Nailfold video-capillaroscopy in the сomparative study of blood microcirculation in patients with paroxysmal and permanent atrial fibrillation
E.N. Sovetnikov1, Y.I. Gurfinkel1, L.I. Dyachuk1, A.E. Lugovtsov2, P.B. Ermolinskiy2, A.A. Romanova2, and A.V. Priezzhev2
1Medical Research and Education Center of Lomonosov Moscow State University, 27-10 Lomonosovsky pr-t, Moscow, 119991, Russia.
2Department of Physics of Lomonosov Moscow State University, 1-2 Leninskie Gory, Moscow, 119991, Russia.
Abstract
Atrial fibrillation (AF) refers to a serious cardiac pathology, which is manifested by abnormal heart rhythm caused by irregular atrial contractions. AF increases the risk of stroke by 5 times due to the formation of blood clots in the auricle of the left atrium, which can travel through the vascular system to the brain and cause a stroke. For this reason, patients suffering from AF have to permanently take anticoagulants to prevent thrombosis.
There are two main forms of AF: paroxysmal, characterized by episodes of irregular atrial contractions lasting up to 7 days, passing independently or with the help of drug treatment, and permanent, in which the rhythm of AF persists permanently. The study of blood microcirculation allows to estimate the capillary blood flow velocity, the presence of red blood cell aggregates, the degree of perivascular tissue edema and a number of other parameters, and accordingly reflects the effectiveness of anticoagulant therapy. The blood microcirculation is measured using the method nailfold video-capillaroscopy.
The aim of the work was both to evaluate the blood microcirculation parameters evaluated by capillaroscopy in AF patients and healthy volunteers, and to reveal statistically significant differences of the parameters between patients with paroxysmal AF (66 patients) and permanent AF (34 patients). The mean age of the patients was 71.6±10.1 years, including 49 females (mean age 72.6±9.7) and 51 males (mean age 70.6±10.6). All patients were receiving oral anticoagulants. Forty six healthy volunteers (mean age 38±19) also participated in the study. Microcirculation parameters were measured using the Kapillaroskan-1 device (AET, Russia) with the use of machine learning for digital image processing.
In both groups of AF patients, statistically significant differences of all capillaroscopy parameters were found in comparison with the group of healthy volunteers. The groups of patients with paroxysmal form and permanent form of AF also showed statistically significant differences in terms of the number of aggregates per minute, perivascular zone size, and mean capillary blood flow velocity. The obtained results seem to be due to the insufficient effect of oral anticoagulants on blood microcirculation parameters in patients with AF.
The revealed difference between the results obtained in patients with paroxysmal and permanent form of AF is presumably explained by the different degree of heart rhythm chaotization, which in paroxysmal form of AF is manifested only episodically during atrial flutter paroxysms, whereas in permanent form of AF the irregularity of the heart rhythm persists permanently.
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Egor Sovetnikov
Lomonosov Moscow State University
Russia
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