FMSF-HS Test Service
The FMSF-HS test allows assessment of microcirculatory status based on analysis of baseline oscillations and the reperfusion signal, showing changes in NADH fluorescence due to induced reactive hyperemia (PORH).
Details
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 impaired in many diseases and disorders, quantitative assessment of skin flowmotion can be used to screen for early symptoms of such conditions. Skin flowmotion can be monitored closely and precisely using the FMSF technique.
Since NADH fluorescence is sensitive to the supply of oxygen to the epidermis via skin microcirculation, use of the FMSF technique to monitor flowmotion appears to be a unique tool for the characterization of microcirculatory status.
Flowmotion parameters
Two different periods of oscillations can be distinguished in the FMSF signal:
- basal oscillations at rest,
- flowmotion during the reperfusion stage.
Analysis of flowmotion on the reperfusion line following post-occlusive reactive hyperemia (PORH) allows for quantitative assessment of the patient’s reaction to transient hypoxia. Flowmotion parameters characterizing the microcirculatory response to hypoxia have been found to be impaired among patients with various diseases and disorders, including hypertension, diabetes, peripheral artery disease, and cardiovascular diseases. Flowmotion parameters have also been found to be dependent on age and gender.
Microcirculatory oscillations in the recorded FMSF signal are analyzed in three major frequency intervals, ≤0.021 Hz, 0.021-0.052 Hz, and 0.052-0.15 Hz, which correspond to endothelial (endo), neurogenic (neuro), and myogenic (myo) activity, respectively.
The mean squared error of the deviation in the fluorescence signal (increased 106 times) from the baseline at rest (FM parameter) and during reperfusion (FM(R) is used as a measure of oscillation strength. FM and FM(R) remain unitless values, because the changes in fluorescence are normalized. Another measure of oscillation strength is the Power Spectral Density (PSD) parameter. PSD is strongly correlated with the values for FM and FM(R) and can be used to determine the contribution of each component of the oscillations to the total value.
In summary, the following quantitative measures of oscillations are defined:
- FM – a parameter characterizing basal flowmotion at rest;
- FM(R) – a parameter representing flowmotion during the reperfusion phase, which reflects the strong effect of hypoxia on flowmotion, mainly due to increased activity by the vessels. This parameter enables the assessment of vascular wall stiffness,
- HS (Hypoxia Sensitivity) – a direct measure of the intensity of flowmotion related to myogenic oscillations (0.052–0.15 Hz) recorded during reperfusion.
Hypoxia Sensitivity parameter (HS)
Myogenic oscillations are stimulated on the reperfusion line after transient ischemia, which is achieved by restricting blood flow in the brachial artery using an occlusion cuff. Since the HS (Hypoxia Sensitivity) parameter measures the intensity of flowmotion, it is well-suited for quantitative characterization of the microcirculatory response to hypoxia. The HS parameter, describing the microcirculatory response to hypoxia, has been found to depend on age, gender, hypertension, diabetes, and CVD.
Intended uses
- assessment of microcirculation dysfunction in diabetes, cardiovascular diseases, peripheral artery disease, and hypertension;
- prognosis of the healing process in chronic wounds (including diabetic foot ulcers);
- assessment of tolerance to physical exercise for amateur and competitive sports;
- assessment of adaptation to high altitudes;
- identification of patients in possible need of preventive or therapeutic interventions.
Summary
The FMSF technique appears to be uniquely suited to the analysis of basal flowmotion and its hypoxia response, and may be used for characterization of microcirculatory status. The FMSF technique enables disorders to be detected at an early stage of development and facilitates monitoring of the treatment process.
Customer reviews
No reviews were found for FMSF-HS Test Service. Be the first to review!