Perspectives: Microcirculation in hypertension and cardiovascular disease

Pries, Axel R.

doi:10.1093/eurheartj/sut007

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…It remains unclear at which point ‘structural rarefaction’ can be reversed and/or whether preservation of microvascular function may prevent end-organ damage. These are important potential targets for therapeutic interventions at all stages of CKD [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, alterations in end-organ microvascular structure and function may preface the pathologic cascade into end-organ disease including diabetes, hypertension and kidney disease [ 7 – 9 ]. A recent focus on measuring tissue capillary rarefaction, defined as a decrease in the number of perfused capillaries in an area of tissue, has allowed an early assessment of microvascular function and tissue perfusion in various disease states including chronic kidney disease (CKD) [ 10 – 12 ]. Techniques developed to measure capillary rarefaction in the skin have been shown to accurately reflect central organ pathology including coronary artery disease and vascular calcification in dialysis patients [ 13 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Capillary rarefaction: an early marker of microvascular disease in young hemodialysis patients

Edwards-Richards

DeFreitas

Katsoufis

et al. 2014

Clinical Kidney Journal

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BackgroundPediatric patients with chronic kidney disease (CKD) are at increased risk of early cardiovascular disease and premature death. Abnormalities in microvascular structure and function may presage end-organ damage including vascular calcification and myocardial ischemia associated with disordered mineral metabolism. Early detection of microvascular rarefaction (reduced density of capillaries) may identify at-risk patients and prompt timely therapeutic interventions. Our objective was to study capillary rarefaction in pediatric hemodialysis (HD) patients and to determine possible associations with mineral metabolism and cardiac risk biomarkers.MethodsCapillary density (CD) was measured by nailfold capillaroscopy in 19 pediatric HD patients and 20 healthy controls. Demographic and biochemical markers were collected at entry and 6-month follow-up.ResultsCD was significantly decreased in HD patients compared with controls with a deficit of 24 and 31% at baseline and subsequent follow-up. Maximal CD correlated significantly with intact parathyroid hormone (iPTH) (r = −0.45; P = 0.005), serum calcium (r = −0.38; P = 0.02) and 25(OH) vitamin D levels (r = +0.36; P = 0.03) in HD patients. Capillary functional measures were similar to controls. By multivariate analysis, the primary negative determinants of CD were African American race and hyperparathyroidism; whereas, glomerular disease had a positive influence on capillary rarefaction (R2 = 64.2% variance; P = 0.001).ConclusionPediatric HD patients demonstrate a ‘structural deficit’ in CD but show preserved ‘functional integrity’. Capillary rarefaction, an early risk factor of incipient vascular calcification, was strongly associated with biomarkers of altered mineral metabolism. Further studies are warranted to determine the impact of optimizing blood pressure and metabolic control on changes in capillary rarefaction in young CKD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Capillary rarefaction: an early marker of microvascular disease in young hemodialysis patients

Edwards-Richards

DeFreitas

Katsoufis

et al. 2014

Clinical Kidney Journal

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“…Given the well-established etiology of PHT (Figure 2A and 2B ) [ 21 , 24 , 40 ], these observations hint that the vasoconstrictive microvascular rarefactions from dysfunctional endothelial NO production may critically contribute to clinical carcinogenesis in general via CFE. Although the observed linear associations (Figure 3 , Figure 4 and Figure 5 ) do not qualify as evidence of this hypothesis by themselves, the hypothesis itself is alternatively supported by a store of non-clinical, retrospective and prospective studies that have shown immunity-mediated cancer preventive and antimetastatic effects of factors that promote peripheral vasodilation and endothelial NO production (Table 1 ).…”

Section: Introductionmentioning

confidence: 86%

“…These results implicate potential roles of age-dependent endothelial dysfunctions causing reduced endogenous NO generation [ 18 , 32 ] in exacerbating the reduction of larger blood cell availability in the constricted capillary-rich tissues. For convenient discussions, we coined this exacerbating development of RBC and WBC deficiencies in capillary-rich tissues due to constrictive and/or plugging-prone endothelial dysfunctions with the term “Chung-Fåhræus effect” (CFE) [ 21 , 24 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

Immunological consequences of ageing microvascular hemodynamic changes in view of cancer development and treatment

Chung¹,

Lee

Sood

2017

Oncotarget

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Risk factors of cardiovascular diseases have long been implicated as risk factors for carcinogenesis, but clear explanations for their association have not been presented. In this article, fundamental concepts from carcinogenesis, microvascular hemodynamics, and immunity are collectively reviewed and analyzed in context of the known features of vascular ageing effects, in formulating a theory that suggests reduced microvascular immunity as an important driving factor for carcinogenesis. Furthermore, scientific, preclinical, and clinical evidence that support this new theory are presented in an interdisciplinary manner, offering new explanations to previously unanswered factors that impact cancer risks and its treatment outcome such as chronic drug use, temperature, stress and exercise effects among others. Forward-looking topics discussing the implications of this new idea to cancer immunotherapeutics are also discussed.

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Quantitative Indexes of Leukocytes in Spontaneously Hypertensive Rats During Various Periods of Arterial Hypertension Development

et al. 2015

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SHR rats were examined in the period before arterial hypertension development (5th week), during the increase in BP (6th-10th weeks), and under conditions of constantly elevated BP (11th-12th weeks). The total number of leukocytes did not differ in SHR and normotensive WKY rats. However, the relative number of lymphocytes and monocytes was shown to differ in various periods of arterial hypertension development. Our results suggest that white blood cells (primarily lymphocytes) are involved in the development of arterial hypertension.

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Perspectives: Microcirculation in hypertension and cardiovascular disease

Cited by 5 publications

References 22 publications

Capillary rarefaction: an early marker of microvascular disease in young hemodialysis patients

Capillary rarefaction: an early marker of microvascular disease in young hemodialysis patients

Immunological consequences of ageing microvascular hemodynamic changes in view of cancer development and treatment

Quantitative Indexes of Leukocytes in Spontaneously Hypertensive Rats During Various Periods of Arterial Hypertension Development

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