The goal of this clinical investigation is to explore a non-invasive technology for measuring the microcirculatory structure, composition and function in patients from a primary care population. The main aims are: 1. To evaluate the robustness of the technology for assessment of the molecular composition and structure of the skin tissue and microcirculatory function, on a prospective primary care population. 2. To evaluate the device and method on its capability to detect deficiencies in circulation, compared with existing reference systems with similar characteristics for patients with known cardiovascular disease risk and/or diabetes.
The clinical investigation aims to evaluate the potential value of an investigational medical device (IMD) based on a technology called SFDI, Spatial Frequency Domain Imaging. This is a non-invasive contactless technology for in-vivo measurement of the structure and molecular composition of the skin and its embedded blood volume. The technology is a promising tool for diagnostic support of pathology to the microcirculation, like in peripheral arterial disease and diabetes, but also for general cardiovascular disease risk assessment. The IMD can measure the concentration of deoxy- and oxyhemoglobin, melanin and water, as well as structural properties in skin tissue, at two imaging depths. The study participants mainly consist of a prospective primary care population, that undergo an investigation (including SFDI assessment) at a primary care visit. Other assessment data collected during the visit (including medical history, blood pressure, blood values, ankle-brachial index) is retrieved from the participant's medical journal. An extended examination (including SFDI assessment with addition of a 3-minute post-occlusive hyperemia (PORH) test and vascular assessment using the reference system Perimed Periflux 6000) will be offered to participants based on increased risk of cardiovascular disease in the primary care population, or for separately invited subjects with increased cardiovascular risk, known diabetes or as healthy controls. Repeated yearly measurements may be performed in subjects who are interested in doing so. A subset of participants will undergo a multi-modal investigation which includes combining data from the current study with contactless laser vibrometry data from the investigation "Cardio Alpha" (CIV ID: CIV-22-08-040426). The hypothesis is that cardiovascular disease (CVD) risk assessment may be improved through a multi-modal approach, combining data on both macro- and microcirculatory function. Another subset of participants will undergo a diabetic feet assessment protocol, including an SFDI assessment of the soles of the feet and assessment using reference methods for macro-and microcirculation, and a foot neuropathy assessment. A third subset of participants will undergo a skin cancer assessment protocol, including SFDI assessment of a suspected lesion on the skin.
Study Type
OBSERVATIONAL
Enrollment
8,000
Atrium Health Care Centre
Stockholm, Sweden
RECRUITINGNeko Health Centre, Regeringsgatan
Stockholm, Sweden
RECRUITINGNeko Health Centre, Sibyllegatan
Stockholm, Sweden
RECRUITINGAssociation between IMD-derived variables and markers for circulatory deficiencies measured by CE-marked reference systems
Evaluate the correlation between IMD-derived parameters and outcomes related to vascular function, including ankle-brachial index, toe-brachial index and tcpO2, acquired by CE-marked reference system Perimed® Periflux 6000 or CE-marked oscillometric ABI measurement device.
Time frame: Same day as enrolment, or typically within 3-6 months from enrolment. If 1-year follow-up, then 1 year and 3-6 months from enrolment.
Performance of a combined risk score using data from Spectrum 1 and the in parallel performed investigation "Cardio Alpha"(CIV-ID: CIV-22-08-040426)
Assess performance in prediction of cardiovascular disease risk when adding parameters from the clinical study "Cardio Alpha" to parameters from the present study. Outcomes will include known CVD or CVD risk, based on established risk factors, risk scores, clinical information and outcomes from reference devices from both investigations.
Time frame: Same day as enrolment or typically within 3-6 months following enrolment. If 1-year follow-up, then typically 1 year and 3-6 months from enrolment.
Association between peak oxygen saturation measured by spatial frequency domain imaging (SFDI) on the palm and forearm and cardiovascular risk factors.
To evaluate the association between peak oxygenation obtained from the investigational device upon release of a 3-minute post-occlusive hyperemia (PORH) test, and established CVD risk factors, including brachial blood pressure, BMI, hypertension diagnosis, diabetes mellitus diagnosis, smoking status, hsCRP and HbA1C, in a large cohort within primary care.
Time frame: Typically 3-6 months from enrolment. If 1-year follow-up, then 1 year and 3-6 months from enrolment.
Correlation between oxygenation on sole of the foot and tissue ischemia level
To evaluate correlation between markers of oxygenation (oxygen conc., total hemoglobin conc., oxy-and deoxy-hemoglobin conc.) on the foot sole and transcutaneous oxygen pressure (tcpO2), acquired using Perimed® Periflux 6000 reference device, in diabetic subjects.
Time frame: Same day as enrolment.
Correlation between oxygenation on sole of the foot and neuropathy
To evaluate the correlation between markers of oxygenation (oxygen conc., total hemoglobin conc., oxy-and deoxy-hemoglobin conc.) on foot sole and degree of neuropathy assessed by VibroSense® Meter II neuropathy score, in diabetic subjects.
Time frame: Same day as enrolment.
Correlation between water concentration on sole of the foot and tissue ischemia level
Regression coefficient from correlation between water concentration within measured volume on foot sole and transcutaneous oxygen pressure (tcpO2), acquired using Perimed® Periflux 6000 reference device
Time frame: Same day as enrolment.
Correlation between water concentration on sole of the foot and neuropathy
Regression coefficient from correlation between melanin and water concentration within measured volume on foot sole and degree of neuropathy assessed by VibroSense® Meter II neuropathy score.
Time frame: Same day as enrolment.
Difference in oxygenation/ hemoglobin gradient between lesion and surrounding tissue
Relative gradient in oxy- and deoxy-hemoglobin concentration, total hemoglobin concentration and/or oxygen concentration in malignant and non-malignant skin lesions compared to surrounding tissue.
Time frame: At follow-up, within 3 months of enrolment.
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