Is endothelial microvascular function equally impaired among patients with chronic Chagas and ischemic cardiomyopathy?

Systemic microvascular endothelial dysfunction is associated with left ventricular ejection fraction reduction in chronic Chagas disease patients

“…The skin is an accessible region for the study of the microvasculature, with recent data suggesting the association of cutaneous microvascular ED with other vascular beds, including the coronary circulation 7 . In a previous study from our group, 8 microvascular ED was demonstrated in CD patients with reduced left ventricular ejection fraction (LVEF), when compared to healthy individuals. At the present study, we addressed whether ED is also present in patients with preserved LVEF.…”

“…Microvascular ED has been recognized in systemic vessels of patients presenting advanced HF with reduced LVEF of either ischemic or idiopathic etiologies, 10,11 and previously by our group in CD patients. 8 Another mechanism proposed as related to the progression of CD cardiomyopathy and observed in patients with preserved LVEF is vascular dysautonomy, 22 which is also associated with ED in chronic CD patients. 23 In order to evaluate the degree of microvascular ED in chronic CD patients, we compared the patient group with healthy individuals, matched for sex, age, and body mass index.…”

Evaluation of systemic microvascular reactivity in adults with congenital heart disease

“…We have performed a sample size calculation to confirm that the number of patients included in the study would be appropriate to verify potential statistical differences between groups. Sample size calculation was performed using GPower (version 3.0.10, University of Kiel, Kiel, Germany), based on the difference between groups for microvascular responses to acetylcholine of 0.11 APU/mm Hg (cutaneous microvascular conductance), with a standard deviation of 0.17 APU/mm Hg . Assuming 70% of power and 5% significance level, a minimum of 29 patients in each group was necessary.…”

“…The microcirculatory tests were performed after a 20-minute rest with the patients in a supine position in an environment with a controlled temperature (23 ± 1°C) approximately 60 minute after a light breakfast, according to a previously validated standard experimental protocol. [44][45][46][47] Endothelium-dependent microvascular reactivity was evaluated using a recently standardized and validated LSCI laser system 47 at a wavelength of 785 nm (PeriCam PSI system, Perimed, Järfälla, Sweden) combined with iontophoresis of acetylcholine (ACh) for the continuous and noninvasive measurement of cutaneous microvascular perfusion in arbitrary perfusion units (APUs). Endothelial-independent cutaneous microvascular reactivity was analyzed using the same system but combined with sodium nitroprusside (SNP) iontophoresis.…”

Microcirculation and Cardiovascular Diseases

“…12 In another study, we demonstrated that the systemic microvascular endothelial function is similarly compromised in patients with ischemic heart disease or chronic Chagas heart disease. 13 …”