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Patients with chronic mesenteric ischemia have an altered sublingual microcirculation

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العنوان: Patients with chronic mesenteric ischemia have an altered sublingual microcirculation
المؤلفون: Mustafa Suker, Jihan Harki, M Sherezade Tovar-Doncel, Ernst J. Kuipers, Louisa van de Loo van Dijk, Désirée van Noord, Casper H.J. van Eijck, Can Ince, Marco J. Bruno
المساهمون: Translational Physiology, ACS - Microcirculation, Gastroenterology & Hepatology, Surgery, Internal Medicine, Intensive Care
المصدر: Clinical and experimental gastroenterology, 11, 405-414. Dove Medical Press Ltd.
Clinical and Experimental Gastroenterology
Clinical and Experimental Gastroenterology, 11, 405-414. Dove Medical Press Ltd.
بيانات النشر: Dove Press, 2018.
سنة النشر: 2018
مصطلحات موضوعية: medicine.medical_specialty, Sublingual microcirculation, diagnosis, Ischemia, sublingual microcirculation, ischemia, 030204 cardiovascular system & hematology, Microcirculation, 03 medical and health sciences, 0302 clinical medicine, Vessel density, Internal medicine, medicine, In patient, Original Research, chronic mesenteric ischemia, Cytocam-IDF, Clinical and Experimental Gastroenterology, business.industry, Gastroenterology, medicine.disease, Chronic mesenteric ischemia, Cardiology, Significant response, 030211 gastroenterology & hepatology, business, Microvascular flow
الوصف: Jihan Harki,1,* Mustafa Suker,2,* M Sherezade Tovar-Doncel,3 Louisa JD van Dijk,1 Désirée van Noord,1 Casper HJ van Eijck,2 Marco J Bruno,1 Ernst J Kuipers,1,4 Can Ince5 1Department of Gastroenterology and Hepatology, 2Department of Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands; 3Department of Anesthesiology, University Hospital Rio Hortega, Valladolid, Spain; 4Department of Internal Medicine, 5Department of Intensive Care, Erasmus MC University Medical Center, Rotterdam, the Netherlands *These authors contributed equally to this work Background: Little is known about the microcirculatory alterations in patients with chronic mesenteric ischemia (CMI). We hypothesized that patients with CMI have an impaired microcirculatory function and show an oral microcirculatory response after caloric challenge compared to healthy controls.Methods: All patients and controls received the standard workup for CMI. Sublingual microcirculation was evaluated before (T0) and 20 minutes after (T1) feeding. The total vessel density (TVD; mm/mm2), perfused vessel density (PVD; mm/mm2), proportion of perfused vessels (PPV; %) and microvascular flow index (MFI; AU) were assessed.Results: We included 12 patients (63.2 years [IQR 48.8–70.4 years], 67% males) and 12 controls (32.7 years [IQR 27.7–38.1 years], 42% males). At baseline, patients with CMI had a decreased PPV of the sublingual small vessels (median 84.8% vs 95.7%, P=0.006), PPV of all vessels (PPV median 85.4% vs 95.3%, P=0.007) and microvascular flow index of all vessels (MFIa; median 3.00 vs 2.80, P=0.039) compared to healthy controls. After caloric challenge, PVD increased significantly in both small vessels (perfused vessel density of the small vessels [PVDs]) and all vessels (perfused vessel density of all vessels [PVDa]; PVDs [T0]) median 16.3 [IQR 13.3–22.1] vs [T1] median 19.9 [IQR 14.2–26.2], P=0.008; PVDa [T0] median 19.1 [IQR 16.2–23.6] vs [T1] median 22.2 [IQR 16.5–28.9], P=0.02; proportion of perfused vessels of the small vessels (PPVs; [T0] median 84.8% [IQR 75.3–90.4] vs [T1] median 91.0% [IQR 80.1–93.8], P=0.010). In contrast, no significant changes in microcirculatory parameters were observed after caloric challenge in healthy controls.Conclusion: Patients with CMI have an impaired sublingual microcirculation at baseline and show a significant response in the sublingual microcirculation after caloric challenge, whereas healthy controls have a normal microcirculation at baseline and show no reactive response upon a caloric challenge as seen in CMI patients. Sublingual microcirculation visualization may offer a rapid noninvasive method to identify patients at risk for having CMI. Keywords: chronic mesenteric ischemia, ischemia, sublingual microcirculation, Cytocam-IDF, diagnosis
وصف الملف: text/html; application/pdf
اللغة: English
تدمد: 1178-7023
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2b2447ed3dd1f7ff851af2793a0fcc57
https://www.dovepress.com/patients-with-chronic-mesenteric-ischemia-have-an-altered-sublingual-m-peer-reviewed-article-CEG
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....2b2447ed3dd1f7ff851af2793a0fcc57
قاعدة البيانات: OpenAIRE
الوصف
تدمد:11787023