Summary

非侵入性的评估微血管和内皮功能

Published: January 29, 2013
doi:

Summary

毛细管显微镜是一种非侵入性的,相对廉价的直接可视化的微循环的方法。前臂血流技术提供接受血管内皮功能的非侵入性的措施。

Abstract

作者们利用甲襞微循环和前臂血流技术调查的微血管功能障碍在心血管疾病的发病机制中的作用。毛细管显微镜是一种非侵入性的,相对廉价的直接可视化的微循环的方法。毛细管招聘百分比评估,将毛细血管密度的增加引起的闭塞后反应性充血(闭塞后反应性充血毛细血管密度减去基线毛细血管密度),最大毛细血管密度(被动静脉阻塞的过程中观察到的)。百分比灌注毛细血管代表所有的毛细血管目前,灌注功能活跃,比​​例的计算方法是将闭塞后反应性充血的毛细血管密度最大的毛细血管密度。两者%的毛细管招聘和百分之灌注毛细血管反映毛细血管功能。前臂血流(FBF)技术公关ovides接受血管内皮功能的非侵入性的措施:该比率FBF 最高 / FBF 作为血管舒张的估计值,计算除以四个FBF由四个FBF 值的平均值的最大值的平均值。前臂血管阻力最大的血管扩张(FVR 最大值 )计算的平均动脉压(MAP)除以FBF 最大 。甲襞微循环和前臂技术,易于接受的患者,可以学得很快。

的微血管和内皮细胞的功能,使用本文介绍的方法可能有未来效用在临床病人的心血管疾病的危险减贫战略措施。正如我们所发表的报告表明,微血管和内皮功能障碍被发现在初始阶段包括高血压前期,高血压,血管和内皮细胞功能的措施最终可能会有助于早期识别,终末期血管病变的危险分层和预防,其潜在的致命后果。

Protocol

病例报告 (如适用):不适用,这仍然是一个实验的研究过程,尚未应用于临床。 诊断,评估和计划 (必填,如果适用):不适用,这仍然是一个实验的研究过程,尚未应用于临床。 过程 (必填):这部分应包括有关程序一步一步的描述,下面的指导方针。 1。毛细管显微镜( 图1)</s…

Representative Results

在血压正常和高血压个体之间的微血管的外观的差异是显而易见的,通过比较图4和图5。组织良好的行中的血压正常的个体中, 图4示出了典型的网络直毛细血管。相比之下, 图5显示了一个弄乱模式,皱缩,卷曲的毛细血管。 作者有持续的兴趣的微血管功能障碍在心血管疾病的发病机制中的作用。在他们的第一NIH / NHLBI资助?…

Discussion

毛细管显微镜(毛细血管显微镜)的毛细管结构是一个非标准的措施。然而,目前有没有为直接毛细管structure.Furthermore评估的标准方法,毛细血管显微镜已被广泛用于直接评价capillarydensity发表的作品,12日,13日,10日,11日,14日至18日在大,越来越多的。此外,我们已经证实了的毛细血管显微镜技术的关联甲襞微循环的研究结果与前臂血流,血管功能的一个行之有效的措施,10日,11?…

Divulgazioni

The authors have nothing to disclose.

Acknowledgements

这项工作是由Grant的奖数R01HL096593和K23HL72825从国家心脏,肺和血液研究所的支持。的内容是纯粹的托马斯杰斐逊大学的责任,并不一定代表国家心脏,肺和血液研究所和美国国立卫生研究院的官方意见。

Riferimenti

  1. Serne, E. H., Gans, R. O., ter Maaten, J. C., ter Wee, P. M., Donker, A. J., Stehouwer, C. D. Capillary recruitment is impaired in essential hypertension and relates to insulin’s metabolic and vascular actions. Cardiovasc. Res. 49, 161-168 (2001).
  2. Bollinger, A., Fagrell, B. . Clinical Capillaroscopy: A guide to its use in clinical research and practice. , (1990).
  3. Antonios, T. F., Rattray, F. E., Singer, D. R., Markandu, N. D., Mortimer, P. S., MacGregor, G. A. Maximization of skin capillaries during intravital video-microscopy in essential hypertension: comparison between venous congestion, reactive hyperaemia and core heat load tests. Clin. Sci. (Lond). 97, 523-528 (1999).
  4. Sivertsson, R. The hemodynamic importance of structural vascular changes in essential hypertension. Acta. Physiol. Scand. Suppl. 343, 1-56 (1970).
  5. Raitakari, O. T., Celermajer, D. S. Testing for endothelial dysfunction. Ann. Med. 32, 293-304 (2000).
  6. Tousoulis, D., Antoniades, C., Stefanadis, C. Evaluating endothelial function in humans: a guide to invasive and non-invasive techniques. Heart. 91, 553-558 (2005).
  7. Higashi, Y., Sasaki, S., Nakagawa, K., Matsuura, H., Kajiyama, G., Oshima, T. A noninvasive measurement of reactive hyperemia that can be used to assess resistance artery endothelial function in humans. Am. J. Cardiol. 87, 121-125 (2001).
  8. Higashi, Y., Yoshizumi, M. New methods to evaluate endothelial function: method for assessingendothelial function in humans using a strain-gauge plethysmography: nitric oxide-dependent and independent vasodilation. J. Pharmacol. Sci. 93, 399-404 (2003).
  9. Lind, L., Sarabi, M., Millgard, J. Methodological aspects of the evaluation of endothelium dependent vasodilatation in the human forearm. Clin. Physiol. 18, 81-87 (1998).
  10. Cheng, C., Diamond, J. J., Falkner, B. Functional capillary rarefaction in mild blood pressure elevation. Clinical and Translational Science. 1, 75-79 (2008).
  11. Cheng, C., Daskalakis, C., Falkner, B. Capillary rarefaction in treated and untreated hypertensive subjects. Therapeutic Advances in Cardiovascular Disease. 2, 79-88 (2008).
  12. Antonios, T. F., Singer, D. R., Markandu, N. D., Mortimer, P. S., MacGregor, G. A. Rarefaction of skin capillaries in borderline essential hypertension suggests an early structural abnormality. Hypertension. 34, 655-658 (1999).
  13. Noon, J. P., Walker, B. R., Webb, D. J., et al. Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure. J. Clin. Invest. 99, 1873-1879 (1997).
  14. Antonios, T. F., Rattray, F. M., Singer, D. R., Markandu, N. D., Mortimer, P. S., MacGregor, G. A. Rarefaction of skin capillaries in normotensive offspring of individuals with essential hypertension. Heart. 89, 175-178 (2003).
  15. de Jongh, R. T., Ijzerman, R. G., Serne, E. H., et al. Visceral and truncal subcutaneous adipose tissue are associated with impaired capillary recruitment in healthy individuals. J. Clin. Endocrinol. Metab. 91, 5100-5106 (2006).
  16. de Jongh, R. T., Serne, E. H., Ijzerman, R. G., de Vries, G., Stehouwer, C. D. Free fatty acid levels modulate microvascular function: relevance for obesity-associated insulin resistance, hypertension, and microangiopathy. Diabetes. 53, 2873-2882 (2004).
  17. de Jongh, R. T., Serne, E. H., RG, I. J., Stehouwer, C. D. Microvascular function: a potential link betweensalt sensitivity, insulin resistance and hypertension. J. Hypertens. 25, 1887-1893 (2007).
  18. Ijzerman, R. G., Voordouw, J. J., Van Weissenbruch, M. M., et al. TNF-alpha levels are associated withskin capillary recruitment in humans: a potential explanation for the relationship between TNF-alpha and insulin resistance. Clin. Sci. (Lond). 110, 361-368 (2006).
  19. Yvonne-Tee, G. B., Rasool, A. H., Halim, A. S., Rahman, A. R. Noninvasive assessment of cutaneous vascular function in vivo using capillaroscopy, plethysmography and laser-Doppler instruments: its strengths and weaknesses. Clin. Hemorheol. Microcirc. 34, 457-473 (2006).
  20. Wilkinson, I. B., Webb, D. J. Venous occlusion plethysmography in cardiovascular research: methodology and clinical applications. Br. J. Clin. Pharmacol. 52, 631-646 (2001).
  21. Thijssen, D. H., Bleeker, M. W., Smits, P., Hopman, M. T. Reproducibility of blood flow and post-occlusive reactive hyperaemia as measured by venous occlusion plethysmography. Clin. Sci. (Lond). 108, 151-157 (2005).
  22. Leslie, S. J., Attina, T., Hultsch, E., et al. Comparison of two plethysmography systems in assessment of forearm blood flow. J. Appl. Physiol. 96, 1794-179 (2004).
  23. James, M. A., Tullett, J., Hemsley, A. G., Shore, A. C. Effects of aging and hypertension on the microcirculation. Hypertension. 47, 968-9674 (2006).
  24. Debbabi, H., Uzan, L., Mourad, J. J., Safar, M., Levy, B. I., Tibirica, E. Increased skin capillary density in treated essential hypertensive patients. Am. J. Hypertens. 19, 477-483 (2006).
  25. Serne, E. H., Gans, R. O., ter Maaten, J. C., Tangelder, G. J., Donker, A. J., Stehouwer, C. D. Impaired skincapillary recruitment in essential hypertension is caused by both functional and structural capillary rarefaction. Hypertension. 38, 238-242 (2001).
  26. Carpentier, P. H. New techniques for clinical assessment of the peripheral microcirculation. Drugs. 58, 17-22 (2001).
  27. Shore, A. C. Capillaroscopy and the measurement of capillary pressure. Br. J. Clin. Pharmacol. 50, 501-513 (2000).
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Cheng, C., Daskalakis, C., Falkner, B. Non-invasive Assessment of Microvascular and Endothelial Function. J. Vis. Exp. (71), e50008, doi:10.3791/50008 (2013).

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