The comparison of endothelial function between conduit artery and microvasculature in patients with coronary artery disease

Tajima, Emi; Sakuma, Masashi; Tokoi, Seiko; Matsumoto, Hisae; Saito, Fumie; Watanabe, Ryoji; Toyoda, Shigeru; Abe, Shichiro; Inoue, Teruo

doi:10.5603/cj.a2018.0077

Cited by 14 publications

(13 citation statements)

References 22 publications

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“…The endothelial dysfunction in the large conduit arteries and resistance small vessels have been reported to have different correlations with cardiovascular risk factors and may be unrelated to one another, suggesting differential regulation of endothelial function in these two vascular beds 8,17,18,28,29 . The discrepancy between macro- and microvascular dysfunction could be explained by the fact that they may mirror different stages of disease 8,30 .…”

Section: Discussionmentioning

confidence: 99%

“…The discrepancy between macro-and microvascular dysfunction could be explained by the fact that they may mirror different stages of disease 8,30 . The endothelial dysfunction in conduit arteries can reflect a process of existing CAD, while microvascular dysfunction may be a prognostic biomarker, which may precede endothelial impairment in large arteries and the subsequent clinical manifestations [8][9][10]30 . For example, several studies have highlighted the detection of microvascular dysfunction as potentially clinically relevant for the early diagnosis of microvascular disorders, before macrovascular disease 11,31,32 .…”

Section: Discussionmentioning

confidence: 99%

“…In particular, microvascular (diameter < 150-200 um) ED is not only a marker of CVD and its progression 6,7 but it also precedes the development of macrovascular disease and associated CVRF [8][9][10][11] . Skin microvascular ED is implicated in CAD and HF and manifests in subjects with CVRF, such as hypertension, dyslipidemia and smoking 12 .…”

Section: Introductionmentioning

confidence: 99%

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Fast Optoacoustic Mesoscopy of Microvascular Endothelial Dysfunction in Cardiovascular Risk and Disease

Karlas

Fasoula

et al. 2021

Preprint

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Microvascular endothelial dysfunction (ED) precedes the ED in larger arteries and is an early marker of cardiovascular disease (CVD). While precise assessment of microvascular ED could thus be used for the early detection and risk stratification of CVD, detailed interrogation of skin microvascular ED is limited by the technology available. Herein, we applied a novel approach for the non-invasive assessment of skin microvascular ED by developing fast plane raster-scan optoacoustic mesoscopy (FP-RSOM) to visualize and quantify skin microvasculature perfusion changes during post-occlusive hyperemia (PORH) tests. We combined static three-dimensional RSOM imaging with fast dynamic FP-RSOM measurements (1 frame / second) in human skin in vivo, which allowed for the first time to fully visualize the cutaneous microvascular response and further quantify changes of individual vessel diameter, total blood volume and vessel density during the PORH process. We further computed biomarkers from FP-RSOM images to quantify skin endothelial function within different skin layers as a function of skin depth, while conventional approaches mainly measure overall changes within sampled tissue volumes. FP-RSOM applied on smokers and patients with CVD showed clear ED in both groups compared to healthy volunteers. Moreover, FP-RSOM imaging showed higher sensitivity in quantifying the effects of smoking and CVD on skin microvascular endothelial function compared to clinically used laser Doppler flowmetry and tissue spectrometry (O2C). Our study introduces FP-RSOM as a novel tool to visualize and quantify skin microvascular ED as an early marker for the diagnostics and monitoring of cardiovascular risk and disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fast Optoacoustic Mesoscopy of Microvascular Endothelial Dysfunction in Cardiovascular Risk and Disease

Karlas

Fasoula

et al. 2021

Preprint

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“…We performed simultaneous measurement of FMD and RHI within 7 days before cardiac catheterization, as previously described (Tomiyama et al 2014;Tajima et al 2020). In brief, subjects were instructed to fast overnight and to abstain from alcohol, smoking, caffeine and antioxidant vitamins for at least 12 hours prior to measurements.…”

Section: Simultaneous Measurement Of Fmd and Rhimentioning

confidence: 99%

“…Although both FMD and RHI measurements can predict cardiovascular events, the clinical significance of these two vascular endothelial function tests in patients with cardiovascular diseases may be different, as these methods measure vascular function in different vessels (conduit arteries or microvasculature). Using a method of simultaneous measurement, we recently reported that both FMD and RHI were not correlated in patients with ischemic heart disease (IHD) (Tajima et al 2020). However, there have been no previous reports on vascular endothelial function of both conduit arteries and microvasculature measurements via FMD and RHI in patients with HF.…”

Section: Introductionmentioning

confidence: 99%

Flow-Mediated Vasodilation and Reactive Hyperemia Index in Heart Failure with Reduced or Preserved Ejection Fraction

Waku

Tokoi

Toyoda

et al. 2020

Tohoku J. Exp. Med.

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Vascular endothelial dysfunction is part of the underlying pathophysiology of heart failure. However, there are no reports in which vascular endothelial function of both conduit arteries and microvasculature was assessed in patients with heart failure. This study was aimed to assess vascular endothelial function separately in heart failure with reduced (HFrEF) and preserved ejection fraction (HFpEF). We performed simultaneous measurement of both flow-mediated vasodilation for endothelial function of conduit arteries and reactive hyperemia-peripheral arterial tonometry for that of microvasculature in 88 consecutive patients with chronic heart failure. In 55 patients with ischemic heart disease as an underlying cause of heart failure, flow-mediated vasodilation value was comparable between the two groups of HFrEF (left ventricular ejection fraction < 50%, n = 31) and HFpEF (left ventricular ejection fraction ≥ 50%, n = 24). Reactive hyperemia index measured by reactive hyperemia peripheral arterial tonometry, however, was lower in HFrEF patients compared to HFpEF patients (P = 0.014). In contrast, among 33 patients with non-ischemic heart disease, the degree of flow-mediated vasodilation was lower in HFpEF patients (n = 18) compared with HFrEF patients (n = 15) (P = 0.009), while reactive hyperemia index was comparable between the two groups. The clinical and pathophysiological significance of endothelial function in heart failure differs between conduit artery and microvasculature, and these differences may contribute to the underlying pathophysiology of HFpEF and HFrEF, as well as in ischemic heart disease and non-ischemic heart disease.

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Better vascular function tests in cardiovascular care: learning from evidence and providing improved diagnostics to the patient

Tanaka

Node

2021

Hypertens Res

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The comparison of endothelial function between conduit artery and microvasculature in patients with coronary artery disease

Abstract: Present results suggest that noninvasive assessment of vascular endothelial functions provide pathophysiological information on both conduit arteries and resistance vessels in patients with CAD.

Cited by 14 publications

References 22 publications

Fast Optoacoustic Mesoscopy of Microvascular Endothelial Dysfunction in Cardiovascular Risk and Disease

Fast Optoacoustic Mesoscopy of Microvascular Endothelial Dysfunction in Cardiovascular Risk and Disease

Flow-Mediated Vasodilation and Reactive Hyperemia Index in Heart Failure with Reduced or Preserved Ejection Fraction

Better vascular function tests in cardiovascular care: learning from evidence and providing improved diagnostics to the patient

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