Evaluación cuantitativa de los cambios microvasculares capilaroscópicos en pacientes con cardiopatía isquémica establecida / Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease

Introducción y objetivos: Las alteraciones microvasculares se han asociado a la mayoría de los factores de riesgo cardiovascular, así como a múltiples enfermedades inflamatorias. Sin embargo, se desconoce si estas anomalías son más frecuentes en pacientes con enfermedades coronarias. Nuestro objetivo fue evaluar si existe una relación entre la presencia de cardiopatía isquémica y la existencia de alteraciones capilares funcionales y estructurales en la microcirculación cutánea evaluada mediante videocapilaroscopia. Material y métodos: Comparamos 2 muestras emparejadas de 30 participantes con o sin cardiopatía isquémica pero con un perfil antropométrico y clínico similar. Realizamos una videocapilaroscopia en el dorso del tercer dedo de la mano no dominante cuantificando la densidad capilar basal, así como la densidad capilar tras la oclusión arterial y venosa para evaluar su funcionalidad y la densidad capilar máxima. También calculamos el reclutamiento capilar. Resultados: La densidad microvascular fue significativamente menor en los pacientes con cardiopatía isquémica que en los controles tanto a nivel basal como tras el estudio dinámico (oclusión arterial y venosa). No encontramos diferencias en el reclutamiento capilar. Conclusiones: En nuestro estudio, los pacientes con cardiopatía isquémica presentaban cambios microvasculares tanto funcionales como estructurales. Dado que estos resultados han sido obtenidos de una pequeña muestra, se precisarán estudios que valoren la microcirculación en pacientes coronarios y si esta está relacionada con la respuesta terapéutica y/o el pronóstico de la enfermedad (AU)

Introduction and objectives: Microcirculation disturbances have been associated to most of the cardiovascular risk factors as well as to multiple inflammatory diseases. However, whether these abnormalities are specifically augmented in patients with coronary heart disease is still unknown. We aimed to evaluate if there is a relationship between the presence of coronary heart disease and the existence of functional and structural capillary abnormalities evaluated in the cutaneous microcirculation by videocapillaroscopy. Material and methods: Two matched samples of 30 participants with and without coronary heart disease but with similar clinical and anthropometric characteristics were evaluated by videocapillaroscopy at the dorsal skin of the third finger of the non-dominant hand. We calculated basal capillary density as well as capillary density after a period of arterial and venous occlusion in order to evaluate functionality and maximum capillary density. We also measured capillary recruitment. Results: capillary density at rest was significantly lower in patients suffering from coronary heart disease than in controls. This fact was also found after dynamic tests (arterial and venous occlusion), suggesting functional impairments. Capillary recruitment of the samples was not different in our sample. Conclusions: In our study, patients with coronary heart disease exhibit functional and structural microvascular disturbances. Although this is a very preliminary study, these findings open the door for further studying the microvascular functionality in coronary patients and how it relates to the response to treatment and/or the prognosis of the disease (AU)

Quantitative evaluation of capillaroscopic microvascular changes in patients with established coronary heart disease. / Evaluación cuantitativa de los cambios microvasculares capilaroscópicos en pacientes con cardiopatía isquémica establecida.

INTRODUCTION AND OBJECTIVES: Microcirculation disturbances have been associated to most of the cardiovascular risk factors as well as to multiple inflammatory diseases. However, whether these abnormalities are specifically augmented in patients with coronary heart disease is still unknown. We aimed to evaluate if there is a relationship between the presence of coronary heart disease and the existence of functional and structural capillary abnormalities evaluated in the cutaneous microcirculation by videocapillaroscopy. MATERIAL AND METHODS: Two matched samples of 30 participants with and without coronary heart disease but with similar clinical and anthropometric characteristics were evaluated by videocapillaroscopy at the dorsal skin of the third finger of the non-dominant hand. We calculated basal capillary density as well as capillary density after a period of arterial and venous occlusion in order to evaluate functionality and maximum capillary density. We also measured capillary recruitment. RESULTS: Microvascular capillary density at rest was significantly lower in patients suffering from coronary heart disease than in controls. This fact was also found after dynamic tests (arterial and venous occlusion), suggesting functional impairments. Capillary recruitment of the samples was not different in our sample. CONCLUSIONS: In our study, patients with coronary heart disease exhibit functional and structural microvascular disturbances. Although this is a very preliminary study, these findings open the door for further studying the microvascular functionality in coronary patients and how it relates to the response to treatment and/or the prognosis of the disease.