1
|
Marino P, de Oliveira Lopes G, Pereira Borges J, Carolina Terra Cola M, Arkader Kopiler D, Tibirica E. Evaluation of systemic microvascular reactivity in adults with congenital heart disease. CONGENIT HEART DIS 2018; 13:978-987. [DOI: 10.1111/chd.12660] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/15/2018] [Accepted: 07/15/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Pablo Marino
- National Institute of Cardiology; Rio de Janeiro Brazil
- Antônio Pedro University Hospital, Federal Fluminense University; Niteroi Brazil
| | - Gabriella de Oliveira Lopes
- National Institute of Cardiology; Rio de Janeiro Brazil
- Laboratory of Physical Activity and Health Promotion, Department of Collective Sports, Institute of Physical Education and Sports; Rio de Janeiro State University; Rio de Janeiro Brazil
| | - Juliana Pereira Borges
- Laboratory of Physical Activity and Health Promotion, Department of Collective Sports, Institute of Physical Education and Sports; Rio de Janeiro State University; Rio de Janeiro Brazil
| | | | | | | |
Collapse
|
2
|
Fujii N, Singh MS, Halili L, Louie JC, Kenny GP. The effect of endothelin A and B receptor blockade on cutaneous vascular and sweating responses in young men during and following exercise in the heat. J Appl Physiol (1985) 2016; 121:1263-1271. [PMID: 27763878 DOI: 10.1152/japplphysiol.00679.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 09/15/2016] [Accepted: 10/02/2016] [Indexed: 11/22/2022] Open
Abstract
During exercise, cutaneous vasodilation and sweating responses occur, whereas these responses rapidly decrease during postexercise recovery. We hypothesized that the activation of endothelin A (ETA) receptors, but not endothelin B (ETB) receptors, attenuate cutaneous vasodilation during high-intensity exercise and contribute to the subsequent postexercise suppression of cutaneous vasodilation. We also hypothesized that both receptors increase sweating during and following high-intensity exercise. Eleven men (24 ± 4 yr) performed an intermittent cycling protocol consisting of two 30-min bouts of moderate- (40% V̇o2peak) and high-intensity (75% V̇o2peak) exercise in the heat (35°C), each separated by a 20- and 40-min recovery period, respectively. Cutaneous vascular conductance (CVC) and sweat rate were evaluated at four intradermal microdialysis skin sites: 1) lactated Ringer (control), 2) 500 nM BQ123 (a selective ETA receptor blocker), 3) 300 nM BQ788 (a selective ETB receptor blocker), or 4) a combination of BQ123 + BQ788. There were no between-site differences in CVC during each exercise bout (all P > 0.05); however, CVC following high-intensity exercise was greater at BQ123 (56 ± 9%max) and BQ123 + BQ788 (55 ± 14%max) sites relative to the control site (43 ± 12%max) (all P ≤ 0.05). Sweat rate did not differ between sites throughout the protocol (all P > 0.05). We show that neither ETA nor ETB receptors modulate cutaneous vasodilation and sweating responses during and following moderate- and high-intensity exercise in the heat, with the exception that ETA receptors may partly contribute to the suppression of cutaneous vasodilation following high-intensity exercise.
Collapse
Affiliation(s)
- Naoto Fujii
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Maya S Singh
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Lyra Halili
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Jeffrey C Louie
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada
| |
Collapse
|
3
|
Fujii N, Amano T, Halili L, Louie JC, Zhang SY, McNeely BD, Kenny GP. Intradermal administration of endothelin-1 attenuates endothelium-dependent and -independent cutaneous vasodilation via Rho kinase in young adults. Am J Physiol Regul Integr Comp Physiol 2016; 312:R23-R30. [PMID: 27881399 DOI: 10.1152/ajpregu.00368.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/31/2016] [Accepted: 11/18/2016] [Indexed: 01/02/2023]
Abstract
We recently showed that intradermal administration of endothelin-1 diminished endothelium-dependent and -independent cutaneous vasodilation. We evaluated the hypothesis that Rho kinase may be a mediator of this response. We also sought to evaluate if endothelin-1 increases sweating. In 12 adults (25 ± 6 yr), we measured cutaneous vascular conductance (CVC) and sweating during 1) endothelium-dependent vasodilation induced via administration of incremental doses of methacholine (0.25, 5, 100, and 2,000 mM each for 25 min) and 2) endothelium-independent vasodilation induced via administration of 50 mM sodium nitroprusside (20-25 min). Responses were evaluated at four skin sites treated with either 1) lactated Ringer solution (Control), 2) 400 nM endothelin-1, 3) 3 mM HA-1077 (Rho kinase inhibitor), or 4) endothelin-1+HA-1077. Pharmacological agents were intradermally administered via microdialysis. Relative to the Control site, endothelin-1 attenuated endothelium-dependent vasodilation (CVC at 2,000 mM methacholine, 80 ± 10 vs. 56 ± 15%max, P < 0.01); however, this response was not detected when the Rho kinase inhibitor was simultaneously administered (CVC at 2,000 mM methacholine for Rho kinase inhibitor vs. endothelin-1 + Rho kinase inhibitor sites: 73 ± 9 vs. 72 ± 11%max, P > 0.05). Endothelium-independent vasodilation was attenuated by endothelin-1 compared with the Control site (CVC, 92 ± 13 vs. 70 ± 14%max, P < 0.01). However, in the presence of Rho kinase inhibition, endothelin-1 did not affect endothelium-independent vasodilation (CVC at Rho kinase inhibitor vs. endothelin-1+Rho kinase inhibitor sites: 81 ± 9 vs. 86 ± 10%max, P > 0.05). There was no between-site difference in sweating throughout (P > 0.05). We show that in young adults, Rho kinase is an important mediator of the endothelin-1-mediated attenuation of endothelium-dependent and -independent cutaneous vasodilation, and that endothelin-1 does not increase sweating.
Collapse
Affiliation(s)
- Naoto Fujii
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| | - Tatsuro Amano
- Laboratory for Exercise and Environmental Physiology, Faculty of Education, Niigata University, Niigata, Japan
| | - Lyra Halili
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| | - Jeffrey C Louie
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| | - Sarah Y Zhang
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| | - Brendan D McNeely
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, University of Ottawa, Ottawa, Canada; and
| |
Collapse
|
4
|
Johnson JM, Minson CT, Kellogg DL. Cutaneous vasodilator and vasoconstrictor mechanisms in temperature regulation. Compr Physiol 2014; 4:33-89. [PMID: 24692134 DOI: 10.1002/cphy.c130015] [Citation(s) in RCA: 241] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In this review, we focus on significant developments in our understanding of the mechanisms that control the cutaneous vasculature in humans, with emphasis on the literature of the last half-century. To provide a background for subsequent sections, we review methods of measurement and techniques of importance in elucidating control mechanisms for studying skin blood flow. In addition, the anatomy of the skin relevant to its thermoregulatory function is outlined. The mechanisms by which sympathetic nerves mediate cutaneous active vasodilation during whole body heating and cutaneous vasoconstriction during whole body cooling are reviewed, including discussions of mechanisms involving cotransmission, NO, and other effectors. Current concepts for the mechanisms that effect local cutaneous vascular responses to local skin warming and cooling are examined, including the roles of temperature sensitive afferent neurons as well as NO and other mediators. Factors that can modulate control mechanisms of the cutaneous vasculature, such as gender, aging, and clinical conditions, are discussed, as are nonthermoregulatory reflex modifiers of thermoregulatory cutaneous vascular responses.
Collapse
Affiliation(s)
- John M Johnson
- Department of Physiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | | | | |
Collapse
|
5
|
Effect of a single, open-sea, air scuba dive on human micro- and macrovascular function. Eur J Appl Physiol 2013; 113:2637-45. [DOI: 10.1007/s00421-013-2676-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 05/31/2013] [Indexed: 11/26/2022]
|
6
|
Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation. J Geriatr Cardiol 2012; 8:215-23. [PMID: 22783308 PMCID: PMC3390092 DOI: 10.3724/sp.j.1263.2011.00215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 08/07/2011] [Accepted: 08/14/2011] [Indexed: 11/25/2022] Open
Abstract
AIMS To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. METHODS Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian Cardiovascular Society (CCS)-class, blood pressure and plasma samples were registered. RESULTS EECP patients showed reduced CCS-class compared to no EECP (P < 0.05). Both EECP and no EECP (P < 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P < 0.05). There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up. Responses to heating, the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P < 0.05). EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class. CONCLUSIONS Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh, SNP and heat compared to healthy subjects. Although EECP reduced the CCS-class, this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.
Collapse
|
7
|
Tesselaar E, Schiffer A, Widdershoven J, Broers H, Hendriks E, Luijten K, Creusen J. Effect of cardiac resynchronization therapy on endothelium-dependent vasodilatation in the cutaneous microvasculature. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:377-84. [PMID: 22268627 DOI: 10.1111/j.1540-8159.2011.03313.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS Cardiac resynchronization therapy (CRT) improves hemodynamic parameters, exercise capacity, symptoms, functional status, and prognosis among patients with chronic heart failure (CHF). The role of the vascular endothelium in these improvements is largely unknown. In this study, we aimed to investigate whether the endothelium-dependent reactivity of the peripheral microcirculation improves in CHF patients during the first 2 months of CRT. METHODS We used local heating and iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP) to measure endothelial function and smooth muscle function in the cutaneous microvasculature of 11 CHF patients before and 2 months after CRT. RESULTS We found that the perfusion response in the skin to local heating was increased 2 months post-CRT compared with baseline, both in terms of maximum perfusion (baseline: 113 [90-137] vs 2-months post-CRT: 137 [98-175], P=0.037) and area under curve (baseline: 1,601 [935-2,268] vs 2-months CRT: 2,205 [1,654-2,757], P=0.047). Also, the perfusion response to iontophoresis of ACh was improved (Emax: 23.9 [20.6-26.2]vs at 2-months CRT: 31.2 [29.3-33.4], P=0.005). No difference was found between the responses to SNP before and after CRT. CONCLUSION These results show that CRT improves endothelium-dependent vasodilatory capacity in the peripheral microcirculation within 2 months of therapy. The improvement in functional capacity that is seen in patients treated with CRT may, therefore, be in part mediated by an improvement of endothelium-dependent vasodilatory capacity.
Collapse
Affiliation(s)
- Erik Tesselaar
- Department of Clinical Physics, TweeSteden Ziekenhuis, Tilburg, the Netherlands.
| | | | | | | | | | | | | |
Collapse
|
8
|
Lindstedt IH, Edvinsson ML, Edvinsson L. Reduced responsiveness of cutaneous microcirculation in essential hypertension – A pilot study. Blood Press 2009; 15:275-80. [PMID: 17380845 DOI: 10.1080/08037050600996586] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Our hypothesis states that the reactivity of the cutaneous microcirculation is reduced in patients with hypertension compared with healthy subjects. The objective was to verify the hypothesis by measuring microvascular function in hypertensive patients. DESIGN The study was a controlled trial with two arms: 15 hypertensives and 15 normotensives were enrolled, aged 30-60 years, and in hypertensives, a diastolic blood pressure of > 90 mmHg. The hypertensive patients were compared with gender- and age-matched controls having a diastolic blood pressure < 90 mmHg. The patients were kept on their medication. METHOD The local cutaneous forearm blood flow was measured by Laser-Doppler flowmetry. The blood flow response to local warming (44 degrees C), to the endothelium-dependent vasodilator acetylcholine (ACh), or to the endothelium-independent dilators sodium nitroprusside (SNP) and calcitonin gene-related peptide (CGRP) administered by iontophoresis were determined. Inflammatory markers and NT-pro brain natriuretic peptide (NT-proBNP) levels in plasma was also measured. Electrocardiograms (ECG) were evaluated and the subjects answered a lifestyle questionnaire. RESULTS The percentage change in vasodilator response to CGRP was significantly lower in the hypertensives compared with normotensives, 285% (95% CI 86-484) vs 764% (95% CI 366-1162) of baseline, p < 0.05. The change to local warming was 2191% (95% CI 1574-2807) in normotensives vs 1384% (95% CI 852-1917) in the hypertensives, p < 0.05. The vasodilator response to ACh was 1249% (95% CI 895-1602) in the normotensives and 873% (95% CI 610-1136) in the hypertensives. The vasodilator response to SNP in the normotensives was 771% (95% CI 436-1107) and 682% (95% CI 416-948) in the hypertensive group. Plasma level of NT-proBNP was 90 ng/1 (95% CI 35-145) in normotensives vs 285 ng/l (95% CI 70-499) in hypertensives (p = 0.06). The ECGs showed a tendency towards left ventricular hypertrophy (LVH) in hypertensives. CONCLUSION Patients with essential hypertension had significantly reduced microvascular dilator responses to CGRP and to local warming. Also, there was a tendency towards reduced responses to ACh. This points towards a generally weaker responsiveness of the cutaneous microvessels in hypertensives and could be a contributing factor to the development of high blood pressure. Patients with essential hypertension also had a tendency of higher plasma levels of NT-proBNP, which could be seen as an early sign of organ damage.
Collapse
Affiliation(s)
- Isak H Lindstedt
- Department of Emergency Medicine, Clinical Sciences, University Hospital, Lund, Sweden.
| | | | | |
Collapse
|
9
|
Nanas S, Gerovasili V, Dimopoulos S, Pierrakos C, Kourtidou S, Kaldara E, Sarafoglou S, Venetsanakos J, Roussos C, Nanas J, Anastasiou-Nana M. Inotropic agents improve the peripheral microcirculation of patients with end-stage chronic heart failure. J Card Fail 2008; 14:400-6. [PMID: 18514932 DOI: 10.1016/j.cardfail.2008.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Revised: 01/23/2008] [Accepted: 02/01/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND Skeletal muscle microcirculation impairment in patients with chronic heart failure (CHF) seems to correlate with disease severity. We evaluated the microcirculation by near-infrared spectroscopy (NIRS) occlusion technique before and after inotropic infusion. METHODS We evaluated 25 patients with stable CHF, 30 patients with end-stage CHF (ESCHF) receiving treatment with intermittent infusion of inotropic agents, and 12 healthy subjects. Thenar muscle tissue oxygen saturation (StO(2)%) was measured noninvasively by NIRS before, during, and after 3-minute occlusion of the brachial artery (occlusion technique) in all subjects and in patients with ESCHF before and after 6 hours of inotropic infusion (dobutamine and/or levosimendan) or placebo (N = 5). RESULTS Patients with ESCHF or CHF presented significantly lower StO(2)% than healthy subjects (74.5% +/- 7%, 78.6% +/- 6%, and 85% +/- 5%, respectively; P = .0001), lower oxygen consumption rate during occlusion (24.6% +/- 8%/min, 28.6% +/- 10%/min, and 38.1% +/- 11.1%/min, respectively; P = .001), and lower reperfusion rate (327% +/- 141%/min, 410% +/- 106%/min, and 480% +/- 133%/min, respectively; P = .002). After 6 hours of inotropic infusion, patients with ESCHF showed significantly increased StO(2)% (74.5% +/- 7% to 82% +/- 9%, P = .001), oxygen consumption rate (24.6% +/- 8%/min to 29.3% +/- 8%/min, P = .009), and reperfusion rate (327% +/- 141%/min to 467% +/- 151%/min, P = .001). No statistical difference was noted in the placebo group. CONCLUSION Peripheral muscle microcirculation as assessed by NIRS is impaired in patients with CHF. This impairment is partially reversed by infusion of inotropic agents in patients with ESCHF.
Collapse
Affiliation(s)
- Serafim Nanas
- Pulmonary and Critical Care Medicine Department, Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, Evgenidio Hospital, Athens, Greeece
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|