Different responses of the retinal and cutaneous microcirculation to transient dysmetabolic conditions

Reimann, Manja; Weiss, Norbert; Ziemssen, Tjalf

doi:10.1016/j.atherosclerosissup.2015.02.001

Cited by 10 publications

(6 citation statements)

References 27 publications

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“…We expected [ 9 , 53 ], but did not find, inverse associations between total-to-HDL cholesterol ratio and retinal and skin microvascular function as assessed here. Mechanistically, dyslipidemia may impair microvascular vasodilation via oxidative modifications of low-density lipoprotein cholesterol, which may cause reduced nitric oxide availability, possibly in conjunction with increased expression of endothelin-1 [ 53 ].…”

Section: Discussioncontrasting

confidence: 55%

Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study

et al. 2017

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ObjectiveMicrovascular dysfunction is an important underlying mechanism of microvascular diseases. Determinants (age, sex, hypertension, dyslipidemia, hyperglycemia, obesity, and smoking) of macrovascular diseases affect large-artery endothelial function. These risk factors also associate with microvascular diseases. We hypothesized that they are also determinants of microvascular (endothelial) function.MethodsIn The Maastricht Study, a type 2 diabetes-enriched population-based cohort study (n = 1991, 51% men, aged 59.7±8.2 years), we determined microvascular function as flicker light-induced retinal arteriolar %-dilation and heat-induced skin %-hyperemia. Multiple linear regression analyses were used to assess the associations of cardiovascular risk factors (age, sex, waist circumference, total-to-high-density lipoprotein (HDL) cholesterol ratio, fasting plasma glucose (FPG), 24-h systolic blood pressure, and cigarette smoking) with retinal and skin microvascular function.ResultsIn multivariate analyses, age and FPG were inversely associated with retinal and skin microvascular function (regression coefficients per standard deviation (SD) were -0.11SD (95%CI: -0.15;-0.06) and -0.12SD (-0.17;-0.07) for retinal arteriolar %-dilation and -0.10SD (-0.16;-0.05) and -0.11SD (-0.17;-0.06) for skin %-hyperemia, respectively. Men and current smokers had -0.43SD (-0.58;-0.27) and -0.32SD (-0.49;-0.15) lower skin %-hyperemia, respectively. 24-h systolic blood pressure, waist circumference, and total-to-HDL cholesterol ratio were not statistically significantly associated with these microvascular functions.ConclusionsAssociations between cardiovascular risk factors and retinal and skin microvascular function show a pattern that is partly similar to the associations between cardiovascular risk factors and macrovascular function. Impairment of microvascular function may constitute a pathway through which an adverse cardiovascular risk factor pattern may increase risk of diseases that are partly or wholly of microvascular origin.

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Section: Discussioncontrasting

confidence: 55%

Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study

et al. 2017

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“…A quantitative assessment of blood flow requires the use of special methods based either on the principle of measuring changes in tissue temperature (thermometry) , the principle of volume change by blood flow (plethysmography) or the principle of the Doppler effect (laser Doppler and Doppler sonography) . It could be used to diagnose endothelial dysfunction (40).…”

Section: Biosignals Used In Cardiovascular Autonomic Function Diagnosmentioning

confidence: 99%

The Investigation of the Cardiovascular and Sudomotor Autonomic Nervous System—A Review

2019

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The autonomic nervous system as operating system of the human organism permeats all organ systems with its pathways permeating that it is involved with virtually all diseases. Anatomically a central part, an afferent part and sympathetic and parasympathetic efferent system can be distinguished. Among the different functional subsystems of the autonomic nervous system, the cardiovascular autonomic nervous system is most frequently examined with easily recordable cardiovascular biosignals as heart rate and blood pressure. Although less widely established, sudomotor tests pose a useful supplement to cardiovascular autonomic assessment as impaired neurogenic sweating belongs to the earliest clinical signs of various autonomic neuropathies as well as neurodegenerative disorders and significantly reduces quality of life. Clinically at first, the autonomic nervous system is assessed with a detailed history of clinical autonomic function and a general clinical examination. As a lof of confounding factors can influence autonomic testing, subjects should be adequately prepared in a standardized way. Autonomic testing is usually performed in that way that the response of the autonomic nervous system to a well-defined challenge is recorded. As no single cardiovascular autonomic test is sufficiently reliable, it is recommended to use a combination of different approaches, an autonomic test battery including test to measure parasympathetic and sympathetic cardiovascular function (deep breathing test, Valsalva maneuver, tilt, or pressor test). More specialized tests include carotid sinus massage, assessment of baroreceptor reflex function, pharmacological tests or cardiac, and regional hemodynamic measurements. Techniques to measure functional integrity of sudomotor nerves include the quantitative sudomotor axon reflex sweat test, analysis of the sympathetic skin response as well as the thermoregulatory sweat test. In addition to these rather established techniques more recent developments have been introduced to reduce technical demands and interindividual variability such as the quantitative direct and indirect axon reflex testing or sudoscan. However, diagnostic accuracy of these tests remains to be determined. We reviewed the current literature on currently available autonomic cardiovascular and sudomotor tests with a focus on their physiological and technical mechanisms as well as their diagnostic value in the scientific and clinical setting.

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“…As a recent example, patients with metabolic syndrome exhibit both an abnormal Ach and SNP responses. The Ach response is clearly correlated with the brachial artery flow‐mediated dilatation , while when compared to the retinal microcirculation, it is less sensitive to acute metabolic changes .…”

Section: Which Dynamic Tests Are Commonly Used?mentioning

confidence: 99%

Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser‐Based‐Techniques

2016

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Several noninvasive techniques have been developed using laser light interaction in the skin to explore the skin's microcirculation. Combined with laser Doppler or LSCI, reactivity tests are used to explore skin endothelial and neurovascular function in humans, including PORH, LTH, PIV, and iontophoresis of vasodilators. Recent advances in our comprehension of the physiological pathways underlying these reactivity tests have been possible through topical or intradermal delivery of drugs that produce elevated local concentrations. Skin microvascular function has also been proposed as a prognostic biomarker or for evaluating the effect of drugs. Comprehension of the physiological pathways, together with recent technological improvements in microcirculation imaging, has provided reliable and reproducible tools to study skin microcirculation.

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Different responses of the retinal and cutaneous microcirculation to transient dysmetabolic conditions

Cited by 10 publications

References 27 publications

Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study

Cardiovascular risk factors as determinants of retinal and skin microvascular function: The Maastricht Study

The Investigation of the Cardiovascular and Sudomotor Autonomic Nervous System—A Review

Current Methods to Assess Human Cutaneous Blood Flow: An Updated Focus on Laser‐Based‐Techniques

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