Infrared Imaging to Assess Endothelial Function in Sickle Cell Disease Patients

红外成像评估镰状细胞病患者的内皮功能

基本信息

批准号：
8743786
负责人：
Alexander Gorbach
金额：
$ 2.83万
依托单位：
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/8743786
关键词：
Acetylcholine Adult Agonist Arginine Biological Availability Biological Markers Blood Vessels Blood flow Cells Cholesterol Clinical Coronary Angiography Cutaneous Diagnostic Diastolic blood pressure Disodium Salt Nitroprusside Dose Endothelium Endothelium-Dependent Relaxing Factors Evaluation Flow-It Forearm Functional disorder Hemoglobin Hemoglobin concentration result Heterogeneity Homocysteine Homocystine Image Imaging Techniques Infusion procedures Intra-Arterial Infusions Measurement Measures Mediating Methodology Modeling National Heart, Lung, and Blood Institute Nitric Oxide Patients Peripheral Photography Plethysmography Protocols documentation Pulmonary Hypertension Pulmonary artery structure Resistance Risk Sickle Cell Sickle Cell Anemia Skin Temperature Stroke Techniques Testing Vasodilation Vasodilator Agents Vasomotor Venous clinical application inhibitor/antagonist novel novel marker omega-N-Methylarginine population based preclinical study pressure response vasomotion

项目摘要

Vascular dysfunction is an important pathophysiologic manifestation of sickle cell disease (SCD), a condition that increases risk of pulmonary hypertension and stroke. We hypothesized that infrared (IR) imaging would detect changes in cutaneous blood flow reflective of vascular function. We performed IR imaging and conventional strain gauge plethysmography in twenty-five adults with SCD at baseline and during intra-arterial infusions of an endothelium-dependent vasodilator acetylcholine (ACh), an endothelium-independent vasodilator sodium nitroprusside (SNP), and an NOS inhibitor L-NMMA. Skin temperature measured by IR imaging increased in a dose-dependent manner to graded infusions of ACh (+1.1◦ C, p < 0.0001) and SNP (+0.9◦ C, p < 0.0001), and correlated with dose-dependent increases in forearm blood flow (ACh: +19.9 mL/min/100mL, p < 0.0001; rs = 0.57, p = 0.003; SNP: +8.6 mL/min/100mL, p < 0.0001; r = 0.70, p = 0.0002). Although IR measurement of skin temperature accurately reflected agonist-induced increases in blood flow, it was less sensitive to decreases in blood flow caused by NOS inhibition. Baseline forearm skin temperature measured by IR imaging correlated significantly with baseline forearm blood flow (31.80.2◦ C, 6.00.4 mL/min/100mL; r = 0.58, p = 0.003), and appeared to represent a novel biomarker of vascular function. It predicted a blunted blood flow response to SNP (r = −0.61, p = 0.002), and was independently associated with a marker of pulmonary artery pressure, as well as hemoglobin level, diastolic blood pressure, homocysteine, and cholesterol (R2 = 0.84, p < 0.0001 for the model). IR imaging of agonist-stimulated cutaneous blood flow represents a less cumbersome alternative to plethysmography methodology. Measurement of baseline skin temperature by IR imaging may be a useful new marker of vascular risk in adults with SCD.

血管功能障碍是镰状细胞疾病（SCD）的重要病理生理表现，这种疾病会增加肺动脉高压和中风的风险。我们假设红外（IR）成像将检测出反射血管功能的皮肤血流的变化。我们在基线时具有SCD的二十五名成年人以及在内皮依赖性血管垫圈乙酰胆碱（ACH）的动脉内输液时进行了IR成像和常规应变计，这是一种内皮依赖性的核氧化钠钠（Nitropruspuspruspuspruspusside（SNP）和NOS nmmabion。通过IR成像测量的皮肤温度以剂量依赖性方式升高到ACH（ +1.1°C，P <0.0001）和SNP（ +0.9°C，P <0.0001）的分级输注，并且与前臂血流的剂量依赖性增加相关（ACH：+19.9 ml/min/min/min/lim min/lim min/lim min/lim min/p <0.0001； ml/min/100ml，p <0.0001; r = 0.70，p = 0.0002）。尽管对皮肤温度的IR测量准确地反映了激动剂诱导的血流增加，但它对由NOS抑制作用引起的血液流量降低不太敏感。通过IR成像测量的基线前臂皮肤温度与基线前臂血流显着相关（31.80.2°C，6.00.4 ml/min/min/100ml; r = 0.58，p = 0.003），似乎代表了血管功能的新型生物标志物。它预测了对SNP的血流反应（R = -0.61，p = 0.002），并且与肺动脉压的标记以及血红蛋白水平，舒张压，外交状态半胱氨酸和胆固醇（R2 = 0.84，P <0.0001）独立相关。激动剂刺激的皮肤血流的IR成像代表了繁琐的综合方法的替代品。通过IR成像测量基线皮肤温度可能是SCD成人血管风险的有用新标记。