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Journal article

Association of microvascular function and endothelial biomarkers with clinical outcome in dengue: an observational study

Abstract:
Background. The hallmark of severe dengue is increased microvascular permeability, but alterations in the microcirculation and their evolution over the course of dengue are unknown. Methods. We conducted a prospective observational study to evaluate the sublingual microcirculation using side-stream dark-field imaging in patients presenting early (<72 hours after fever onset) and patients hospitalized with warning signs or severe dengue in Vietnam. Clinical findings, microvascular function, global hemodynamics assessed with echocardiography, and serological markers of endothelial activation were determined at 4 time points. Results. A total of 165 patients were enrolled. No difference was found between the microcirculatory parameters comparing dengue with other febrile illnesses. The proportion of perfused vessels (PPV) and the mean flow index (MFI) were lower in patients with dengue with plasma than those without leakage (PPV, 88.1% vs 90.6% [P = .01]; MFI, 2.1 vs 2.4 [P = .007]), most markedly during the critical phase. PPV and MFI were correlated with the endothelial activation markers vascular cell adhesion molecule 1 (P < .001 for both) and angiopoietin 2 (P < .001 for both), negatively correlated. Conclusions. Modest microcirculatory alterations occur in dengue, are associated with plasma leakage, and are correlate with molecules of endothelial activation, angiopoietin 2 and vascular cell adhesion molecule 1.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1093/infdis/jiw220

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author


Publisher:
Oxford University Press
Journal:
Journal of infectious diseases More from this journal
Volume:
214
Issue:
5
Pages:
697–706
Publication date:
2016-05-26
Acceptance date:
2016-05-18
DOI:
EISSN:
1537-6613
ISSN:
0022-1899


Language:
English
Keywords:
Pubs id:
pubs:625315
UUID:
uuid:157a0d62-19ad-47c4-a191-14aba54e1f39
Local pid:
pubs:625315
Source identifiers:
625315
Deposit date:
2016-06-10
ARK identifier:

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