Multi-gaussian Decomposition of the Microvascular Pulse Detects Alterations in Type 1 Diabetes

Among diabetic patients, microangiopathy represents a relevant cause of morbidity and mortality. Diabetes induces detrimental changes in the biomechanical characteristics of blood microvessels, and fuels the development of a dysfunctional vascularization. Since the structural properties of the circulatory system affect the microvascular pulse, the aim of this study was to detect these vascular alterations through a model-based quantitative analysis of its waveform. Baseline microvascular perfusion was recorded on the hallux with a laser Doppler flowmeter. 54 healthy subjects (age: 34 ± 26 years) and 22 type 1 diabetic (T1D) patients without known cardiovascular complications and smoking history (age: 34 ± 17 years) were compared. A novel multi-Gaussian decomposition algorithm was applied to reconstruct the heartbeat-related oscillations, which were evaluated according to normalized and physiologically-motivated shape descriptors. Eight out of the nine properties assessed significantly differed between the groups (p < 0.001), indicating that the proposed pulse modeling method is sensitive to the effects of T1D on the peripheral perfusion.