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Slowikowska-Hilczer J, Walczak-Jedrzejowska R, Adamczewska D, Byczkiewicz P, Marchlewska K, Katarzynska J, Gebicki J. A New Approach to the Assessment of Erectile Dysfunction Based on Vasomotion Monitored by the Flow-Mediated Skin Fluorescence (FMSF) Technique-A Preliminary Study. J Clin Med 2024; 13:3210. [PMID: 38892921 PMCID: PMC11173337 DOI: 10.3390/jcm13113210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/29/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Erectile dysfunction (ED) most often has vascular etiology and usually is the earliest symptom of vascular dysfunction. The aim of this study was to evaluate vascular dysfunction with the use of the Flow-Mediated Skin Fluorescence (FMSF) technique in men with and without ED. Methods: Included were 39 men (median age 53) with ED and 40 men (median age 41.5) without ED. Medical interview, physical examination, and anthropometrical measurements were performed for all participants. The serum total testosterone, LH, and SHBG determinations were performed in patients with ED, and the Free Testosterone Index (FTI) was calculated. The FMSF technique was used to measure the microcirculatory oscillations at the baseline and to determine the flowmotion (FM) and vasomotion (VM) parameters. The Normoxia Oscillatory Index (NOI) was calculated, which represents the contribution of the endothelial (ENDO) and neurogenic (NEURO) oscillations relative to all oscillations detected at low-frequency intervals (<0.15 Hz): NOI = (ENDO + NEURO)/(ENDO + NEURO + VM). Results: In men with ED were found significantly lower FM and VM parameters, but the NOI was significantly higher in comparison to men without ED. VM and FM correlated significantly positively with erectile function, orgasmic function, and general sexual satisfaction in the whole group and the FTI in the ED group. The thresholds of 53.5 FM (AUC = 0.7) and 8.4 VM (AUC = 0.7) were predictive values for discriminating men with ED. Conclusions: It was shown that the FMSF diagnostic technique may be helpful in the early diagnosis of microcirculation dysfunction due to impaired vasomotion caused by decreased testosterone activity.
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Affiliation(s)
- Jolanta Slowikowska-Hilczer
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, 92-213 Lodz, Poland; (R.W.-J.); (D.A.); (P.B.); (K.M.)
| | - Renata Walczak-Jedrzejowska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, 92-213 Lodz, Poland; (R.W.-J.); (D.A.); (P.B.); (K.M.)
| | - Daria Adamczewska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, 92-213 Lodz, Poland; (R.W.-J.); (D.A.); (P.B.); (K.M.)
| | - Piotr Byczkiewicz
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, 92-213 Lodz, Poland; (R.W.-J.); (D.A.); (P.B.); (K.M.)
| | - Katarzyna Marchlewska
- Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, 92-213 Lodz, Poland; (R.W.-J.); (D.A.); (P.B.); (K.M.)
| | | | - Jerzy Gebicki
- Angionica Ltd., 90-924 Lodz, Poland; (J.K.); (J.G.)
- Institute of Applied Radiation Chemistry, Lodz University of Technology, 90-924 Lodz, Poland
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Non-Invasive Assessment of Vascular Circulation Based on Flow Mediated Skin Fluorescence (FMSF). BIOLOGY 2023; 12:biology12030385. [PMID: 36979077 PMCID: PMC10044925 DOI: 10.3390/biology12030385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/02/2023]
Abstract
Flow Mediated Skin Fluorescence (FMSF) is a new non-invasive method for assessing vascular circulation and/or metabolic regulation. It enables assessment of both vasoconstriction and vasodilation. The method measures stimulation of the circulation in response to post-occlusive reactive hyperemia (PORH). It analyzes the dynamical changes in the emission of NADH fluorescence from skin tissue, providing the information on mitochondrial metabolic status and intracellular oxygen delivery through the circulatory system. Assessment of the vascular state using the FMSF technique is based on three parameters: reactive hyperemia response (RHR), hypoxia sensitivity (HS), and normoxia oscillatory index (NOI). The RHR and HS parameters determine the risk of vascular circulatory disorders and are the main diagnostic parameters. The NOI parameter is an auxiliary parameter for evaluating the state of microcirculation under stress of various origins (e.g., emotional stress, physical exhaustion, or post-infection stress). The clinical data show that the risk of vascular complications is limited among people whose RHR, log(HS), and NOI parameters are not significantly below the mean values determined by the FMSF technique, especially if they simultaneously meet the conditions RHR > 30% and log(HS) > 1.5 (HS > 30), and NOI > 60%.
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Chudzik M, Cender A, Mordaka R, Zielinski J, Katarzynska J, Marcinek A, Gebicki J. Chronic Fatigue Associated with Post-COVID Syndrome versus Transient Fatigue Caused by High-Intensity Exercise: Are They Comparable in Terms of Vascular Effects? Vasc Health Risk Manag 2022; 18:711-719. [PMID: 36097586 PMCID: PMC9464031 DOI: 10.2147/vhrm.s371468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The pathophysiology of chronic fatigue associated with post-COVID syndrome is not well recognized. It is assumed that this condition is partly due to vascular dysfunction developed during an acute phase of infection. There is great demand for a diagnostic tool that is able to clinically assess post-COVID syndrome and monitor the rehabilitation process. Patients and Methods The Flow Mediated Skin Fluorescence (FMSF) technique appears uniquely suitable for the analysis of basal microcirculatory oscillations and reactive hyperemia induced by transient ischemia. The FMSF was used to measure vascular circulation in 45 patients with post-COVID syndrome. The results were compared with those for a group of 26 amateur runners before and after high-intensity exercise as well as for a control group of 32 healthy age-matched individuals. Results Based on the observed changes in the NOI (Normoxia Oscillatory Index) and RHR (Reactive Hyperemia Response) parameters measured with the FMSF technique, it was found that chronic fatigue associated with post-COVID syndrome is comparable with transient fatigue caused by high-intensity exercise in terms of vascular effects, which are associated with vascular stress in the macrocirculation and microcirculation. Acute and chronic fatigue symptomatology shared similarly altered changes in the NOI and RHR parameters and both can be linked to calcium homeostasis modification. Conclusion The NOI and RHR parameters measured with the FMSF technique can be used for non-invasive clinical assessment of post-COVID syndrome as well as for monitoring the rehabilitation process.
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Affiliation(s)
- Michal Chudzik
- Medical Center, Saint Family Hospital, Lodz, Poland.,Department of Internal Medicine and Geronto-Cardiology, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - Anna Cender
- Medical Center, Saint Family Hospital, Lodz, Poland
| | | | - Jacek Zielinski
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | | | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland.,Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland.,Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
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Katarzynska J, Zielinski J, Marcinek A, Gebicki J. New Approach to Non-Invasive Assessment of Vascular Circulation Based on the Response to Transient Ischemia. Vasc Health Risk Manag 2022; 18:113-116. [PMID: 35283632 PMCID: PMC8910465 DOI: 10.2147/vhrm.s358983] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/26/2022] [Indexed: 01/27/2023] Open
Affiliation(s)
| | - Jacek Zielinski
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
| | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
- Correspondence: Jerzy Gebicki; Andrzej Marcinek, Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, 90-924, Poland, Tel +48 42 631 31 71; +48 42 631 30 96, Email ;
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The State of Microcirculatory Hemodynamics in Patients with Moderate and Severe COVID-19. Bull Exp Biol Med 2021; 171:453-457. [PMID: 34542748 PMCID: PMC8450309 DOI: 10.1007/s10517-021-05248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Indexed: 11/21/2022]
Abstract
Microcirculatory hemodynamic indexes (HI) were assessed in patients with moderate and severe COVID-19. In both groups, a significant increase in the absolute spectral indexes (HI1, HI2, and HI3) and the ratio of low-frequency to high-frequency component (HI1/HI3) was revealed. In the group of severe infection, only the “slow” index (low-frequency HI1) of microcirculatory hemodynamics was significantly lower. The oscillatory indices MAYER1-3 and RESP1-3 were reduced in patients of both groups. The aggravation of the disease course was accompanied by depression of the low-frequency index HI1. Regulatory shifts compensate for disturbances in microcirculatory processes in moderate COVID-19, but severe course was associated with their decompensation.
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Assessment of microvascular function and pharmacological regulation in genetically confirmed familial hypercholesterolemia. Microvasc Res 2021; 138:104216. [PMID: 34182004 DOI: 10.1016/j.mvr.2021.104216] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Familial hypercholesterolemia (FH) is a genetic lipid disorder leading to accelerated atherosclerosis, premature cardiovascular disease and death. Microvascular endothelial dysfunction is one of the earliest vascular pathology manifestations and may precede symptomatic atherosclerosis. METHODS In this paper, microvascular endothelial function was assessed in FH patients and healthy controls using flow mediated skin fluorescence (FMSF), based on measurements of nicotinamide adenine dinucleotide fluorescence intensity during brachial artery occlusion (ischemic response, IR) and immediately after occlusion (hyperemic response, HR). Low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were used to assess its relation with microvascular parameters evaluated in vivo. RESULTS LDL-C levels were significantly correlated to both HRmax (r = -0.548, p = 0.001) and HRindex (r = -0.514, p = 0.003). Similarly, there was a significant inverse correlation of TC levels and both HRmax (r = -0.538, p = 0.002) and HRindex (r = -0.512, p = 0.003). All FMSF parameters were found lower in FH patients compared to age- and sex-matched healthy controls. Hyperemic response (HRmax) was significantly higher in FH patients examined on statins compared to those without any lipid-lowering treatment (19.9 ± 3.1 vs. 16.4 ± 4.2 respectively, p = 0.022). CONCLUSIONS This study shows that, in patients with FH, microvascular endothelial-dependent hyperemic response is impaired and inversely correlated to plasma cholesterol levels. Microvascular function was found better in FH patients receiving statins.
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Los-Stegienta A, Katarzynska J, Borkowska A, Marcinek A, Cypryk K, Gebicki J. Differentiation of Diabetic Foot Ulcers Based on Stimulation of Myogenic Oscillations by Transient Ischemia. Vasc Health Risk Manag 2021; 17:145-152. [PMID: 33907408 PMCID: PMC8064676 DOI: 10.2147/vhrm.s307366] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/02/2021] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Diabetic foot ulceration is a chronic complication characterized by impaired wound healing. There is a great demand for a diagnostic tool that is able to monitor and predict wound healing. PATIENTS AND METHODS Oscillations in the microcirculation, known as flowmotion, can be monitored very distinctly and precisely using the Flow Mediated Skin Fluorescence (FMSF) technique. The flowmotion response to hypoxia was measured quantitatively in 42 patients with diabetic foot ulcers. RESULTS The flowmotion response to hypoxia parameters FM(R) and HS were used to differentiate the diabetic foot ulcers and correlate them with clinical status. In some cases, FMSF measurements were continued over the period of a year in order to monitor disease progress. The clinical status of the quarter of patients with the highest HS values (group A, HS = 50.2±18.3) was compared to the quarter with the lowest HS values (group B, HS = 4.3±1.7). The patients in the group B were identified as having low prognosis for healing and were characterized by higher incidences of hypertension, hyperlipidemia, prevalent CVD, neuropathy and nephropathy. CONCLUSION Impaired flowmotion responses to hypoxia induced by transient ischemia can be used for differentiation of diabetic foot ulcers and identification of cases with low prognosis for healing.
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Affiliation(s)
| | | | - Anna Borkowska
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Katarzyna Cypryk
- Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
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Gebicki J, Marcinek A, Zielinski J. Assessment of Microcirculatory Status Based on Stimulation of Myogenic Oscillations by Transient Ischemia: From Health to Disease. Vasc Health Risk Manag 2021; 17:33-36. [PMID: 33603387 PMCID: PMC7882797 DOI: 10.2147/vhrm.s292087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/16/2021] [Indexed: 12/17/2022] Open
Affiliation(s)
- Jerzy Gebicki
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland.,Angionica Ltd, Lodz, Poland
| | - Andrzej Marcinek
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland.,Angionica Ltd, Lodz, Poland
| | - Jacek Zielinski
- Department of Athletics, Strength and Conditioning, Poznan University of Physical Education, Poznan, Poland
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Katarzynska J, Cholewinski T, Sieron L, Marcinek A, Gebicki J. Flowmotion Monitored by Flow Mediated Skin Fluorescence (FMSF): A Tool for Characterization of Microcirculatory Status. Front Physiol 2020; 11:702. [PMID: 32636761 PMCID: PMC7317028 DOI: 10.3389/fphys.2020.00702] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/28/2020] [Indexed: 01/20/2023] Open
Abstract
Oscillations in the microcirculation, known as flowmotion, are a well-recognized characteristic of cutaneous blood flow. Since flowmotion reflects the microcirculatory status of the vascular system, which is very often impaired in many diseases and disorders, a quantitative assessment of skin flowmotion could potentially be used to screen for early symptoms of such conditions. In this study, skin flowmotion was monitored using the Flow Mediated Skin Fluorescence (FMSF) technique. The flowmotion parameter was used for quantitative assessment of basal flowmotion both at rest (FM) and during reperfusion [FM(R)] following the post-occlusive reactive hyperemia (PORH). The study population was composed of healthy volunteers between the ages of 30 and 72 (n = 75). The FM parameter showed an inverse dependence relative to age, while the FM(R) parameter was inversely correlated to blood pressure. The FM(R) parameter reflects the strong effect of hypoxia on flowmotion, which is mainly due to increased myogenic activity in the vessels. The FMSF technique appears to be uniquely suited for the analysis of basal flowmotion and the hypoxia response, and may be used for the characterization of microcirculatory status.
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Affiliation(s)
| | | | | | - Andrzej Marcinek
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
| | - Jerzy Gebicki
- Angionica Ltd., Lodz, Poland
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Lodz, Poland
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Gebicki J, Katarzynska J, Marcinek A. Can the microcirculatory response to hypoxia be a prognostic factor for Covid-19? Respir Physiol Neurobiol 2020; 280:103478. [PMID: 32540481 PMCID: PMC7291997 DOI: 10.1016/j.resp.2020.103478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Jerzy Gebicki
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924, Lodz, Poland; Angionica Ltd., Zeromskiego 116, 90-924, Lodz, Poland.
| | | | - Andrzej Marcinek
- Institute of Applied Radiation Chemistry, Lodz University of Technology, Zeromskiego 116, 90-924, Lodz, Poland; Angionica Ltd., Zeromskiego 116, 90-924, Lodz Poland
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