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Matheson C, Simovic T, Heefner A, Colon M, Tunon E, Cobb K, Thode C, Breland A, Cobb CO, Nana-Sinkam P, Garten R, Rodriguez-Miguelez P. Evidence of premature vascular dysfunction in young adults who regularly use e-cigarettes and the impact of usage length. Angiogenesis 2024; 27:229-243. [PMID: 38345700 PMCID: PMC11021332 DOI: 10.1007/s10456-023-09903-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 04/17/2024]
Abstract
BACKGROUND Electronic (e-) cigarettes are increasingly popular tobacco products on the US market. Traditional tobacco products are known to cause vascular dysfunction, one of the earliest indicators of cardiovascular disease (CVD) development. However, little is known about the effect of regular e-cigarette use on vascular function. The purpose of this study was to investigate the impact of regular e-cigarette use on vascular function and cardiovascular health in young, healthy adults. METHODS Twenty-one regular users of e-cigarettes (ECU) and twenty-one demographically matched non-users (NU) completed this study. Vascular health was assessed in the cutaneous microcirculation through different reactivity tests to evaluate overall functionality, endothelium-dependent vasodilation (EDD), and endothelium-independent vasodilation (EID). Macrovascular function was assessed using flow-mediated dilation (FMD). RESULTS Our results suggest that regular users of e-cigarettes present with premature microvascular impairment when compared to non-users. Specifically, they exhibit lower hyperemic (p = 0.003), thermal (p = 0.010), and EDD (p = 0.004) responses. No differences in EID between the groups were identified. We also identified that individuals who use e-cigarettes for longer than 3 years also present with systemic manifestations, as observed by significantly reduced macrovascular (p = 0.002) and microvascular (p ≤ 0.044) function. CONCLUSIONS Our novel data suggests that young, apparently healthy, regular users of e-cigarettes present with premature vascular dysfunction in the microcirculation when compared to non-users. We have also identified systemic vascular dysfunction affecting both the micro and macrovasculature in those young individuals who used e-cigarettes for longer than 3 years. Taken together, these findings associate regular e-cigarette use with premature vascular dysfunctions and adverse cardiovascular outcomes.
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Affiliation(s)
- Chloe Matheson
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Tijana Simovic
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Allison Heefner
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Marisa Colon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Enrique Tunon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Kolton Cobb
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Christopher Thode
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Alison Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Patrick Nana-Sinkam
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, USA
| | - Ryan Garten
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA
| | - Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, 817 West Franklin Street, Richmond, VA, 23284, USA.
- Division of Pulmonary and Critical Care, Virginia Commonwealth University, Richmond, VA, USA.
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Marcinkevics Z, Aglinska A, Rubins U, Grabovskis A. Remote Photoplethysmography for Evaluation of Cutaneous Sensory Nerve Fiber Function. SENSORS 2021; 21:s21041272. [PMID: 33670087 PMCID: PMC7916836 DOI: 10.3390/s21041272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
About 2% of the world’s population suffers from small nerve fiber dysfunction, neuropathy, which can result in severe pain. This condition is caused by damage to the small nerve fibers and its assessment is challenging, due to the lack of simple and objective diagnostic techniques. The present study aimed to develop a contactless photoplethysmography system using simple instrumentation, for objective and non-invasive assessment of small cutaneous sensory nerve fiber function. The approach is based on the use of contactless photoplethysmography for the characterization of skin flowmotions and topical heating evoked vasomotor responses. The feasibility of the technique was evaluated on volunteers (n = 14) using skin topical anesthesia, which is able to produce temporary alterations of cutaneous nerve fibers function. In the treated skin region in comparison to intact skin: neurogenic and endothelial component of flowmotions decreased by ~61% and 41%, the local heating evoked flare area decreased by ~44%, vasomotor response trend peak and nadir were substantially reduced. The results indicate for the potential of the remote photoplethysmography in the assessment of the cutaneous nerve fiber function. It is believed that in the future this technique could be used in the clinics as an affordable alternative to laser Doppler imaging technique.
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Affiliation(s)
- Zbignevs Marcinkevics
- Department of Human and Animal Physiology, Faculty of Biology, University of Latvia, Jelgavas St.1, LV-1004 Riga, Latvia
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
- Correspondence:
| | - Alise Aglinska
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
| | - Uldis Rubins
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
| | - Andris Grabovskis
- Biophotonics Laboratory, Institute of Atomic Physics and Spectroscopy, University of Latvia, Jelgavas St. 3, LV-1004 Riga, Latvia; (A.A.); (U.R.); (A.G.)
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Low BH, Lin YD, Huang BW, Chia T, Bau JG, Huang HY. Impaired Microvascular Response to Muscle Stretching in Chronic Smokers With Type 2 Diabetes. Front Bioeng Biotechnol 2020; 8:602. [PMID: 32596231 PMCID: PMC7300253 DOI: 10.3389/fbioe.2020.00602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/18/2020] [Indexed: 11/25/2022] Open
Abstract
Objective Cigarette smoking promotes endothelial dysfunction and is a prominent catalyst for vascular disease. This study employed laser doppler flowmetry (LDF) and spectral analysis to investigate the skin microvascular response to relatively mild stimulus of stretching in diabetic smokers. Methods The study population consisted of thirty type 2 diabetic male patients (15 smokers vs. 15 non-smokers) and 15 normal non-smoking subjects. The cutaneous blood flow of the calf at both lower limbs was measured by LDF at a supine position throughout and after muscle stretching by passive dorsiflexion of the ankle. Results Following the stretch, post-stretch reactive hyperemia (PSRH) responses were found in all subjects. However, the diabetic non-smokers had relatively higher reactive blood flow than that of the diabetic smokers. The PSRH sustained for a longer time in both diabetic non-smokers and non-diabetic non-smokers in the time domain analysis. By spectral analysis, an observed discrepancy between that of diabetic smokers and diabetic non-smokers was statistically significant. Specifically, the frequency intervals corresponded to a nitric oxide dependent endothelial activity. In addition, an excessive response induced by stretching in frequency intervals of neurogenic activity, when compared with the non-smoking control, was found on diabetic non-smokers. Conclusion All subjects expressed the PSRH effect in cutaneous microcirculation after a 10-s stretch stimulus; however, this effect was observed at a significantly lower intensity in chronic smokers with diabetes. The spectral analysis of the skin blood flow signals provides a pathological index for the assessment of the endothelial dysfunction induced by cigarette smoking. Furthermore, the discrepancy of neurovascular function between that of diabetic non-smokers and normal subjects could also be distinguished via the variations of the spectrum related to neurogenic activity.
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Affiliation(s)
- Boon-Hua Low
- Division of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan
| | - Yue-Der Lin
- Department of Automatic Control Engineering, Feng Chia University, Taichung, Taiwan
| | - Bo-Wen Huang
- Bioinformatics and Biomedical Engineering, Feng Chia University, Taichung, Taiwan
| | - Taipau Chia
- Department of Safety, Health and Environmental Engineering, Hungkuang University, Taichung, Taiwan
| | - Jian-Guo Bau
- Department of Biomedical Engineering, Hungkuang University, Taichung, Taiwan
| | - Hao-Yu Huang
- Department of Biomolecular Chemistry, UW School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Dai Y, Yeh F, Chou Y, Chang Y, Chen T, Li C, Wu C. Cigarette smoking and risk of rosacea: a nationwide population‐based cohort study. J Eur Acad Dermatol Venereol 2020; 34:2593-2599. [DOI: 10.1111/jdv.16595] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/21/2020] [Indexed: 01/01/2023]
Affiliation(s)
- Y.‐X. Dai
- Department of Dermatology Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang‐Ming University Taipei Taiwan
| | - F.‐Y. Yeh
- Institute of Public Health and Department of Public Health National Yang‐Ming University Taipei Taiwan
| | - Y.‐J. Chou
- Institute of Public Health and Department of Public Health National Yang‐Ming University Taipei Taiwan
| | - Y.‐T. Chang
- Department of Dermatology Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang‐Ming University Taipei Taiwan
| | - T.‐J. Chen
- School of Medicine National Yang‐Ming University Taipei Taiwan
- Department of Family Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - C.‐P. Li
- School of Medicine National Yang‐Ming University Taipei Taiwan
- Division of Gastroenterology and Hepatology Department of Medicine Taipei Veterans General Hospital Taipei Taiwan
| | - C.‐Y. Wu
- Department of Dermatology Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang‐Ming University Taipei Taiwan
- Institute of Public Health and Department of Public Health National Yang‐Ming University Taipei Taiwan
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Pino L, de Souza MDGC, Lupi O, Bouskela E. Tuberculoid leprosy: An in vivo microvascular evaluation of cutaneous lesions. PLoS One 2020; 15:e0227654. [PMID: 31929590 PMCID: PMC6957169 DOI: 10.1371/journal.pone.0227654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/22/2019] [Indexed: 12/02/2022] Open
Abstract
Tuberculoid leprosy (TT) is characterized by cutaneous lesions called plaques. Although microvascular ultrastructure of TT patients’ skin is well-documented, little is known about functional aspects of their microcirculation. We aimed, for the first time, to evaluate, in vivo, the microcirculation of TT cutaneous lesions. Seven TT patients, males, under treatment were included in the study. The spectral analysis of frequency components of flowmotion (endothelial, sympathetic, myogenic, cardiac and respiratory) was performed using laser Doppler flowmetry (LDF). Endothelial dependent and independent vasodilatations were assessed by LDF associated to acetylcholine (ACh) and sodium nitroprusside (SNP) iontophoresis, respectively. Vessel density (VD), perfused vessel density (PVD), proportion of perfused vessels (PPV%), microvascular flow index (MFI) and flow heterogeneity index (FHI), reflecting tissue perfusion and oxygenation, were evaluated through sidestream dark field (SDF) imaging. All microvascular analysis were performed in TT lesions and in healthy skin in the contralateral limb of the same patient, used as control skin. VD, PVD and PPV% and MFI were significantly lower in the cutaneous lesion compared to contralateral healthy skin. The contribution of different frequency components of flowmotion, endothelial dependent and independent vasodilatations and FHI were not statistically different between control skin and cutaneous lesion. Our results suggest that TT cutaneous lesions have a significant impairment of tissue perfusion, which may aggravate peripheral nerve degeneration caused by Mycobacterium leprae infection.
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Affiliation(s)
- Livia Pino
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria das Graças Coelho de Souza
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | - Omar Lupi
- Departamento de Dermatologia, Universidade Federal do Estado do Rio de Janeiro (UniRio), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliete Bouskela
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Cigarette Smoking Blunts Exercise-Induced Heart Rate Response among Young Adult Male Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061032. [PMID: 30901920 PMCID: PMC6466384 DOI: 10.3390/ijerph16061032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/10/2019] [Accepted: 03/15/2019] [Indexed: 01/02/2023]
Abstract
This study aimed to examine the exercise-induced heart rate response (HRR) and heart rate variability (HRV) in subjects caused by inhaling smoke from tobacco cigarettes (TC) and aerosolized vapor from electronic nicotine dispensing systems (ENDS) (commonly referred to as e-cigarettes (EC)). A randomized crossover study recruited 24 young adult male smokers with an average age of 23 years and with a smoking habit of at least two years. Heart rate response was recorded after a maximal multistage shuttle 20 m run test (MMST) under three different levels of nicotine: Control 0 mg nicotine of EC (C), 3 mg nicotine of EC (3EC), and 3 mg nicotine of TC (3TC). HRV was evaluated based on the beat-to-beat time interval during the running test. The results showed no statistically significant differences in the run time to exhaustion under the three conditions (C: 398 ± 151 s; 3EC: 399 ± 160 s; 3TC: 381 ± 150 s). Exercise-induced HRR was significantly attenuated under the TC condition (p < 0.05). Intriguingly, the HRV standard deviation of normal-to-normal intervals (SDNN) during exercise significantly increased under 3EC and 3TC. The results showed that a significant acute autonomic cardiac modulation during exercise is induced by an acute episode of EC and TC smoking.
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Dulaney DT, Dokus KM, McIntosh S, Al-Judaibi B, Ramaraju GA, Tomiyama K, Levstik M, Hernandez-Alejandro R, Orloff MS, Kashyap R. Tobacco Use is a Modifiable Risk Factor for Post-Transplant Biliary Complications. J Gastrointest Surg 2017; 21:1643-1649. [PMID: 28785937 DOI: 10.1007/s11605-017-3519-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/24/2017] [Indexed: 01/31/2023]
Abstract
PURPOSE Biliary complications following liver transplantation are a significant source of morbidity, potentially leading to graft failure necessitating retransplantation. We sought to evaluate smoking as an independent risk factor for post-transplant biliary complications. METHODS The clinical course of all adult primary deceased donor liver transplants at our center from 1992 to 2012 was reviewed. Eligible patients were assigned to cohorts based on their lifetime tobacco exposure: never smokers indicating 0 pack-year exposure and all others were ever smokers. Biliary complications were defined as strictures, leaks, or bilomas requiring intervention. Complication rates were analyzed using univariate regression models correlated with donor and recipient characteristics. Associations found during univariate analysis were included in the final multivariate Cox model. RESULTS Eight hundred sixty-five subjects were followed for a median of 65 months; 482 (55.7%) of patients had a positive smoking history at the time of transplant. In univariate analysis, positive tobacco smoking history (HR = 1.36; p = 0.037) and increased time from quit date to transplantation (HR = 0.998; p = 0.011) were positive and negative predictors of biliary complication, respectively. Lifetime tobacco exposure remained a significant predictor of biliary complication on multivariate analysis (HR = 1.408; p = 0.023). CONCLUSIONS Smoking status is an independent predictor of post-transplant biliary complications, and the data presented reinforces the importance of early smoking cessation in the pre-transplantation period.
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Affiliation(s)
- David T Dulaney
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Katherine M Dokus
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Scott McIntosh
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Bandar Al-Judaibi
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Gopal A Ramaraju
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Koji Tomiyama
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Mark Levstik
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Roberto Hernandez-Alejandro
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Mark S Orloff
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA
| | - Randeep Kashyap
- Division of Solid Organ Transplantation, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Box SURG - TRANSPLANT, Rochester, NY, 14642, USA.
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Dar MI, Dar AH, Bilal M, Ahmad M, Haseeb A. Association of Internal Mammary Artery Flow with Different Comorbidities and Post-Coronary Artery Bypass Graft Complications. Cureus 2017; 9:e1584. [PMID: 29062616 PMCID: PMC5650253 DOI: 10.7759/cureus.1584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective The internal mammary artery (IMA) is commonly used arterial graft for coronary artery bypass surgery (CABG). The IMA has a better patency and survival. This study considers different comorbidities and conditions where IMA flow may be low. Therefore, the main objective is to determine the flow of IMA in different diseases, its relation to gender, age, and in different blood groups in order to prevent possible complications. Methods A prospective study was conducted at the Cardiac Surgery Unit, Civil Hospital Karachi from January 2013 to December 2015. The data of 158 patients who underwent primary, isolated, and CABG surgery was collected. Free flow of IMA was measured immediately after harvesting for 30 seconds within a syringe, and its relationship with different diseases and conditions was examined. Data was collected using a structured questionnaire from the patients' medical record files and it was later analyzed and entered into the Statistical Package for Social Sciences (SPSS) software, V17 (IBM SPSS Statistics, Armonk, NY). Results The mean flow was 11.6 ± 9.6 ml. There was no difference in flow related to gender, diabetes, smoking, renal disease, and chronic obstructive pulmonary disease (COPD). There was significantly higher flow in the age group of 50 to 60 years (p = 0.002), hypertensive patients (p = 0.016), patients with liver disease (p = 0.001), BMI > 30 (p = 0.041), and the blood group AB+ (p = 0.02). The atrial fibrillation and readmissions were higher in patients who had low flow. Low flow IMA, which was used on left anterior descending (LAD) artery stenosis patients, showed a significantly higher need of pharmacological and mechanical support. Conclusion IMA should be used carefully in patients where its flow is low; conditions must be analyzed where flow may be low to avoid complications. Further studies are warranted.
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Affiliation(s)
| | | | - Muhammad Bilal
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Mansoor Ahmad
- Department of Pharmacy, Karachi University, Karachi University
| | - Abdul Haseeb
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Druyan A, Atias D, Ketko I, Cohen-Sivan Y, Heled Y. The effects of smoking and nicotine ingestion on exercise heat tolerance. J Basic Clin Physiol Pharmacol 2017; 28:167-170. [PMID: 27831921 DOI: 10.1515/jbcpp-2016-0065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 08/08/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Smoking has a thermogenic effect and is associated with low physical performance. Nevertheless, a direct, quantitative effect of acute smoking on exercise heat tolerance has not been reported. METHODS Sixteen healthy young male volunteers, eight cigarette smokers, and eight non-smokers participated in the study. All subjects performed a maximal oxygen consumption test (VO2max) and a standardized heat tolerance test (HTT) after at least 12 h without smoking under the following conditions: no nicotine exposure, 10 min after nicotine exposure (2 mg nicotine lozenge), and 10 min after smoking two cigarettes (0.8 mg nicotine in each cigarette, smokers only). RESULTS There was no significant effect of nicotine exposure on physiological performance and heat tolerance in the non-smokers group. In the smokers group, cigarette smoking, but not nicotine ingestion, resulted with higher heart rate (by 9±9 bpm) at the end of the HTT (p<0.05). Moreover, both smoking and nicotine ingestion increased smokers' rectal temperature at the end of the HTT (by 0.24±0.16°C and 0.21±0.26°C, respectively, p<0.05) and were associated with higher sweat rate during the HTT (by 0.08±0.07 g/h and 0.06±0.08 g/h, respectively, p<0.05). Heart rate variability (HRV) analysis also revealed a higher LF/HF (low frequency/high frequency) ratio after exposure to nicotine and smoking in the smokers group compared with no exposure (2.13±2.57 and 2.48±2.76, respectively, p<0.05), indicating a higher sympathetic tone. CONCLUSIONS According to this preliminary study, cigarette smoking and nicotine ingestion increase the physiological strain during a HTT in smokers. Acute smoking may, therefore, increase heat intolerance and the risk to heat injuries.
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Li S, Cho E, Drucker AM, Qureshi AA, Li WQ. Cigarette Smoking and Risk of Incident Rosacea in Women. Am J Epidemiol 2017; 186:38-45. [PMID: 28472217 DOI: 10.1093/aje/kwx054] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 07/27/2016] [Indexed: 12/16/2022] Open
Abstract
The relationship between smoking and rosacea is poorly understood. We aimed to conduct the first cohort study to determine the association between smoking and risk of incident rosacea. We included 95,809 women from Nurses' Health Study II (1991-2005). Information on smoking was collected biennially during follow-up. Information on history of clinician-diagnosed rosacea and year of diagnosis was collected in 2005. We used Cox proportional hazards models to estimate age- and multivariable-adjusted hazard ratios and 95% confidence intervals for the association between different measures of smoking and risk of rosacea. During follow-up, we identified 5,462 incident cases of rosacea. Compared with never smoking, we observed an increased risk of rosacea associated with past smoking (multivariable-adjusted hazard ratio = 1.09, 95% confidence interval: 1.03, 1.16) but a decreased risk associated with current smoking (hazard ratio = 0.65, 95% confidence interval: 0.58, 0.72). We further found that increasing pack-years of smoking was associated with an elevated risk of rosacea among past smokers (P for trend = 0.003) and with a decreased risk of rosacea among current smokers (P for trend < 0.0001). The risk of rosacea was significantly increased within 3-9 years since smoking cessation, and the significant association persisted among past smokers who had quit over 30 years before.
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Santesson P, Lins PE, Kalani M, Adamson U, Lelic I, von Wendt G, Fagrell B, Jörneskog G. Skin microvascular function in patients with type 1 diabetes: An observational study from the onset of diabetes. Diab Vasc Dis Res 2017; 14:191-199. [PMID: 28467200 DOI: 10.1177/1479164117694463] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The development of disturbances in skin microcirculation in type 1 diabetes is not well characterised. We assessed skin microcirculation longitudinally from the onset of diabetes up to 29 years of duration to investigate when such disturbances start. MATERIAL AND METHODS Seventeen adult patients with type 1 diabetes participated. Skin microvascular function in digit IV of the left hand was investigated by laser Doppler fluxmetry (LDF, arbitrary units [AU]). LDF was carried out at rest and following one-min arterial occlusion. Time to peak LDF (s) and percentage increase of LDF (post-occlusive reactive hyperaemia, PRH%) were determined. Retinopathy was assessed from fundus photographs or ophthalmoscopic recordings. RESULTS Skin microvascular function remained normal during the first five years. Compared with baseline and a non-diabetic reference group, time to peak LDF was prolonged after 7-9 years of diabetes ( p < 0.01). PRH% was lower than in the reference group after 7-9 years ( p < 0.01), and lower than baseline after 24-29 years of diabetes ( p < 0.05). All but one patient developed retinopathy and the first signs were found after 10 years of diabetes. CONCLUSIONS Functional disturbances in total skin microcirculation were observed after seven years in patients with type 1 diabetes and preceded diabetic complications such as retinopathy.
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Affiliation(s)
- Pia Santesson
- 1 Microcirculatory Laboratory, Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Per-Eric Lins
- 1 Microcirculatory Laboratory, Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Majid Kalani
- 2 Division of Cardiovascular Medicine, Department of Clinical sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Ulf Adamson
- 1 Microcirculatory Laboratory, Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Isak Lelic
- 1 Microcirculatory Laboratory, Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Gunvor von Wendt
- 3 Department of Medical Retina, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden
| | - Bengt Fagrell
- 4 Department of Medicine, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Gun Jörneskog
- 1 Microcirculatory Laboratory, Division of Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
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Treu C, de Souza MDGC, Lupi O, Sicuro FL, Maranhão PA, Kraemer-Aguiar LG, Bouskela E. Structural and functional changes in the microcirculation of lepromatous leprosy patients - Observation using orthogonal polarization spectral imaging and laser Doppler flowmetry iontophoresis. PLoS One 2017; 12:e0175743. [PMID: 28419120 PMCID: PMC5395185 DOI: 10.1371/journal.pone.0175743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/30/2017] [Indexed: 01/22/2023] Open
Abstract
Leprosy is a chronic granulomatous infection of skin and peripheral nerves caused by Mycobacterium leprae and is considered the main infectious cause of disability worldwide. Despite the several studies regarding leprosy, little is known about its effects on microvascular structure and function in vivo. Thus, we have aimed to compare skin capillary structure and functional density, cutaneous vasomotion (spontaneous oscillations of arteriolar diameter), which ensures optimal blood flow distribution to skin capillaries) and cutaneous microvascular blood flow and reactivity between ten men with lepromatous leprosy (without any other comorbidity) and ten age- and gender-matched healthy controls. Orthogonal polarization spectral imaging was used to evaluate skin capillary morphology and functional density and laser Doppler flowmetry to evaluate blood flow, vasomotion and spectral analysis of flowmotion (oscillations of blood flow generated by vasomotion) and microvascular reactivity, in response to iontophoresis of acetylcholine and sodium nitroprusside. The contribution of different frequency components of flowmotion (endothelial, neurogenic, myogenic, respiratory and cardiac) was not statistically different between groups. However, endothelial-dependent and -independent vasodilatations elicited by acetylcholine and sodium nitroprusside iontophoresis, respectively, were significantly reduced in lepromatous leprosy patients compared to controls, characterizing the existence of microvascular dysfunction. These patients also presented a significant increase in the number of capillaries with morphological abnormalities and in the diameters of the dermal papilla and capillary bulk when compared to controls. Our results suggest that lepromatous leprosy causes severe microvascular dysfunction and significant alterations in capillary structure. These structural and functional changes are probably induced by exposure of the microvascular bed to chronic inflammation evoked by the Mycobacterium leprae.
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Affiliation(s)
- Curt Treu
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria das Graças Coelho de Souza
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | - Omar Lupi
- Departamento de Dermatologia, Universidade Federal do Estado do Rio de Janeiro (Uni-Rio), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernando Lencastre Sicuro
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Priscila Alves Maranhão
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
- Ambulatório de Obesidade, Policlínica Piquet Carneiro, Departamento de Medicina Interna, Faculdade de Ciências Médicas, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eliete Bouskela
- Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular, Centro Biomédico, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, Rio de Janeiro, Brazil
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Akcay A, Aydin MN, Acar G, Mese B, Çetin M, Akgungor M, Cabioglu E, Bozoglan O, Ardic I, Çakici M. Evaluation of left atrial mechanical function and atrial conduction abnormalities in Maras powder (smokeless tobacco) users and smokers. Cardiovasc J Afr 2016; 26:114-9. [PMID: 26592906 PMCID: PMC4538911 DOI: 10.5830/cvja-2014-070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 11/27/2014] [Indexed: 11/17/2022] Open
Abstract
Objective In Turkey, a type of smokeless tobacco called Maras powder (MP) is widely used in the south-eastern region. Smokeless tobacco is found in preparations for chewing and for absorption by the nasal and oral mucosae. The purpose of this study was to investigate whether MP damages intra- and inter-atrial conduction delay and left atrial (LA) mechanical function as much as cigarette smoking. Method A total of 150 chronic MP users (50 males, 32.5 ± 5.4 years), smokers (50 males, 32.1 ± 6.0 years) and controls (50 males, 30.1 ± 5.8 years) were included in the study. LA volumes were measured echocardiographically according to the biplane area–length method. Atrial electromechanical coupling was measured with tissue Doppler imaging and LA mechanical function parameters were calculated. Results The LA passive emptying fraction was significantly decreased and LA active emptying volume (LAAEV) was significantly increased in the MP group (p = 0.012 and p = 0.024, respectively), and the LA active emptying fraction (LAAEF) was significantly increased in the smokers (p = 0.003). There was a positive correlation between the amount of MP used and smoking (pack years) with LAAEV and LAAEF (r = 0.26, p = 0.009 and r = 0.25, p = 0.013, respectively). Lateral atrial electromechanical intervals (PA) were significantly higher in MP users, and the septal mitral PA was statistically higher in the smokers (p = 0.05 and p = 0.04, respectively). Conclusion We suggest that atrial electromechanical coupling intervals were prolonged and LA mechanical function was impaired in MP users and smokers, but there was no significant difference between the MP users and smokers. These findings may be markers of subclinical cardiac involvement and tendency for atrial fibrillation.
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Affiliation(s)
- Ahmet Akcay
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - M Naci Aydin
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Gurkan Acar
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Bulent Mese
- Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Mustafa Çetin
- Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Akgungor
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Eren Cabioglu
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Orhan Bozoglan
- Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Idris Ardic
- Department of Cardiology, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey
| | - Musa Çakici
- Department of Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
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Zarling JA, Brunt VE, Vallerga AK, Li W, Tao A, Zarling DA, Minson CT. Nitroxide pharmaceutical development for age-related degeneration and disease. Front Genet 2015; 6:325. [PMID: 26594225 PMCID: PMC4635221 DOI: 10.3389/fgene.2015.00325] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Accepted: 10/19/2015] [Indexed: 02/05/2023] Open
Abstract
Nitroxide small molecule agents are in development as preventative or therapeutic pharmaceutical drugs for age-related macular degeneration (AMD) and cardiovascular disease, which are two major diseases of aging. These aging diseases are associated with patient genetics, smoking, diet, oxidative stress, and chronic inflammation. Nitroxide drugs preventing aging-, smoking-, high sugar or high fat diet-, or radiation- and other environmental-induced pathophysiological conditions in aging disease are reviewed. Tempol (TP), Tempol Hydroxylamine (TP-H), and TP-H prodrug (OT-551) are evaluated in (1) non-smokers versus smokers with cutaneous microvascular dysfunction, rapidly reversed by cutaneous TP; (2) elderly cancer patients at risk for radiation-induced skin burns or hair loss, prevented by topical TP; and (3) elderly smoker or non-smoker AMD patients at risk for vision loss, prevented by daily eye drops of OT-551. The human data indicates safety and efficacy for these nitroxide drugs. Both TP and TP-H topically penetrate and function in skin or mucosa, protecting and treating radiation burns and hair loss or smoking-induced cutaneous vascular dysfunction. TP and TP-H do not penetrate the cornea, while OT-551 does effectively penetrate and travels to the back of the eye, preserving visual acuity and preserving normal and low light luminance in dry AMD smokers and non-smoker patients. Topical, oral, or injectable drug formulations are discussed.
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Affiliation(s)
| | - Vienna E. Brunt
- Department of Human Physiology, University of Oregon, EugeneOR, USA
| | | | - Weixing Li
- Colby Pharmaceutical Company, Menlo ParkCA, USA
| | - Albert Tao
- Department of Biomedical Engineering, Washington University in St. Louis, St. LouisMO, USA
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Murbach M, Neufeld E, Cabot E, Zastrow E, Córcoles J, Kainz W, Kuster N. Virtual population-based assessment of the impact of 3 Tesla radiofrequency shimming and thermoregulation on safety and B1 + uniformity. Magn Reson Med 2015; 76:986-97. [PMID: 26400841 DOI: 10.1002/mrm.25986] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 07/20/2015] [Accepted: 08/21/2015] [Indexed: 01/22/2023]
Abstract
PURPOSE To assess the effect of radiofrequency (RF) shimming of a 3 Tesla (T) two-port body coil on B1 + uniformity, the local specific absorption rate (SAR), and the local temperature increase as a function of the thermoregulatory response. METHODS RF shimming alters induced current distribution, which may result in large changes in the level and location of absorbed RF energy. We investigated this effect with six anatomical human models from the Virtual Population in 10 imaging landmarks and four RF coils. Three thermoregulation models were applied to estimate potential local temperature increases, including a newly proposed model for impaired thermoregulation. RESULTS Two-port RF shimming, compared to circular polarization mode, can increase the B1 + uniformity on average by +32%. Worst-case SAR excitations increase the local RF power deposition on average by +39%. In the first level controlled operating mode, induced peak temperatures reach 42.5°C and 45.6°C in patients with normal and impaired thermoregulation, respectively. CONCLUSION Image quality with 3T body coils can be significantly increased by RF shimming. Exposure in realistic scan scenarios within guideline limits can be considered safe for a broad patient population with normal thermoregulation. Patients with impaired thermoregulation should not be scanned outside of the normal operating mode. Magn Reson Med 76:986-997, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | | | - Earl Zastrow
- IT'IS Foundation, Zurich, Switzerland.,Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Juan Córcoles
- Department of Electronic and Communication Technology, Universidad Autónoma de Madrid (UAM), Escuela Politécnica Superior, Madrid, Spain
| | - Wolfgang Kainz
- US Food and Drug Administration (FDA), Center for Devices and Radiological Health (CDRH), Silver Spring, Maryland, USA
| | - Niels Kuster
- IT'IS Foundation, Zurich, Switzerland.,Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
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Moyen NE, Anderson HM, Burchfield JM, Tucker MA, Gonzalez MA, Robinson FB, Ganio MS. Forearm cutaneous vascular and sudomotor responses to whole body passive heat stress in young smokers. Am J Physiol Regul Integr Comp Physiol 2015; 309:R36-42. [PMID: 25924880 DOI: 10.1152/ajpregu.00079.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/23/2015] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to compare smokers and nonsmokers' sudomotor and cutaneous vascular responses to whole body passive heat stress. Nine regularly smoking (SMK: 29 ± 9 yr; 10 ± 6 cigarettes/day) and 13 nonsmoking (N-SMK: 27 ± 8 yr) males were passively heated until core temperature (TC) increased 1.5°C from baseline. Forearm local sweat rate (LSR) via ventilated capsule, sweat gland activation (SGA), sweat gland output (SGO), and cutaneous vasomotor activity via laser-Doppler flowmetry (CVC) were measured as mean body temperature increased (ΔTb) during passive heating using a water-perfused suit. Compared with N-SMK, SMK had a smaller ΔTb at the onset of sweating (0.52 ± 0.19 vs. 0.35 ± 0.14°C, respectively; P = 0.03) and cutaneous vasodilation (0.61 ± 0.21 vs. 0.31 ± 0.12°C, respectively; P < 0.01). Increases in LSR and CVC per °C ΔTb (i.e., sensitivity) were similar in N-SMK and SMK (LSR: 0.63 ± 0.21 vs. 0.60 ± 0.40 Δmg/cm(2)/min/°C ΔTb, respectively, P = 0.81; CVC: 82.5 ± 46.2 vs. 58.9 ± 23.3 Δ%max/°C ΔTb, respectively; P = 0.19). However, the plateau in LSR during whole body heating was higher in N-SMK vs. SMK (1.00 ± 0.13 vs. 0.79 ± 0.26 mg·cm(-2)·min(-1); P = 0.03), which was likely a result of higher SGO (8.94 ± 3.99 vs. 5.94 ± 3.49 μg·gland(-1)·min(-1), respectively; P = 0.08) and not number of SGA (104 ± 7 vs. 121 ± 9 glands/cm(2), respectively; P = 0.58). During whole body passive heat stress, smokers had an earlier onset for forearm sweating and cutaneous vasodilation, but a lower local sweat rate that was likely due to lower sweat output per gland. These data provide insight into local (i.e., forearm) thermoregulatory responses of young smokers during uncompensatory whole body passive heat stress.
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Affiliation(s)
- Nicole E Moyen
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Hannah M Anderson
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Jenna M Burchfield
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Matthew A Tucker
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Melina A Gonzalez
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Forrest B Robinson
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
| | - Matthew S Ganio
- Human Performance Laboratory, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, Arkansas
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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: 257] [Impact Index Per Article: 23.4] [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.
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Affiliation(s)
- John M Johnson
- Department of Physiology, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Abstract
The microcirculation, like all physiological systems undergoes modifications during the course of pregnancy. These changes aid the adaption to the new anatomical and physiological environment of pregnancy and ensure adequate oxygen supply to the fetus. Even though the microcirculation is believed to be involved in major pregnancy related pathologies, it remains poorly understood. The availability of safe and non-interventional technologies enabling scientists to study the intact microcirculation of the pregnant patient will hopefully expand our understanding. In this article we review the physiological changes occurring in the microcirculation during pregnancy and the role of the microcirculation in gestational related pathologies. We will also describe the available techniques for the measurement and evaluation of the microcirculation. Lastly we will highlight the possible fields in which these techniques could be utilized to help provide a clearer view of the microcirculation in the pregnant woman.
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Affiliation(s)
| | | | | | - V. CERNY
- Department of Anesthesiology and Intensive Care Medicine, Charles University in Prague, Faculty of Medicine Hradec Kralove, Czech Republic
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Jang SY, Ju EY, Huh EH, Kim JH, Kim DK. Determinants of brachial-ankle pulse wave velocity and carotid-femoral pulse wave velocity in healthy Koreans. J Korean Med Sci 2014; 29:798-804. [PMID: 24932081 PMCID: PMC4055813 DOI: 10.3346/jkms.2014.29.6.798] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 04/09/2014] [Indexed: 01/22/2023] Open
Abstract
The aim of this study was to determine the normal value of brachial-ankle pulse wave velocity (baPWV) and carotid-femoral pulse wave velocity (cfPWV) according to age group, gender, and the presence of cardiovascular risk factors in healthy Koreans, and to investigate the association between PWV and risk factors such as prehypertension, dyslipidemia, smoking, and obesity. We measured an arterial stiffness in 110 normal subjects who were 20 to 69 yr-old with no evidence of cardiovascular disease, cerebrovascular accident or diabetes mellitus. The mean values of baPWV and cfPWV were 12.6 (± 2.27) m/sec (13.1 ± 1.85 in men, 12.1 ± 2.51 in women; P=0.019) and 8.70 (± 1.99) m/sec (9.34 ± 2.13 in men, 8.15 ± 1.69 in women; P=0.001), respectively. The distribution of baPWV (P<0.001) and cfPWV (P=0.006) by age group and gender showed an increase in the mean value with age. Men had higher baPWV and cfPWV than women (P<0.001). There was a difference in baPWV and cfPWV by age group on prehypertension, dyslipidemia, current smoking, or obesity (P<0.001). In multiple linear regression, age and prehypertension were highly associated with baPWV and cfPWV after adjustment for confounding factors (P<0.001). The present study showed that baPWV and cfPWV are associated with age, gender, and prehypertension in healthy Koreans.
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Affiliation(s)
- Shin Yi Jang
- Division of Cardiology, Department of Internal Medicine, Vascular Center, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Young Ju
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Eun Hee Huh
- Division of Cardiology, Department of Internal Medicine, Vascular Center, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Vascular Center, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk-Kyung Kim
- Division of Cardiology, Department of Internal Medicine, Vascular Center, Heart Vascular and Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Fujii N, Brunt VE, Minson CT. Tempol improves cutaneous thermal hyperemia through increasing nitric oxide bioavailability in young smokers. Am J Physiol Heart Circ Physiol 2014; 306:H1507-11. [PMID: 24682395 DOI: 10.1152/ajpheart.00886.2013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We recently found that young cigarette smokers display cutaneous vascular dysfunction relative to nonsmokers, which is partially due to reduced nitric oxide (NO) synthase (NOS)-dependent vasodilation. In this study, we tested the hypothesis that reducing oxidative stress improves NO bioavailability, enhancing cutaneous vascular function in young smokers. Ten healthy young male smokers, who had smoked for 6.3 ± 0.7 yr with an average daily consumption of 9.1 ± 0.7 cigarettes, were tested. Cutaneous vascular conductance (CVC) during local heating to 42°C at a rate of 0.1°C/s was evaluated as laser-Doppler flux divided by mean arterial blood pressure and normalized to maximal CVC, induced by local heating to 44°C plus sodium nitroprusside administration. We evaluated plateau CVC during local heating, which is known to be highly dependent on NO, at four intradermal microdialysis sites with 1) Ringer solution (control); 2) 10 μM 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (tempol), a superoxide dismutase mimetic; 3) 10 mM N(ω)-nitro-l-arginine (l-NNA), a nonspecific NOS inhibitor; and 4) a combination of 10 μM tempol and 10 mM l-NNA. Tempol increased plateau CVC compared with the Ringer solution site (90.0 ± 2.3 vs. 77.6 ± 3.9%maximum, P = 0.028). Plateau CVC at the combination site (56.8 ± 4.5%maximum) was lower than the Ringer solution site (P < 0.001) and was not different from the l-NNA site (55.1 ± 4.6%maximum, P = 0.978), indicating the tempol effect was exclusively NO dependent. These data suggest that in young smokers, reducing oxidative stress improves cutaneous thermal hyperemia to local heating by enhancing NO production.
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Affiliation(s)
- Naoto Fujii
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
| | - Vienna E Brunt
- Department of Human Physiology, The University of Oregon, Eugene, Oregon
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Sucakli MH, Ozkan F, Inci MF, Celik M, Keten HS, Bozoglan O. Effects of smokeless tobacco (Maras powder) use on carotid intima media thickness. Med Sci Monit 2013; 19:859-64. [PMID: 24129168 PMCID: PMC3808230 DOI: 10.12659/msm.889654] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this study was to investigate the effects of smokeless tobacco (Maras powder, Nicotiana rustica Linn) on carotid intima media thickness. Material/Methods The study included 32 Maras powder users presenting to our Family Medicine outpatient clinic and 30 non-users of Maras powder as a control group. Carotid intima media thickness was measured by duplex ultrasonography. Results All the participants were male. The mean duration of Maras powder use was 27.3±11.6 years. Carotid intima media thickness was 0.73±0.20 mm in the Maras powder users and 0.49±0.14 mm in the controls. Blood pressure measured before Maras powder use in Maras powder users was similar to that measured in the control group (p>0.05). Systolic blood pressures were 136.6±12.4 mmHg and 109.7±9.7 mmHg after 30–60 minutes using Maras powder in the Maras powder users and in the controls, respectively. Diastolic blood pressures were 87.2±6.1 mmHg and 62.8±8.1 mmHg after 30–60 minutes using Maras powder in the Maras powder users and the controls, respectively. Carotid intima media thickness was significantly correlated with systolic blood pressure (r=0.613, p<0.001) and diastolic blood pressure (r=0.612, p<0.001). Conclusions Carotid intima media thickness was higher in Maras powder users than in nonusers of the powder. Increased carotid intima media thickness can be associated with an immediate increase in systolic and diastolic blood pressures. Therefore, attempts to increase public awareness about smoking should also be directed towards prevention of Maras powder use.
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Affiliation(s)
- Mustafa Haki Sucakli
- Department of Family Medicine, Kahramanmaras Sutcuimam University, Medical Faculty, Kahramanmaras, Turkey
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Fujii N, Reinke MC, Brunt VE, Minson CT. Impaired acetylcholine-induced cutaneous vasodilation in young smokers: roles of nitric oxide and prostanoids. Am J Physiol Heart Circ Physiol 2013; 304:H667-73. [PMID: 23316063 DOI: 10.1152/ajpheart.00731.2012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Cigarette smoking attenuates acetylcholine (ACh)-induced cutaneous vasodilation in humans, but the underlying mechanisms are unknown. We tested the hypothesis that smokers have impaired nitric oxide (NO)- and cyclooxygenase (COX)-dependent cutaneous vasodilation to ACh infusion. Twelve young smokers, who have smoked more than 5.2 ± 0.7 yr with an average daily consumption of 11.4 ± 1.2 cigarettes, and 12 nonsmokers were tested. Age, body mass index, and resting mean arterial pressure were similar between the groups. Cutaneous vascular conductance (CVC) was evaluated as laser-Doppler flux divided by mean arterial pressure, normalized to maximal CVC (local heating to 43.0°C plus sodium nitroprusside administration). We evaluated the increase in CVC from baseline to peak (CVCΔpeak) and area under the curve of CVC (CVCAUC) during a bolus infusion (1 min) of 137.5 μM ACh at four intradermal microdialysis sites: 1) Ringer (control), 2) 10 mM N(G)-nitro-l-arginine methyl ester (l-NAME; NO synthase inhibitor), 3) 10 mM ketorolac (COX inhibitor), and 4) combination of l-NAME + ketorolac. CVCΔpeak and CVCAUC at the Ringer site in nonsmokers were greater than in smokers (CVCΔpeak, 42.9 ± 5.1 vs. 22.3 ± 3.5%max, P < 0.05; and CVCAUC, 8,085 ± 1,055 vs. 3,145 ± 539%max·s, P < 0.05). In nonsmokers, CVCΔpeak and CVCAUC at the l-NAME site were lower than the Ringer site (CVCΔpeak, 29.5 ± 6.2%max, P < 0.05; and CVCAUC, 5,377 ± 1,109%max·s, P < 0.05), but in smokers, there were no differences between the Ringer and l-NAME sites (CVCΔpeak, 16.8 ± 4.3%max, P = 0.11; and CVCAUC, 2,679 ± 785%max·s, P = 0.30). CVCΔpeak and CVCAUC were reduced with ketorolac in nonsmokers (CVCΔpeak, 13.3 ± 3.6%max, P < 0.05; and CVCAUC, 1,967 ± 527%max·s, P < 0.05) and smokers (CVCΔpeak, 7.8 ± 1.8%max, P < 0.05; and CVCAUC, 1,246 ± 305%max·s, P < 0.05) and at the combination site in nonsmokers (CVCΔpeak, 15.9 ± 3.1%max, P < 0.05; and CVCAUC, 2,660 ± 512%max·s, P < 0.05) and smokers (CVCΔpeak, 11.5 ± 2.6%max, P < 0.05; and CVCAUC, 1,693 ± 409%max·s, P < 0.05), but the magnitudes were greater in nonsmokers (P < 0.05). These results suggest that impaired ACh-induced skin vasodilation in young smokers is related to diminished NO- and COX-dependent vasodilation.
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Affiliation(s)
- Naoto Fujii
- The University of Oregon, Department of Human Physiology, Eugene, OR 97403-1240, USA
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Deteriorated function of cutaneous microcirculation in chronic congestive heart failure. J Geriatr Cardiol 2012; 8:82-7. [PMID: 22783290 PMCID: PMC3390083 DOI: 10.3724/sp.j.1263.2011.00082] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 05/31/2011] [Accepted: 06/07/2011] [Indexed: 11/29/2022] Open
Abstract
Background Chronic congestive heart failure is a complex condition that leads to dysfunction in the peripheral microcirculation. We have previously shown that vascular reactivity is reduced with increasing age. In this study, we examined a group of very old patients with severe chronic heart failure to test the hypothesis that vascular function is further compromised by a combination of heart failure and aging. Methods Cutaneous forearm blood flow was measured by laser Doppler flowmetry and compared among three groups: Group 1 (n = 20, mean ± SE: 85.5 ± 4 years), heart failure patients with New York Heart Association class IV (NYHA IV) and with a NT-proBNP level ≥ 5000 ng/L; Group 2 (n = 15, mean ± SE: 76.5 ± 2 years), heart failure patients with NYHA II and NT-proBNP ≤ 2000 ng/L, and Group 3 (n = 10, mean ± SE: 67.6 ± 3.0 years), healthy controls with no clinical signs of heart failure. The vasodilator response to the iontophoretic administration of acetylcholine (ACh), acting via an endothelial mechanism, and sodium nitroprusside (SNP), acting via a smooth muscle cell mechanism, were studied. Results All patients with heart failure had significantly reduced vascular reactivity independent of the mode of stimulation (ACh, SNP or heat) when compared to healthy controls. However, the responses did not differ between the two groups of heart failure patients. Conclusions Cutaneous vascular reactivity is reduced in heart failure patients and does not correlate with the severity of the condition or age of patients.
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Mieczkowska J, Mosiewicz J, Sak J, Grzybowski A, Terlecki P, Barud W, Kwaśniewski W, Tutka P. Effects of cigarette smoking, metabolic syndrome and dehydroepiandrosterone deficiency on intima-media thickness and endothelial function in hypertensive postmenopausal women. Med Sci Monit 2012; 18:CR225-34. [PMID: 22460094 PMCID: PMC3560833 DOI: 10.12659/msm.882622] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Cigarette smoking is a major risk factor of atherosclerosis. The aim of this study was to assess the relationship between smoking and arterial hypertension as well as endothelial dysfunction in postmenopausal women without clinically manifested symptoms of atherosclerosis. Material/Methods The study groups consisted of 35 current smokers and 45 nonsmokers. The thickness of intima-media complex (IMT), a marker of atherosclerosis, was measured in carotid arteries. Plasma concentrations of fasting glucose, insulin, lipoproteins, inflammatory markers (tumor necrosis factor-alpha, intercellular adhesion molecule-1), matrix metalloproteinases (metalloproteinase-9, tissue inhibitor of metalloproteinase-1), insulin, and dehydroepiandrosterone sulfate (DHEA-S) were measured. Results Smokers compared with nonsmokers showed lower fasting glucose levels in blood (87.0±10.9 and 93.2±13.6 mg/dl, p<0.05), higher mean systolic (131.1±15.9 vs. 123.0±10.9 mm Hg, p<0.05) and diastolic (81.7±11.4 vs. 75.2±9.2 mm Hg, p<0.05) blood pressure during daytime, and higher average heart rate during the daytime (78.2±9.3/min vs. 71.5±9.5/min, p<0.01) and at night (67.2±10.6/min vs. 61.7±7.7/min, p<0.05), respectively. The IMT in the right carotid artery was significantly higher in smokers than in nonsmokers (0.96±0.16 mm vs. 0.82±0.21, p<0.05) and was positively correlated with smoking intensity (R=0.36) and habit duration (R=0.35). The comparison of inflammatory markers, metalloproteinases, and DHEA-S concentrations in plasma did not reveal significant differences between the 2 groups. A significant negative correlation between DHEA-S concentration in plasma and IMT in right carotid artery was found in smokers. Conclusions Smoking in hypertensive postmenopausal women is associated with lower fasting blood glucose and BMI values, but higher arterial pressure and heart rate, and increases in IMT in right carotid artery.
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Affiliation(s)
- Jolanta Mieczkowska
- Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
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Spoendlin J, Voegel J, Jick S, Meier C. A study on the epidemiology of rosacea in the U.K. Br J Dermatol 2012; 167:598-605. [DOI: 10.1111/j.1365-2133.2012.11037.x] [Citation(s) in RCA: 153] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Contrast-enhanced ultrasound evaluation of peripheral microcirculation in diabetic patients: effects of cigarette smoking. Radiol Med 2012; 118:206-14. [PMID: 22580811 DOI: 10.1007/s11547-012-0830-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 09/26/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE Cigarette smoking and diabetes mellitus predisposes to vascular disease. Our study aimed to evaluate the chronic effects of cigarette smoking on peripheral microcirculation assessed with contrast-enhanced ultrasound (CEUS) in diabetic patients. MATERIALS AND METHODS The study population comprised ten smoker (7/3 M/W, age 42-76 years) and 16 nonsmoker (8/8 men/women, age 47-80 years) diabetic patients. The ankle-brachial index (ABI) was determined, and colour Doppler ultrasound (CDUS) of the lower legs was performed to determine the presence of peripheral arteriopathy disease (PAD). Microvascular blood flow in the gastrocnemius muscle was evaluated with CEUS. RESULTS No differences were observed in ABI and CDUS examination between smokers and nonsmokers. Smoking had a significant effect on microcirculatory function. Timeto-peak (TTP), arrival time in tissue (ATt) and artery/ tissue transit time (A/Ttt) were significantly prolonged in smokers (TTP 43.76 ± 9.38 s vs. 34.12 ± 6.8 s, p=0.011, ATt 28.9 ± 7.5s vs. 22.4 ± 6.4 s, p=0.017 and A/Ttt 6.81 ± 4.52 s vs. 3.25 ± 3.27 s, p=0.02), with no significant differences between patients with and without PAD. CONCLUSIONS The long-term exposure to cigarette smoke affects microcirculatory function. Contrast imaging is a noninvasive technique that can document these effects.
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Nakhjavani M, Morteza A, Jenab Y, Ghaneei A, Esteghamati A, Karimi M, Farokhian A. Gender difference in albuminuria and ischemic heart disease in type 2 diabetes. Clin Med Res 2012; 10:51-6. [PMID: 22031479 PMCID: PMC3355738 DOI: 10.3121/cmr.2011.1021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The value of urinary albumin excretion in the prediction of myocardial ischemia in men and women with type 2 diabetes is not well understood. We questioned whether gender influences the albuminuria-ischemic heart disease relationship in patients with type 2 diabetes. METHODS We designed a matched case-control study of 926 patients with albuminuria (cases) and 926 age and body mass index matched patients without albuminuria (controls). Ischemic heart disease was defined as the presence of (1) history of angina pectoris or angina equivalent symptoms and critical care unit admission, (2) myocardial infarction and/or electrocardiographic evidence of Q-wave myocardial infarction, (3) coronary revascularization and/or stenting, (4) positive myocardial single-photon emission computed tomography scan, (5) ischemic ST-segment or T-wave changes, and (6) positive stress testing. RESULTS Patients with albuminuria had a lower glomerular filtration rate and a longer diabetes duration than patients without albuminuria. In the group of cases, there were a greater number of men with ischemic heart disease (120 of 370; 32.4%) compared to women (97 of 559; 17.4%) (P<0.001). The odds ratio of having ischemic heart disease according to the presence or absence of albuminuria was 1.25 [95% CI: 1.01-1.56] (P<0.05) in all studied populations, 0.79 [95% CI: 0.51-1.21] (P=0.14) in women, and 2.84 [95% CI: 1.68-4.79] (P<0.001) in men. We showed that diabetes duration, high-density lipoprotein, low-density lipoprotein, and hemoglobin A(1c) influence albuminuria in women, while diabetes duration, fasting blood sugar, and diastolic blood pressure influence albuminuria in men. CONCLUSIONS Men with albuminuria are at increased risk of ischemic heart disease compared to women. This may be related to the role of high-density lipoprotein on the albuminuria-gender relationship.
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Affiliation(s)
- Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center-EMRC, Vali-Asr Hospital, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.
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Rahmanian-Schwarz A, Molnar V, H.-O. R, Gonser P, Willkomm L, Amr A, Held M, Schaller HE, Bernhard H. Dermal perfusion of common donor sites free flaps in chronic smokers and nonsmokers. EPLASTY 2011; 11:e52. [PMID: 22220217 PMCID: PMC3243457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The smoking behavior of the patient influences the indication of plastic surgeon in his reconstruction procedure on the assumption that smoking may increase the complication risks. In the present study, we evaluate the particular aspect of topographic differences in dermal perfusion in chronic smokers and nonsmokers. METHODS The perfusion parameter of 8 common donor sites for free flap transplantation were investigated in 152 smoking and nonsmoking subjects (n = 152; women: n = 78, 51%; men: n = 74, 49%; smokers: n = 38, 25%; nonsmokers: n = 114, 75%) using the O2C device (LAE Medizintechnik Giessen GmbH, Gießen, Germany). Oxygen saturation (%), relative hemoglobin concentration (AU [arbitrary unit]), Velocity (AU) and Flow (AU) were monitored noninvasively and compared. RESULTS All monitored regions did not show any significant differences in parameters oxygen saturation (smokers = 40%, nonsmokers = 44.5%), relative hemoglobin concentration (smokers = 60 AU, nonsmokers = 60 AU), flow (smokers = 19.5 AU, nonsmokers = 16.5 AU) and velocity (smokers = 10 AU, nonsmokers = 10 AU) between chronic smoking and nonsmoking subjects (P < .05). Also, a distinction between smokers and nonsmokers as a function of gender (women: n = 78, 51%; men: n = 74, 49%) showed no significant differences in all 4 parameters. CONCLUSIONS Varied statements regarding surgical complications in chronic and acute smokers were described in the literature. This raises the question of how far restricting the indication of reconstruction procedure for smoking patients due to higher complications is justified. In our study, there is no significant drop of dermal perfusion parameters after chronic tobacco consumption. Nonetheless, the unfavorable effects of smoking in general to human body and health remain undoubted.
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Affiliation(s)
- Afshin Rahmanian-Schwarz
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany,Correspondence:
| | - Viktor Molnar
- bDepartment of Plastic, Hand, Aesthetic and Burn Surgery, Stiftungsklinikum Mittelrhein, Koblenz, Germany
| | - Rennekampff H.-O.
- cDepartment of Plastic Surgery, Hand and Burns Surgery, University Aachen, Germany
| | - Phillipp Gonser
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
| | - Lina Willkomm
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
| | - Amro Amr
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
| | - Manuel Held
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
| | - Hans-Eberhard Schaller
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
| | - Hirt Bernhard
- aDepartment of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University Tuebingen, Germany
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Bengtsson C, Andersson SE, Edvinsson L, Edvinsson ML, Sturfelt G, Nived O. Effect of Medication on Microvascular Vasodilatation in Patients with Systemic Lupus Erythematosus. Basic Clin Pharmacol Toxicol 2010; 107:919-24. [DOI: 10.1111/j.1742-7843.2010.00604.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Minson CT. Thermal provocation to evaluate microvascular reactivity in human skin. J Appl Physiol (1985) 2010; 109:1239-46. [PMID: 20507974 DOI: 10.1152/japplphysiol.00414.2010] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
With increased interest in predictive medicine, development of a relatively noninvasive technique that can improve prediction of major clinical outcomes has gained considerable attention. Current tests that are the target of critical evaluation, such as flow-mediated vasodilation of the brachial artery and pulse-wave velocity, are specific to the larger conduit vessels. However, evidence is mounting that functional changes in the microcirculation may be an early sign of globalized microvascular dysfunction. Thus development of a test of microvascular reactivity that could be used to evaluate cardiovascular risk or response to treatment is an exciting area of innovation. This mini-review is focused on tests of microvascular reactivity to thermal stimuli in the cutaneous circulation. The skin may prove to be an ideal site for evaluation of microvascular dysfunction due to its ease of access and growing evidence that changes in skin vascular reactivity may precede overt clinical signs of disease. Evaluation of the skin blood flow response to locally applied heat has already demonstrated prognostic utility, and the response to local cooling holds promise in patients in whom cutaneous disorders are present. Whether either of these tests can be used to predict cardiovascular morbidity or mortality in a clinical setting requires further evaluation.
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Muir AD, McKeown PP, Bayraktutan U. Role of gender, smoking profile, hypertension, and diabetes on saphenous vein and internal mammary artery endothelial relaxation in patients with coronary artery bypass grafting. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2010; 3:199-205. [PMID: 20716944 PMCID: PMC2952078 DOI: 10.4161/oxim.3.3.11757] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Revised: 02/16/2010] [Accepted: 03/10/2010] [Indexed: 11/19/2022]
Abstract
The aim of this study was to investigate if there was a link between the relaxant responses in saphenous vein (SV) and internal mammary artery (IMA) segments obtained from patients undergoing coronary artery bypass grafting and the patients' cardiovascular risk factors. Endothelium-(in)dependent relaxations were assessed by isometric tension studies. Endothelium-dependent relaxant responses were greater in IMA than SV and gender, smoking profile and history of hypertension but not diabetes appeared to have an influence on these responses. Endothelium-dependent relaxant responses in both IMA and SV were greater in males than females and relaxant responses in IMA segments were attenuated in smokers, whereas the opposite effect was noted in SV segments. Endothelium-dependent relaxant responses in SV were lower in patients with hypertension. Endothelium-independent relaxant responses were greater in IMA than SV. Endothelium-independent responses were greater in male patients' SV segments, but gender played no role in IMA segments. Diabetes had no effect on endothelium-independent responses in IMA, but SV segments from diabetic patients had greater responses. Neither conduit's endothelium-independent response was affected by hypertensive status. The relationship between risk factor status and endothelial responses is multifactorial, with gender, hypertension, diabetes and smoking status all contributing.
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Affiliation(s)
- Andrew Duncan Muir
- Department of Medicine; Institute of Clinical science; Queen's University Belfast; Belfast, UK
| | - Pascal Patrick McKeown
- Department of Medicine; Institute of Clinical science; Queen's University Belfast; Belfast, UK
| | - Ulvi Bayraktutan
- Division of Stroke Medicine; Clinical Sciences Building; University of Nottingham; Nottingham City Hospital Campus; Nottingham, UK
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Muir AD, McKeown PP, Bayraktutan U. Role of gender, smoking profile, hypertension, and diabetes on saphenous vein and internal mammary artery endothelial relaxation in patients with coronary artery bypass grafting. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2010; 3. [PMID: 20716944 PMCID: PMC2952078 DOI: 10.4161/oxim.3.3.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of this study was to investigate if there was a link between the relaxant responses in saphenous vein (SV) and internal mammary artery (IMA) segments obtained from patients undergoing coronary artery bypass grafting and the patients' cardiovascular risk factors. Endothelium-(in)dependent relaxations were assessed by isometric tension studies. Endothelium-dependent relaxant responses were greater in IMA than SV and gender, smoking profile and history of hypertension but not diabetes appeared to have an influence on these responses. Endothelium-dependent relaxant responses in both IMA and SV were greater in males than females and relaxant responses in IMA segments were attenuated in smokers, whereas the opposite effect was noted in SV segments. Endothelium-dependent relaxant responses in SV were lower in patients with hypertension. Endothelium-independent relaxant responses were greater in IMA than SV. Endothelium-independent responses were greater in male patients' SV segments, but gender played no role in IMA segments. Diabetes had no effect on endothelium-independent responses in IMA, but SV segments from diabetic patients had greater responses. Neither conduit's endothelium-independent response was affected by hypertensive status. The relationship between risk factor status and endothelial responses is multifactorial, with gender, hypertension, diabetes and smoking status all contributing.
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Affiliation(s)
- Andrew Duncan Muir
- Department of Medicine; Institute of Clinical science; Queen's University Belfast; Belfast, UK
| | - Pascal Patrick McKeown
- Department of Medicine; Institute of Clinical science; Queen's University Belfast; Belfast, UK
| | - Ulvi Bayraktutan
- Division of Stroke Medicine; Clinical Sciences Building; University of Nottingham; Nottingham City Hospital Campus; Nottingham, UK
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Xu CB, Zheng JP, Zhang W, Zhang Y, Edvinsson L. Lipid-soluble smoke particles upregulate vascular smooth muscle ETB receptors via activation of mitogen-activating protein kinases and NF-kappaB pathways. Toxicol Sci 2008; 106:546-55. [PMID: 18718921 DOI: 10.1093/toxsci/kfn173] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cigarette smoke is a strong risk factor for cardiovascular disease. However, the underlying molecular mechanisms that lead to cigarette smoke-associated cardiovascular disease remain elusive. With functional and molecular methods, we demonstrate for the first time that lipid-soluble cigarette smoke particles (dimethylsulfoxide-soluble cigarette smoke particles; DSP) increased the expression of endothelin type B (ET(B)) receptors in arterial smooth muscle cells. The increased ET(B) receptors in arterial smooth muscle cells was documented as enhanced contractility (sensitive myograph technique), elevated levels of ET(B) receptor mRNA (quantitative real-time PCR), and protein expressions (immunohistochemistry and Western blotting). Intracellular signaling was studied with Western blotting and phosphoELISA; this revealed that DSP induced extracellular-regulated protein kinases 1 and 2 (ERK1/2), p38, and nuclear factor-kappaB (NF-kappaB) phosphorylation within 3 h. Blocking ERK1/2, p38, or NF-kappaB activation by their specific inhibitors significantly attenuated the DSP-induced upregulation of ET(B) receptor-mediated contraction and both ET(B) receptor mRNA and protein expression. In addition, dexamethasone abolished the DSP-induced upregulation of ET(B) receptor-mediated contraction. In conclusion, upregulation of ET(B) receptors by DSP in arterial smooth muscle cells involves activation of mitogen-activating protein kinases (ERK1/2 and p38) and the downstream transcriptional factor NF-kappaB pathways.
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Affiliation(s)
- Cang-Bao Xu
- Division of Experimental Vascular Research, Institute of Clinical Science in Lund, Lund University, 221 84 Lund, Sweden.
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