Peripheral microcirculatory hemodynamic changes in patients with myocardial ischemia.
BACKGROUND
Patients with coronary heart disease demonstrate changes in skin microcirculation and a decrease in cutaneous blood mass.


OBJECTIVE
The goal of this study was to assess the feasibility of diagnosing myocardial ischemia based on peripheral microcirculatory variables.


METHODS
The skin microcirculatory measurements were monitored using an LPT system comprising a Laser Doppler Flowmeter (LDF), a photoplethysmograph (PPG) and a transcutaneous oxygen tension device (tc-PO2). Concurrently, heart rate and blood pressure were monitored. Measurements were performed before and after exercise stress test. Subjects were divided into ischemic (20) and nonischemic (27) patients based on myocardial perfusion imaging (MPI).


RESULTS
The results indicate differences in LPT variables between ischemic and nonischemic patients following exercise, while no differences in the central variable values were observed between the two groups.


CONCLUSIONS
Peripheral microcirculatory variables may be useful for non-invasive assessment of myocardial ischemia. The system has clinical potential for sensitive and noninvasive monitoring of vital variables during medical procedures in clinics, as well as in home care for patients who suffer from ischemic cardiac diseases.
Department of Medical Engineering, Afeka Tel Aviv Academic College of Engineering, 218 Bney-Efraim Rd., Tel Aviv, Israel; Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel. Electronic address: zehava@afeka.ac.il.
Zehava
Z
Ovadia-Blechman
Department of Mechanical Engineering and Mechatronics, Ariel University, Israel.
Idit
I
Avrahami
Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel.
Einat
E
Weizman-Shammai
Nuclear Cardiology Unit, Assuta Medical Centers, Israel.
Tali
T
Sharir
Neufeld Cardiac Research Institute, Tel Aviv University, Sheba Medical Center, Tel-Hashomer, Israel; Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Michael
M
Eldar
Nuclear Medicine Institute, Hillel Yaffe Medical Center, Hadera, affiliated to the Rappaport Medical School, The Technion Israel Institute of Technology, Haifa, Israel.
Pierre
P
Chouraqui
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D005080:Exercise Test; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000473:pathology; D055414:Myocardial Perfusion Imaging / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D017156:Photoplethysmography; D012867:Skin / Q000098:blood supply*
D010100:Oxygen
Myocardial ischemia; Non-invasive measurement; Peripheral microcirculation