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Contribution of laser Doppler flowmetry with venoarteriolar reflex, cold, and rewarming testing, and intravital capillaroscopy to diagnose Raynaud's phenomenon

Authors Zeman J, Turyanytsya O, Kapsa V, Eliáš M

Received 18 November 2013

Accepted for publication 3 January 2014

Published 7 May 2014 Volume 2014:2 Pages 47—52

DOI https://doi.org/10.2147/JVD.S57755

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


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


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