Assessment of the Microcirculation in Cardiovascular Disease

Struijker‐Boudier, Harry A.J.; Crijns, F. R. L.; Stolte, Jens; Essen, Helma van

doi:10.1042/cs0910131

Cited by 17 publications

(8 citation statements)

References 46 publications

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“…Thus, the acute consequences of other influences in severely ill patients have stronger influence. Moreover, the microvascular alterations in diabetes are more associated with a progressive rarefication of the microvascular network which leads to fixed anatomical alterations [18].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the sublingual microcirculation in cardiogenic shock

Jung

Ferrari²,

Rödiger³

et al. 2009

Clinical Hemorheology and Microcirculation

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Objectives: Orthogonal polarized spectral imaging-and sidestream darkfield-technique have enabled visual evaluation of the microcirculation. Different investigators described microcirculatory alterations, especially in surgical patients suffering from septic shock. We investigated the sublingual microcirculation in non-surgical patients admitted to our medical, intensive care unit (ICU).Methods: In 24 severely ill (APACHE-II Score: 27.8 ± 11.3), intubated patients admitted to our ICU the sublingual microcirculation was recorded with a handheld intravital microscope. Sublingual vessels were categorized according to their size (small: 10-25 µm; medium: 26-50 µm; large: 51-100 µm) and the flow in semiquantitative categories (0: no flow; 1: intermittent flow; 2: sluggish flow; 3: continuous flow).Results: Patients with cardiogenic shock (n = 7) had lower microflow compared with patients without cardiogenic shock (small p < 0.001, medium p < 0.001, large p = 0.003). Several other diseases, including diabetes and arterial hypertension, age, gender, had no influence. In general, patients with a flow less than 3 in the small vessels showed higher arterial blood lactate levels (p = 0.043) compared to continuous flow.Conclusions: A consequence of cardiogenic shock is the impairment of microcirculation with organ hypoperfusion. We observed that cardiac output is correlated to disturbance in microflow in the smallest vessels. On-line evaluation of microcirculation in vivo may be a valid tool for optimizing therapeutic measures in high risk patients.Additional online material may be found at: http://www.kim1.uniklinik-jena.de/Microcirculation.html.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the sublingual microcirculation in cardiogenic shock

Jung

Ferrari²,

Rödiger³

et al. 2009

Clinical Hemorheology and Microcirculation

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“…Abnormal angiogenesis has already been demonstrated in hypertensive animal models as well as in different stages of hypertension in humans [14–16]. There seems to be an impaired ability for vascular growth resulting from structural alteration of the microvascular network, which includes capillary rarefaction, increased arteriol length and tortuosity [17–19]. The basic observation underlying the hypothesis that essential hypertension is based on an impaired capacity for vascular growth is the nature of the structural alterations of microvascular beds in essential hypertension [19].…”

Section: Discussionmentioning

confidence: 99%

Elevated VEGF‐plasma levels in young patients with mild essential hypertension

Stumpf

Jukic

Yılmaz

et al. 2008

Eur J Clin Investigation

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“…These observations are therefore in agreement with rarefaction as the mechanism of increased peripheral resistance in the early stages of hypertension, as opposed to decreases in resting diameter. 34 In WKY, macromolecular leak occurred during propofol anaesthesia. A known side effect of Ca 2+ antagonist drugs is oedema.…”

Section: Discussionmentioning

confidence: 99%