Abstract 19187: Sublingual Glycocalyx Measurement, a Novel Non-Invasive Technique to Predict Coronary Artery Disease
Background: A relatively thick endothelial lining, known as the glycocalyx (GC), forms the true interface between flowing blood and the vascular wall. The GC regulates several key endothelial functions including vascular permeability, coagulation and inflammation and contributes to the protection against atherogenic challenges. In healthy blood vessels, the GC provides limited access to flowing red blood cells (RBC). Recent observations have suggested that RBCs penetrate deeper into a damaged GC and therefore may serve as a marker for GC damage, which has been associated with microcirculatory dysfunction that accompanies, among others, coronary artery disease (CAD). Aim: In the present study we tested whether the presence of CAD could be predicted by measuring the dimension of the RBC perfused boundary region (PBR), which fills up the space between median RBC column width (MCW) and the outer edge of RBC permeable vascular lumen. In healthy blood vessels PBR is relatively small due to limited penetration of RBC into the GC and it is hypothesized that PBR will increase for a given MCW when GC is damaged.
Method: We used sidestream dark field imaging, a novel stroboscopic LED ring-based clinical imaging modality, of the sublingual microvasculature in subjects with (N=10) and without (N=10, controls) angiographic CAD. From these images, MCW and PBR were determined in over 3000 vascular segments (vessel diameter between 10 and 20µm) per subject.
Results: CAD patients displayed a significant increase in PBR compared to controls. The mean PBR increased from 2.31 ± 0.09µm to 2.64 ± 0.11µm (P<0.05) comparing controls with CAD patients, respectively, consistent with a 0.3 µm deeper penetration of RBCs into the GC.
Conclusion: These data demonstrate that CAD patients have a significant increase in the width of the RBC accessible component of the sublingual microvascular GC compared to control subjects. A wider permeable portion of the GC indicates a change in GC structure which may be associated with a reduced vascular protective function of the GC. Moreover, SDF imaging might provide a novel, noninvasive method to detect CAD.
- © 2012 by American Heart Association, Inc.