Assessment of Temporal Characteristics of Perfusion Curves Recorded by Laser Doppler Flowmetry and/or Optical Incoherent Fluctuation Flowmetry in Patients with Diabetes Mellitus

Abstract

Investigation of peripheral vascular status and perfusion assessment are promising tools for early diagnosis of micro- and macroangiopathic complications in diabetes mellitus. Among these, perfusion assessment during functional testing is particularly informative. In the literature, the time to maximum perfusion (Tmax) is the most commonly used indicator of the rate of development of the hyperemic response.
This report addresses the challenges of assessing the temporal characteristics of perfusion curves, such as Tmax, and proposes solutions to these problems. The study included both healthy volunteers and patients with type 2 diabetes. Laser Doppler flowmetry (LDF) and incoherent optical fluctuation flowmetry (IOFF) were used to assess perfusion. Perfusion assessment was performed using occlusion tests and local heating tests.
Tmax during reactive hyperemia did not differ between healthy subjects and type 2 diabetic patients with varying degrees of impairment. On the plantar surface of the foot, the lowest Tmax was observed in type 2 diabetic patients with occlusive lower limb vascular lesions, which may lead to misinterpretation of test results. Instead of Tmax, we suggest using the time to reach a given area under the perfusion curve (Tauc). Compared to Tmax, Tauc increased the area under the ROC curve for detecting diabetes-related impairment from 0.6 to 0.69 for the occlusion test and from 0.53 to 0.68 for the local heating test.
Assessment of the Tauc parameter is more informative than evaluation of the Tmax of hyperemia. This new indicator can potentially improve the quality of diagnosis of microcirculatory disorders in patients with diabetes.
This work was supported by grant MK-4421.2022.3.


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Speaker

Alexey Glazkov
Moscow Regional Research and Clinical Institute
Russia

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