Impaired Tissue Perfusion

Lévy, Bernard; Schiffrin, Ernesto L.; Mourad, Jean‐Jacques; Denis, Arnaud; Vicaut, Éric; Safar, Michel E.; Struijker‐Boudier, Harry A.J.

doi:10.1161/circulationaha.107.763730

Cited by 411 publications

(192 citation statements)

References 101 publications

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“…In patients with hypertension, microvascular structure is altered and microvascular function is impaired (20,22). We and others have hypothesized that microvascular abnormalities may not only be a consequence of hypertension, but may in fact precede -and contribute to -the elevation of blood pressure, hence creating a vicious circle (6,23). Indeed, structural and functional microvascular abnormalities have been reported in normotensive subjects at risk for hypertension (14,(24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Insulin's microvascular vasodilatory effects are inversely related to peripheral vascular resistance in overweight, but insulin‐sensitive subjects

Hornstra

Serné

Eringa

et al. 2013

Obesity

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Objective: The mechanisms underlying obesity-related hypertension are incompletely understood. Microvascular dysfunction might play a role by increasing peripheral vascular resistance (PVR). Metabolic and microvascular effects of insulin are impaired in obesity, but how these impairments contribute to disturbed blood pressure homeostasis is unclear. Specifically, it is unknown whether local microvascular vasoactive effects of insulin play a role in determining systemic vascular resistance. The aim of this study was to investigate the association between PVR and local microvascular effects of insulin. Design and Methods: Thirty-seven healthy, overweight subjects (age 25-55 years, BMI 25-30 kg/m 2 ) were cross-sectionally studied. Local insulin-mediated vasodilation was measured using skin laser Doppler fluxmetry combined with transcutaneous iontophoresis of insulin. For comparison, local vasodilatory effects of acetylcholine and sodium nitroprusside were measured. PVR was calculated from mean arterial pressure and cardiac output, assessed by pulse-dye densitometry. Results: PVR was inversely correlated with insulin-mediated vasodilation (r ¼ À0.50; P < 0.01). This finding was maintained after adjustment for age, sex, blood pressure, and smoking. PVR was not associated with local microvascular effects of acetylcholine. Conclusions: Our study in overweight subjects suggests that insulin's role in the microvasculature may contribute to blood pressure control.

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Section: Discussionmentioning

confidence: 99%

Insulin's microvascular vasodilatory effects are inversely related to peripheral vascular resistance in overweight, but insulin‐sensitive subjects

Hornstra

Serné

Eringa

et al. 2013

Obesity

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“…Increased arterial stiffness is associated with abnormalities of both stresses owing to fluctuations of the pressure and speed of blood flow in the arterial lumen 66) . These stresses trigger signaling cascades in the arterial wall contributing to vascular growth, such as tyrosine kinase, phosphatidyl inositol-3-kinase, protein kinase C, epithelial sodium channel, and/or nicotinamide adenine dinucleotide phosphate oxidase signaling, and activation of these signaling casing the formation of focal plaque lesions in the systemic arterial tree, and therefore, the intima-media thickness of the carotid artery and/or size of a carotid plaque are acceptable markers to predict future cardiovascular events 59) .…”

Section: D: Arterial Remodeling and Atherogenic Actionsmentioning

confidence: 99%

Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors

Tomiyama

Matsumoto

Shiina

et al. 2016

J Atheroscler Thromb

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Since 2001, brachial-ankle pulse wave velocity (brachial-ankle PWV) measurement has been applied for risk stratification of patients with atherosclerotic cardiovascular disease and/or its risk factors in Japan. Measurement of the brachial-ankle PWV is simple and well standardized, and its reproducibility and accuracy are acceptable. Several cross-sectional studies have demonstrated a significant correlation between the brachial-ankle PWV and known risk factors for cardiovascular disease; the correlation is stronger in subjects with cardiovascular disease than in those without cardiovascular disease. We conducted a meta-analysis, which demonstrated that the brachial-ankle PWV is an independent predictor of future cardiovascular events. Furthermore, the treatment of cardiovascular risk factors and lifestyle modifications have been shown to improve the brachial-ankle PWV. Thus, at present, brachial-ankle PWV is close to being considered as a useful marker in the management of atherosclerotic cardiovascular disease and/or its risk factors.

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“…[8][9][10][11] The microcirculation is generally defined as the network of small arteries, arterioles capillaries and venules that serve metabolic and other tissues. [12][13][14] Microcirculatory dysfunction has been proposed to be an additional mechanism relating obesity to CVD, through insulin resistance and hypertension. 15 Reduced capillary blood flow may contribute to the development of insulin resistance in muscle and other organs.…”

Section: Introductionmentioning

confidence: 99%

Macrovascular and microvascular dysfunction in the metabolic syndrome

et al. 2010

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The metabolic syndrome (MetS) is associated with increased risk of type-2 diabetes and cardiovascular disease (CVD). We hypothesized that both small and large arteries may be impaired in subjects with the MetS, even in the absence of known CVD or diabetes. We compared both skin capillary density (CD) and pulse-wave velocity (PWV) in 36 cases with the MetS with those from 108 age-and gender-matched controls from the SU.VIM.AX-2 cohort. Compared with controls, MetS subjects demonstrated increased PWV (12.2 ± 2.8 vs. 10.7 ± 1.9 m s À1 , P¼0.005) and lower functional CD (83.1 ± 15.7 vs. 89.4 ± 14.2 capillaries per mm 2 , P¼0.03). Functional CD was inversely related to fasting glucose, triglycerides (TGs) and HOMA-IR (all Po0.05). On the other hand, no association was found between CD and BP or with PWV. In multivariate models, the odds ratios (95% confidence interval) for one standard deviation change, for having an impaired PWV (X12 m s À1 , n¼44), were: 1.65 (1.11-2.45) for systolic BP and 1.93 (1.25-2.99) for TG only. For impaired CD (p80 capillaries per mm 2 ), the odds ratios (95% confidence interval) were 1.45 (1.00-2.08) for TG and 1.65 (1.13-2.43) for fasting glucose, only. In conclusion, MetS subjects exhibited evidence of macro-and microcirculatory dysfunction, even in the absence of diabetes and CVD. The common mechanism linking MetS components to CVD risk through small-and large-artery dysfunctions may be mediated through metabolic factors related to insulin resistance, not to increased BP.

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Impaired Tissue Perfusion

Cited by 411 publications

References 101 publications

Insulin's microvascular vasodilatory effects are inversely related to peripheral vascular resistance in overweight, but insulin‐sensitive subjects

Insulin's microvascular vasodilatory effects are inversely related to peripheral vascular resistance in overweight, but insulin‐sensitive subjects

Brachial-Ankle PWV: Current Status and Future Directions as a Useful Marker in the Management of Cardiovascular Disease and/or Cardiovascular Risk Factors

Macrovascular and microvascular dysfunction in the metabolic syndrome

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