Visualizing and quantifying the impact of reactive hyperemia on cutaneous microvessels in humans

Abstract

The mechanisms underlying reactive hyperemia (RH) responses in microvessels are poorly understood. Previous assessment tools have not been capable of directly visualising microvessels during physiological stimulation in humans. Optical coherence tomography (OCT) is capable of imaging and quantifying subcutaneous microvessels as small as ~30µm. In this study we use OCT to visualise and quantify skin microvascular changes in response to RH for the first time in humans. We also assessed the reproducibility of this technique. OCT and LDF were used simultaneously to scan cutaneous microvessels in 10 young healthy subjects on 2 days. We applied a speckle decorrelation algorithm to assess OCT images and calculated flow rate, speed, diameter and density parameters. Measures were obtained at rest (baseline) and 30-seconds following a 5-min cuff inflation (RH). All data were compared between days. The RH stimulus significantly increased (P<0.0001) OCT-derived microvascular diameter (37.6±3.4 vs 44.5±5.2µm), flow rate (82.4±23.4vs 240.1±58.6pl.s-1), speed (48±5.7 vs 101.5±17.1µm.s-1), density (5.1±1.7 vs 14.6± 2.6%) and also LDF-derived flux (12.3±5.7 vs 31.6±9.1 PU). At baseline, OCT-derived diameter (r=0.55), flow (r=0.64), speed (r=0.55) and density (r=0.75) showed significant between-day correlations (P <0.05), as did LDF results (r=0.74). In response to RH, OCT-derived diameter (r=0.63) and density (r=0.64) showed significant correlations (P<0.05), whereas flow (r=0.45), speed (r=0.43) and LDF (r=0.26) were less reproducible. Our study is novel in that it establishes the feasibility of using OCT to visualize and quantify microvascular structure and function responses to RH in humans.