Imaging Technology Detects Early Signs of Cardiovascular Risk Through Skin

Cardiovascular disease often begins with subtle dysfunction in the body’s smallest blood vessels, long before symptoms or major structural damage appear. These early changes, known as microvascular endothelial dysfunction, are difficult to detect with current non-invasive tools, limiting timely prevention and intervention. A new imaging approach now makes it possible to visualize and quantify these early microvascular abnormalities directly through the skin, offering a way to identify cardiovascular risk at a much earlier stage.

Researchers at Helmholtz Munich (Munich, Germany), in collaboration with Technical University of Munich (Munich, Germany), have created fast-RSOM, an advanced form of Raster Scan Optoacoustic Mesoscopy designed to image the smallest blood vessels beneath the skin without injections or surgical procedures. Fast-RSOM works by delivering short pulses of light into tissue, which generate ultrasound signals that are converted into high-resolution, three-dimensional images.

This approach enables visualization of individual capillaries and distinct skin layers, allowing direct assessment of how blood vessels expand and contract in response to physiological stimuli. Using fast-RSOM, the researchers were able to non-invasively measure dynamic biomarkers of microvascular endothelial dysfunction in humans at single-capillary resolution.

The technology detected subtle impairments in blood vessel function that typically arise before clinical symptoms or measurable large-vessel disease. These changes were associated with known cardiovascular risk factors such as smoking, obesity, and high blood pressure. The findings, published in Nature Biomedical Engineering, demonstrate that fast-RSOM can quantitatively capture early microvascular damage rather than relying on indirect risk estimates.

By identifying early microvascular dysfunction, fast-RSOM could enable earlier intervention, personalized therapy selection, and more precise monitoring of cardiovascular health. The technology may also be useful for tracking how lifestyle changes or medications affect vascular function over time.

Because the system is fast, portable, and non-invasive, it could be integrated into outpatient clinics for routine cardiovascular risk assessment. The researchers plan to validate the technology in larger and more diverse patient populations and to integrate fast-RSOM-derived biomarkers into clinical decision-making workflows.

“By enabling earlier interventions and more precise monitoring, fast-RSOM could transform how cardiovascular diseases are prevented and managed – improving outcomes for patients and reducing healthcare costs in the long term,” said TUM Professor Vasilis Ntziachristos.

Related Links:
Helmholtz Munich
Technical University of Munich