Profiling the endothelial function using both peripheral artery tonometry (EndoPAT) and Laser Doppler Flowmetry (LD) - Complementary studies or waste of time?

Jakubowski, M.; Turek-Jakubowska, Aleksandra; Szahidewicz-Krupska, Ewa; Gawryś, Karolina; Gawryś, Jakub; Doroszko, Adrian

doi:10.1016/j.mvr.2020.104008

Cited by 15 publications

(16 citation statements)

References 46 publications

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“…This assessed reactive hyperaemia resembles post-ischemic hyperaemia after 5 min arterial occlusion involving many microvascular metabolites, including adenosine and NO, rather than only endothelium-dependent hyperaemia, which would occur after 1–3 min occlusion [ 62 ]. This response being not fully endothelium-specific is further supported by studies showing poor comparability of results of digital post-occlusive hyperaemia with other microvascular assessments such as laser Doppler flowmetry with iontophoresis of an endothelium-dependent stimulus [ 63 , 64 ]. Moreover, the reactive hyperaemia is minimally affected after smoking cessation [ 65 , 66 ], while smoking is a well-known trigger for oxidative stress and its effects on NO-dependent endothelial vasodilatation [ 67 , 68 ]).…”

Section: Evidence Of Microvascular Dysfunction In Hfpefmentioning

confidence: 96%

The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction

et al. 2022

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Heart failure with preserved ejection fraction (HFpEF) is a condition with increasing incidence, leading to a health care problem of epidemic proportions for which no curative treatments exist. Consequently, an urge exists to better understand the pathophysiology of HFpEF. Accumulating evidence suggests a key pathophysiological role for coronary microvascular dysfunction (MVD), with an underlying mechanism of low-grade pro-inflammatory state caused by systemic comorbidities. The systemic entity of comorbidities and inflammation in HFpEF imply that patients develop HFpEF due to systemic mechanisms causing coronary MVD, or systemic MVD. The absence or presence of peripheral MVD in HFpEF would reflect HFpEF being predominantly a cardiac or a systemic disease. Here, we will review the current state of the art of cardiac and systemic microvascular dysfunction in HFpEF (Graphical Abstract), resulting in future perspectives on new diagnostic modalities and therapeutic strategies.

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Section: Evidence Of Microvascular Dysfunction In Hfpefmentioning

confidence: 96%

The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction

et al. 2022

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“…95 The acquisition is generally obtained under basal conditions and upon stimulation of reactive hyperemia through cuff inflation to at least 10 mm Hg above SBP, 96 local heating (generally maximal vasodilation is obtained at 39–44 °C), 75,97 physical exercise, 98 or microinvasive iontophoresis. 78…”

Section: Laser Doppler Flowmetrymentioning

confidence: 99%

New Noninvasive Methods to Evaluate Microvascular Structure and Function

et al. 2022

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The structural and functional alterations of microvessels are detected because of physiological aging and in several cardiometabolic diseases, including hypertension, diabetes, and obesity. The small resistance arteries of these patients show an increase in the media or total wall thickness to internal lumen diameter ratio (MLR or WLR), often accompanied by endothelial dysfunction. For decades, micromyography has been considered as a gold standard method for evaluating microvascular structural alterations through the measurement of MLR or WLR of subcutaneous small vessels dissected from tissue biopsies. Micromyography is the most common and reliable method for assessing microcirculatory endothelial function ex vivo, while strain-gauge venous plethysmography is considered the reference technique for in vivo studies. Recently, several noninvasive methods have been proposed to extend the microvasculature evaluation to a broader range of patients and clinical settings. Scanning laser Doppler flowmetry and adaptive optics are increasingly used to estimate the WLR of retinal arterioles. Microvascular endothelial function may be evaluated in the retina by flicker light stimulus, in the finger by tonometric approaches, or in the cutaneous or sublingual tissues by laser Doppler flowmetry or intravital microscopy. The main limitation of these techniques is the lack of robust evidence on their prognostic value, which currently reduces their widespread use in daily clinical practice. Ongoing and future studies will overcome this issue, hopefully moving the noninvasive assessment of the microvascular function and structure from bench to bedside.

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“…In the current study, we assessed endothelial vasodilatory function using EndoPAT 2000 and Laser Doppler Flowmetry (LDF). According to Jakubowski et al, these methods evaluate independent mechanisms regulating the profile of endothelial vasodilatory function 16 . We have shown reduced microvascular response to local peripheral thermal stimulus measured by LDF in diabetic subjects in comparison to the control group with no significant difference in the indexes provided by EndoPAT 2000.…”

Section: Discussionmentioning

confidence: 99%

“…In this purpose, the methods for the assessment of endothelial function, which are proven to have an additional predictive value comparing to traditional risk factors 15 , such as EndoPAT 2000 and Laser Doppler Flowmetry, are used. Although both methods examine the endothelial function by evaluating changes in peripheral microcirculation, recent reports indicate their dependence on different mechanisms regulating its vasodilatory function 16 .…”

Section: Introductionmentioning

confidence: 99%

Increased Intraplatelet ADMA Level May Promote Platelet Activation in Diabetes Mellitus

Gawryś

Wiśniewski

Szahidewicz-Krupska

et al. 2020

Oxidative Medicine and Cellular Longevity

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Background. Antiplatelet therapy has become a standard therapeutic approach in the secondary prevention of cardiovascular system disorders of thrombotic origin. Patients with concomitant diabetes mellitus (DM) obtain fewer benefits from this treatment. Hence, the pathophysiology of altered platelet function in response to glucose metabolism impairment should be of particular interest. Objectives. The aim of our study was to verify if the platelet expression of the asymmetric dimethylarginine (ADMA) in diabetic patients differs in comparison to the nondiabetic ones. The correlation of platelet-ADMA with platelet activation and aggregation as well as with other risk factors was also investigated. Material and Methods. A total of 61 subjects were enrolled in this study, including thirty-one type 2 diabetic subjects without diabetes-related organ damage. Physical examination was followed by blood collection with an assessment of platelet aggregation, traditional biochemical cardiovascular risk factors, and evaluation of nitric oxide bioavailability parameters in plasma and thrombocytes. Subsequently, the assessment of endothelial function using Peripheral Arterial Tonometry and Laser Doppler Flowmetry (LDF) was performed. Results. In the DM group, elevated concentration of intraplatelet ADMA and higher ADMA/SDMA ratio compared to the control group was observed. It was accompanied by higher ADP-mediated platelet aggregation and lower microvascular response to a local thermal stimulus measured by LDF in the diabetes group. Conclusions. Type 2 diabetes is related to higher intraplatelet concentration of asymmetric dimethylarginine (ADMA), which may result in impaired platelet-derived nitric oxide synthesis and subsequent increased platelet activity, as assessed by the ADP-induced aggregation. Laser Doppler Flowmetry, compared to EndoPAT 2000, appears to be a more sensitive indicator of the impaired microvasculature vasodilation in diabetics without the presence of clinically significant target organ damage.

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Profiling the endothelial function using both peripheral artery tonometry (EndoPAT) and Laser Doppler Flowmetry (LD) - Complementary studies or waste of time?

Cited by 15 publications

References 46 publications

The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction

The Role of Systemic Microvascular Dysfunction in Heart Failure with Preserved Ejection Fraction

New Noninvasive Methods to Evaluate Microvascular Structure and Function

Increased Intraplatelet ADMA Level May Promote Platelet Activation in Diabetes Mellitus

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