open access
Flow-mediated skin fluorescence: A novel method for the estimation of sleep apnea risk in healthy persons and cardiac patients


- Department of Cardiology, Medical University of Lodz, Poland
- Department of Cardiac Rehabilitation, Bieganski Hospital, Lodz, Poland
- Department of Cardiology, Bieganski Hospital, Lodz, Poland
open access
Abstract
Background: A pilot study revealed a relationship between the results of flow mediated skin fluorescence (FMSF) and of ECG-Holter-based estimated apnea/hypopnea index (eAHI) in asymptomatic individuals. The aim of this study was to test whether the results of FMSF show a relationship with the eAHI in patients with coronary artery disease or aortic stenosis.
Methods: Twenty-one patients (12 coronary disease, 9 aortic stenosis) and 37 healthy volunteers were included. FMSF was assessed before, during and after the pressure occlusion of the brachial artery, using a prototype device allowing the quantification of skin fluorescence. The values of FMSF expressed as baseline (BASE), maximum (MAX), and minimum (MIN) were analyzed. The percentages of ischemic response (IR) and hyperemic response (HR) were calculated. The eAHI was assessed from night ECG-Holter recordings. Differences between the groups and the relationships between the parameters were analyzed statistically.
Results: Mean ± standard deviation of BASE, MAX, MIN and IR were not significantly different in both groups (p > 0.05). HR was significantly lower in cardiac patients (14.7 ± 7.5 vs. 11.8 ± 5.1; p = 0.048), whose eAHI was significantly higher (11.0 ± 7.4 vs. 36.3 ± 16.5; p < 0.01). Negative correlation for MAX and eAHI was found in volunteers and patients: r = –0.38, p = 0.02 and r = –0.47, p = 0.03, respectively. In volunteers, HR had a negative correlation with eAHI: r = –0.34, p = 0.04.
Conclusions: This pioneer study confirms that FMSF can be used to detect the negative correlation between MAX fluorescence and eAHI not only among healthy volunteers, but also among cardiac patients with coronary artery disease or aortic stenosis.
Abstract
Background: A pilot study revealed a relationship between the results of flow mediated skin fluorescence (FMSF) and of ECG-Holter-based estimated apnea/hypopnea index (eAHI) in asymptomatic individuals. The aim of this study was to test whether the results of FMSF show a relationship with the eAHI in patients with coronary artery disease or aortic stenosis.
Methods: Twenty-one patients (12 coronary disease, 9 aortic stenosis) and 37 healthy volunteers were included. FMSF was assessed before, during and after the pressure occlusion of the brachial artery, using a prototype device allowing the quantification of skin fluorescence. The values of FMSF expressed as baseline (BASE), maximum (MAX), and minimum (MIN) were analyzed. The percentages of ischemic response (IR) and hyperemic response (HR) were calculated. The eAHI was assessed from night ECG-Holter recordings. Differences between the groups and the relationships between the parameters were analyzed statistically.
Results: Mean ± standard deviation of BASE, MAX, MIN and IR were not significantly different in both groups (p > 0.05). HR was significantly lower in cardiac patients (14.7 ± 7.5 vs. 11.8 ± 5.1; p = 0.048), whose eAHI was significantly higher (11.0 ± 7.4 vs. 36.3 ± 16.5; p < 0.01). Negative correlation for MAX and eAHI was found in volunteers and patients: r = –0.38, p = 0.02 and r = –0.47, p = 0.03, respectively. In volunteers, HR had a negative correlation with eAHI: r = –0.34, p = 0.04.
Conclusions: This pioneer study confirms that FMSF can be used to detect the negative correlation between MAX fluorescence and eAHI not only among healthy volunteers, but also among cardiac patients with coronary artery disease or aortic stenosis.
Keywords
autofluorescence, obstructive sleep apnea, screening


Title
Flow-mediated skin fluorescence: A novel method for the estimation of sleep apnea risk in healthy persons and cardiac patients
Journal
Issue
Article type
Original Article
Pages
948-953
Published online
2020-10-26
Page views
4678
Article views/downloads
1283
DOI
Pubmed
Bibliographic record
Cardiol J 2022;29(6):948-953.
Keywords
autofluorescence
obstructive sleep apnea
screening
Authors
Tomasz Rechciński
Urszula Cieślik-Guerra
Patryk Siedlecki
Barbara Uznańska-Loch
Ewa Trzos
Karina Wierzbowska-Drabik
Ewa Szymczyk
Paulina Wejner-Mik
Małgorzata Kurpesa
Piotr Lipiec
Jarosław D. Kasprzak


- Dredla BK, Castillo PR. Cardiovascular consequences of obstructive sleep apnea. Curr Cardiol Rep. 2019; 21(11): 137.
- Rechciński T, Cieślik-Guerra U, Siedlecki P, et al. Flow-mediated skin fluorescence – a novel screening tool for cardiovascular risk. Eur Heart J. 2018; 39(Suppl 899): P4459.
- Mayevsky A, Barbiro-Michaely E. Shedding light on mitochondrial function by real time monitoring of NADH fluorescence: II: human studies. J Clin Monit Comput. 2013; 27(2): 125–145.
- Piotrowski L, Urbaniak M, Jedrzejczak B, et al. Note: flow mediated skin fluorescence: a novel technique for evaluation of cutaneous microcirculation. Rev Sci Instrum. 2016; 87(3): 036111.
- Sibrecht G, Bugaj O, Filberek P, et al. Flow-mediated skin fluorescence method for non-invasive measurement of the NADH at 460 nm – a possibility to assess the mitochondrial function. Post Biol Kom. 2017; 44(4): 333–52.
- de Chazal P, Heneghan C, Sheridan E, et al. Automated processing of the single-lead electrocardiogram for the detection of obstructive sleep apnoea. IEEE Trans Biomed Eng. 2003; 50(6): 686–696.
- Ben Ahmed H, Boussaid H, Hamdi I, et al. [Prevalence and predictors of obstructive sleep apnea in patients admitted for acute myocardial infarction]. Ann Cardiol Angeiol (Paris). 2014; 63(2): 65–70.
- Mehra R, Principe-Rodriguez K, Kirchner HL, et al. Sleep apnea in acute coronary syndrome: high prevalence but low impact on 6-month outcome. Sleep Med. 2006; 7(6): 521–528.
- Szyszko A, Franceschini C, Gonzalez-Zuelgaray J. Reliability of a Holter-based methodology for evaluation of sleep apnoea syndrome. Europace. 2009; 11(1): 94–99.
- Ożegowski S, Wilczyńska E, Piorunek T, et al. Usefulness of ambulatory ECG in the diagnosis of sleep-related breathing disorders. Kardiol Pol. 2007; 65(11): 1321–8.
- Uznańska B, Trzos E, Rechciński T, et al. Repeatability of sleep apnea detection in 48-hour holter ECG monitoring. Ann Noninvasive Electrocardiol. 2010; 15(3): 218–222.
- Hellmann M, Tarnawska M, Dudziak M, et al. Reproducibility of flow mediated skin fluorescence to assess microvascular function. Microvasc Res. 2017; 113: 60–64.
- Tarnawska M, Dorniak K, Kaszubowski M, et al. A pilot study with flow mediated skin fluorescence: A novel device to assess microvascular endothelial function in coronary artery disease. Cardiol J. 2018; 25(1): 120–127.
- Lacedonia D, Carpagniano GE, Cisetti E, et al. Mitochondrial DNA alteration in obstructive sleep apnoea. Resp Res. 2015; 16: 47.
- Kim YS, Kwak JW, Lee KE, et al. Can mitochondrial dysfunction be a predictive factor for oxidative stress in patients with obstructive sleep apnea? Antioxid Redox Signal. 2014; 21(9): 1285–1288.