Peripheral microcirculatory hemodynamic changes in patients with myocardial ischemia

Background: Patients with coronary heart disease demonstrate changes in skin microcirculation and a decrease in cutaneous blood mass. Objective: The goal of this study was to assess the feasibility of diagnosing myocardial ischemia based on peripheral microcirculatory variables. Methods: The skin microcirculatory measurements were monitored using an LPT system comprising a Laser Doppler Flowmeter (LDF), a photoplethysmograph (PPG) and a transcutaneous oxygen tension device (tc-PO₂). Concurrently, heart rate and blood pressure were monitored. Measurements were performed before and after exercise stress test. Subjects were divided into ischemic (20) and nonischemic (27) patients based on myocardial perfusion imaging (MPI). Results: The results indicate differences in LPT variables between ischemic and nonischemic patients following exercise, while no differences in the central variable values were observed between the two groups. Conclusions: Peripheral microcirculatory variables may be useful for non-invasive assessment of myocardial ischemia. The system has clinical potential for sensitive and noninvasive monitoring of vital variables during medical procedures in clinics, as well as in home care for patients who suffer from ischemic cardiac diseases.