells in tissue. Frequency shifted scattered light is detected and provide an electrical signal. Physical models for LDF use the DC and AC components of this signal. If AC is small relative to the DC, digitalization becomes an issue, and if more than two LDF signal acquisitions and analysis have to be done simultaneously, the device becomes expensive and bulky. We propose here a versatile and inexpensive acquisition system, which overcomes quantization errors issue by first separating DC from AC, then amplifying AC and finally recombining both signals before digitalization. We designed an analog circuit combined with a 12 bit analog-to-digital converter, a microcontroller unit and a Raspberry Pi2 (Rpi2) for the signal processing. Results are accessed remotely from the Rpi2 through HTTP protocol. Multiple systems can easily be used simultaneously for multichannel acquisitions.

Early sign of microangiopathy in systemic sclerosis: The significance of cold stress test in dynamic laser Doppler flowmetry

2019 ◽  
Vol 71 (3) ◽  
pp. 373-378 ◽  
Author(s):  
Sebastian Yu ◽  
Stephen Chu-Sung Hu ◽  
Hsin-Su Yu ◽  
Yi-Ying Chin ◽  
Yang-Chun Cheng ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Cold Stress ◽  
Laser Doppler Flowmetry ◽  
Stress Test ◽  
Early Sign ◽  
Laser Doppler ◽  
Doppler Flowmetry ◽  
Cold Stress Test
Sign in / Sign up

Export Citation Format

Share Document