Contribution of laser Doppler flowmetry with venoarteriolar reflex, cold, and rewarming testing, and intravital capillaroscopy to diagnose Raynaud's phenomenon
Jan Zeman,1 Oksana Turyanytsya,1 Vojtĕch Kapsa,2 Mojmír Eliáš3
1Department of Clinical Cardiology and Angiology, Hospital Bulovka, 2Charles University in Prague, Faculty of Mathematics and Physics, 3Kooperativa a.s., Pobrezni, Prague, Czech Republic
Background: The early differential diagnosis of Raynaud’s phenomenon (RP) is crucial for the prognosis and therapy of these patients. In our microcirculatory laboratory, we use intravital capillaroscopy (IC), plethysmography (P), and laser Doppler flowmetry (LDF) for examining acrosyndromes. We combine LDF with venoarteriolar reflex test, cold test, and rewarming test to achieve more reliable diagnoses of acrosyndromes.
Patients and methods: We examined LDF and IC according to a strict protocol using a battery of tests (venoarteriolar reflex test, cold test, rewarming test) applied to five different groups of people and compared their results: healthy controls, primary Raynaud’s phenomenon (PRP), systemic scleroderma, vibration white finger, and peripheral artery occlusive disease. Our tests included 340 individuals (72 patients plus 268 controls).
Results: Although all tests provided some differences between controls and patients, only the rewarming test offered significant results for differential diagnoses.
Conclusion: IC and LDF combined with the battery of tests (venoarteriolar reflex test, cold test, rewarming test) under standard conditions can be used as reliable tools to distinguish between PRP and some types of secondary RP (especially in the case of systemic scleroderma, vibration white fingers, or peripheral artery occlusive disease; RPs with organic occlusions of the small arteries causing the diseases). Our methodology can help to distinguish between other types of RP, as well.
Keywords: Raynaud’s phenomenon, acrosyndrome, laser Doppler flowmetry, intravital capillaroscopy, scleroderma, vibration white finger, peripheral artery occlusive disease
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]