High-salt intake affects sublingual microcirculation and is linked to body weight change in healthy volunteers

Rorije, Nienke M. G.; Rademaker, Emma; Schrooten, Esmee M.; Wouda, Rosa D; Heide, Jacob J Homan Van Der; Born, Bert‐Jan H. van den; Vogt, Liffert

doi:10.1097/hjh.0000000000002015

Cited by 18 publications

(9 citation statements)

References 31 publications

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“…A recent meta-analysis showed that genetic determinants of retinal arteriolar tortuosity are also linked to cardiovascular health 30 . We performed exploratory correlation analyses on the relation between the retinal changes and previously published sublingual changes in this population 10 , however no associations were found (data not shown), likely due to differences inherent to the specific method (e.g. measurement of sublingual microvascular vessels with SDF vs. intermediate vessels in the retina, and specific distinct microcirculatory parameters with each method).…”

Section: Discussionmentioning

confidence: 92%

“…Despite these strengths, certain limitations need to be addressed. First, the sample size was relatively small and retinal endpoints were the secondary exploratory outcomes of a previously published trial on sublingual microcirculation 10 . More subtle effects may be missed in small study populations, and data that show trends without statistical significance may have encountered a power problem (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Sample size calculation. The primary aim of this study was to assess capillary recruitment from capillary density measurements with sublingual Sidestream Dark Field-imaging, the results of which were recently published 10 . The predefined secondary aim was to assess the effect of dietary salt intake on the retinal microcirculation.…”

Section: Methodsmentioning

confidence: 99%

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High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial

Wenstedt

Beugelink

Schrooten

et al. 2021

Sci Rep

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The retinal microcirculation is increasingly receiving credit as a relatively easily accessible microcirculatory bed that correlates closely with clinical cardiovascular outcomes. The effect of high salt (NaCl) intake on the retinal microcirculation is currently unknown. Therefore, we performed an exploratory randomized cross-over dietary intervention study in 18 healthy males. All subjects adhered to a two-week high-salt diet and low-salt diet, in randomized order, after which fundus photographs were taken and assessed using a semi-automated computer-assisted program (SIVA, version 4.0). Outcome parameters involved retinal venular and arteriolar tortuosity, vessel diameter, branching angle and fractal dimension. At baseline, participants had a mean (SD) age of 29.8 (4.4) years and blood pressure of 117 (9)/73 (5) mmHg. Overall, high-salt diet significantly increased venular tortuosity (12.2%, p = 0.001). Other retinal parameters were not significantly different between diets. Changes in arteriolar tortuosity correlated with changes in ambulatory systolic blood pressure (r = − 0.513; p = 0.04). In conclusion, high-salt diet increases retinal venular tortuosity, and salt-induced increases in ambulatory systolic blood pressure associate with decreases in retinal arteriolar tortuosity. Besides potential eye-specific consequences, both phenomena have previously been associated with hypertension and other cardiovascular risk factors, underlining the deleterious microcirculatory effects of high salt intake.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial

Wenstedt

Beugelink

Schrooten

et al. 2021

Sci Rep

Self Cite

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“…As shown in Fig. 2 , homeostasis is broken down, and vascular endothelial glycocalyx shedding/degradation occurs in conditions of cellular stress, ischemia/reperfusion injury [ 35 ], the presence of endotoxins [ 36 ], inflammatory mediators [ 37 ], atrial natriuretic peptide, excessive reactive oxygen species [ 38 ], hyperglycemia [ 39 , 40 ], high-salt intake [ 41 ], hypertension [ 42 ], familial hypercholesterolemia [ 43 ], and oxidized low-density lipoprotein (ox-LDL) [ 44 ]. Of note, rosuvastatin administration has been shown to partially restore damaged vascular endothelial cells in patients with heterozygous familial hypercholesterolemia [ 43 ].…”

Section: Vascular Endothelial Glycocalyxmentioning

confidence: 99%

Endothelial glycocalyx damage as a systemic inflammatory microvascular endotheliopathy in COVID-19

Yamaoka‐Tojo

2020

Biomedical Journal

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In atherosclerosis patients, vascular endothelial dysfunction is commonly observed alongside damage of the vascular endothelial glycocalyx, an extracellular matrix bound to and encapsulating the endothelial cells lining the blood vessel wall. Although atherosclerotic risk factors have been reported in severe patients with coronavirus disease 2019 (COVID-19), the exact mechanisms are unclear. The mortality associated with the COVID-19 outbreak is increased by comorbidities, including hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD), and cardiovascular disease. Besides, older individuals and smokers have significantly worse outcomes. Interestingly, these comorbidities and risk factors are consistent with the pathophysiology that causes vascular endothelial glycocalyx damage. Moreover, vascular glycocalyx dysfunction causes microvascular leakage, which results in interstitial pulmonary abnormal shadows (multiple patchy shadows with a ground glass inter-pneumonic appearance). This is frequently followed by severe acute respiratory distress syndrome (ARDS), closely related to coagulo-fibrinolytic changes contributing to disseminated intravascular coagulation (DIC) and Kawasaki disease shock syndrome, as well as inducing activation of the coagulation cascade, leading to thromboembolism and multiple organ failure. Notably, SARS-CoV-2, the causative virus of COVID-19, binds to ACE2, which is abundantly present not only in human epithelia of the lung and the small intestine, but also in vascular endothelial cells and arterial smooth muscle cells. Moreover, COVID-19 can induce severe septic shock, and sepsis can easily lead to systemic degradation of the vascular endothelial glycocalyx. In the current review, we propose new concepts and therapeutic goals for COVID-19-related vascular endothelial glycocalyx damage, based on previous vascular endothelial medicine research.

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“…Proper disease management to prevent damage to the VEGLX will lead to the development of future atherosclerotic diseases and the prevention of cardiovascular events [67]. To prevent cardiovascular disease in the COVID-19 era, we should limit the intake of high amounts of sodium [68], oxidized lipoproteins [69], and sugar [18,19]. In addition, preventing obesity and smoking while encouraging increased physical activity is crucial in order to ensure the sufficient management of coronary risk factors.…”

Section: The Vascular Endothelial Glycocalyx and Covid-19mentioning

confidence: 99%

Cardiovascular Disease Prevention in the COVID-19 Era

Yokoyama¹,

Kamide²,

Tojo³

et al. 2021

austinjcardiovascdisatherosclerosis

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Although the coronavirus disease 2019 (COVID-19) pandemic is still ongoing, the path towards a better future is finally becoming clear as a result of the initiation of COVID-19 vaccination. While pneumonia was initially emphasized as the only complication of COVID-19, it has become clear that fatal complications, such as a thromboembolism, are also likely to occur. In the era of recurring coronavirus infections, it is important to identify the causes and risk factors regarding exacerbations in patients who may develop severe COVID-19. This review describes how to prevent COVID-19 exacerbations in the context of cardiovascular disease, especially exacerbations related to the vascular endothelium.

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High-salt intake affects sublingual microcirculation and is linked to body weight change in healthy volunteers

Cited by 18 publications

References 31 publications

High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial

High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial

Endothelial glycocalyx damage as a systemic inflammatory microvascular endotheliopathy in COVID-19

Cardiovascular Disease Prevention in the COVID-19 Era

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