Nicotinamide Adenine Dinucleotide Fluorescence Monitoring - a Potential Tool for Microvascular and Mitochondrial Function Assessment in Heart Failure

Sep 30, 2026

Uploaded by dabgoudw

Flow-mediated skin fluorescence (FMSF) using reduced nicotinamide adenine dinucleotide (NADH) is presented as a non-invasive optical approach to evaluate microvascular and mitochondrial function in patients with chronic heart failure (HF). The method tracks changes in cutaneous NADH fluorescence during the postocclusive reactive hyperemia (PORH) test, relating fluorescence dynamics to perfusion, endothelial responses, hypoxic sensitivity, and ischemic response parameters. Because endothelial dysfunction and mitochondrial impairment contribute to HF progression, FMSF may support disease monitoring, treatment evaluation, and risk stratification through accessible peripheral vascular assessment.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages3

Reading Time8 min

AccessFree to download

Background and Rationale

Endothelial dysfunction and mitochondrial impairment in heart failure

Flow-Mediated Skin Fluorescence (FMSF) Method

NADH fluorescence principles and measurement during PORH

Key parameters for microvascular function

Parameters for mitochondrial function assessment

Clinical Relevance

Monitoring progression, treatment success, and risk stratification

TECHNOLOGY NOTE Cardiology Journal 2025, Vol. 32, No. 6, 692–694 DOI:10.5603/cj.106572 Copyright © 2025 Via Medica ISSN 1897–5593 eISSN 1898–018X Nicotinamide adenine dinucleotide fluorescence monitoring as a potential tool for the microvascular and mitochondrial function assessment in heart failure Aleksandra Parzuchowska 1 , Maria Tarnawska 1 , Dorota Smolarek 1 , Barbara Kutryb-Zając2, 3 , Marcin Hellmann 1 1Department of Cardiac Diagnostics, Medical University of Gdansk, Poland 2Department of Biochemistry, Medical University of Gdansk, Poland 3Centre of Experimental Cardiooncology, Medical University of Gdansk, Poland The new flow-mediated skin fluorescence (FMSF) technique, based on reduced nicotinamide adenine dinucleotide (NADH) fluorescence, is a promising method that can help assess the function of both mitochondria and microcirculation inpatients with chronic heart failure (HF). This could also prove useful in monitoring disease progression, treatment success and risk stratification. Heart failure remains a significant clinical and public health problem, contributing to high rates of morbidity and mortality. Heart failure can arise from various underlying conditions, of which coronary obstructive atherosclerosis and coronary microvascular dysfunction are the most frequent [1] . Endothelial dysfunction is a common feature of both conditions. A substantial body of evidence indicates that microvascular endothelial dysfunction is one of the earliest steps in the pathogenesis of cardiovascular disease. Indeed, it represents a key mechanism underlying the development of heart failure across the entire spectrum of ejection fraction [2, 3] . The impairment of mitochondrial function in cardiomyocytes and cardiac endothelial cells has also been reported in HF [4]. Therefore, a comprehensive assessment of global mitochondrial and microvascular function may hold diagnostic, prognostic and therapeutic value in cardiovas- The ability to monitor pharmacotherapy and assess microvascular and mitochondrial function may serve as a valuable tool for risk stratification in HF patients and play a crucial role in the management of HF and other related circulatory disorders. Owing to its accessibility, cutaneous microcirculation is often used as a representative vascular bed for assessing global microvascular function [6]. The newly developed FSMF technique is a non-invasive optical method for determining microvascular function and metabolic regulation. It measures changes in the cutaneous fluorescence intensity of NADH in response to variations in blood flow within microcirculation during the postocclusive reactive hyperemia (PORH) test. NADH molecules emit fluorescence at a wavelength of 460 nm when excited by ultraviolet light. As a key electron carrier, NADH is essential for redox reactions, energy production, and maintaining cellular antioxidant status. During glycolysis, NAD + is reduced to NADH in the cytoplasm as glucose is converted to pyruvate. Cytosolic NADH contributes to energy production via shuttles transferring electrons into mitochondria. Mitochondrial NADH, mainly produced in the tricarboxylic acid (TCA) cycle, donates electrons to the electron transport chain, cular diseases [5] . driving oxidative phosphorylation, the primary ATP Address for correspondence: Marcin Hellmann, M.D., Ph.D., Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, 80–214 Gdansk, Poland; tel: + 48 58 349 33 80, fax: + 48 58 349 33 79, [e-mail: marcin.hellmann@gumed.edu.pl](e-mail: marcin.hellmann@gumed.edu.pl) Received: 3.06.2025 Accepted: 3.11.2025 Early publication date: 19.11.2025 This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or

FAQs

What is flow-mediated skin fluorescence (FMSF) and how does it work?

FMSF is a non-invasive optical technique based on reduced NADH fluorescence. It measures changes in cutaneous fluorescence intensity during the postocclusive reactive hyperemia (PORH) test in response to controlled blood-flow variation.

Which parameters are used to assess microvascular function?

Microvascular function is evaluated using parameters including flow motion (FM), hypoxia sensitivity (HS), and the hyperemic response (HRmax/RHR), which reflects macrovascular endothelial function after restricted blood flow.

How can mitochondrial function be assessed with this approach?

Mitochondrial function can be analyzed using ischemic response (IRmax), HS, basal NADH fluorescence level, and the normoxia oscillatory index (NOI), linking fluorescence behavior to metabolic regulation.

Sep 30, 2026

Uploaded by dabgoudw