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Dillon GA, Stanhewicz AE, Serviente C, Greaney JL, Alexander LM. Hydrogen sulfide-dependent microvascular vasodilation is improved following chronic sulfhydryl-donating antihypertensive pharmacotherapy in adults with hypertension. Am J Physiol Heart Circ Physiol 2021; 321:H728-H734. [PMID: 34477463 DOI: 10.1152/ajpheart.00404.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hypertension is characterized by systemic microvascular endothelial dysfunction, in part due to a functional absence of hydrogen sulfide (H2S)-mediated endothelium-dependent dilation. Treatment with a sulfhydryl-donating ACE inhibitor (SH-ACE inhibitor) improves endothelial function in preclinical models of hypertension. To date, no studies have directly assessed the effects of SH-ACE-inhibitor treatment on H2S-dependent vasodilation in humans with hypertension. We hypothesized that SH-ACE-inhibitor treatment would improve H2S-mediated endothelium-dependent vasodilation. Ten adults with hypertension [1 woman and 9 men; 56 ± 9 yr; systolic blood pressure (SBP): 141 ± 8.5 mmHg; diastolic blood pressure (DBP): 90.3 ± 6 mmHg] were treated (16 wk) with the SH-ACE-inhibitor captopril. Red blood cell flux (laser-Doppler flowmetry) was measured continuously during graded intradermal microdialysis perfusion of the endothelium-dependent agonist acetylcholine (ACh; 10-10 to 10-1 M) alone (control) and in combination with an inhibitor of enzymatic H2S production [10-3 M aminooxyacetate (AOAA)] preintervention and postintervention. Cutaneous vascular conductance (CVC; flux/mmHg) was calculated and normalized to the site-specific maximal CVC (0.028 M sodium nitroprusside and local heat to 43°C). Area under the curve was calculated using the trapezoid method. The 16-wk SH-ACE-inhibitor treatment resulted in a reduction of blood pressure (systolic BP: 129 ± 10 mmHg; diastolic BP: 81 ± 9 mmHg, both P < 0.05). Preintervention, inhibition of H2S production had no effect on ACh-induced vasodilation (316 ± 40 control vs. 322 ± 35 AU AOAA; P = 0.82). Captopril treatment improved ACh-induced vasodilation (316 ± 40 pre vs. 399 ± 55 AU post; P = 0.04) and increased the H2S-dependent component of ACh-induced vasodilation (pre: -6.6 ± 65.1 vs. post: 90.2 ± 148.3 AU, P = 0.04). These data suggest that SH-ACE-inhibitor antihypertensive treatment improves cutaneous microvascular endothelium-dependent vasodilation in adults with hypertension, in part via H2S-dependent mechanisms.NEW & NOTEWORTHY This is the first study to prospectively assess the effects of sulfhydryl antihypertensive treatment on microvascular endothelial function in adults with hypertension. Our data suggest that 16 wk of SH-ACE-inhibitor antihypertensive treatment improves cutaneous microvascular endothelium-dependent vasodilation in middle-aged adults with hypertension, in part via H2S-dependent mechanisms.
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Affiliation(s)
- Gabrielle A Dillon
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - Anna E Stanhewicz
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Department of Health and Human Physiology, The University of Iowa, Iowa City, Iowa
| | - Corinna Serviente
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania.,Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, Massachusetts.,Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Jody L Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Department of Kinesiology, University of Texas Arlington, Arlington, Texas
| | - Lacy M Alexander
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
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Glazkova PA, Kulikov DA, Glazkov AA, Terpigorev SA, Rogatkin DA, Shekhyan GG, Krasulina KA, Kulikov AV, Makmatov-Rys MB, Paleev FN. Reactivity of skin microcirculation as a biomarker of cardiovascular events. Pilot study. Clin Hemorheol Microcirc 2021; 78:247-257. [PMID: 33682698 DOI: 10.3233/ch-201016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The role of microcirculatory disorders is progressively being accepted in the pathogenesis of cardiovascular diseases. OBJECTIVE The purpose of current study is to assess whether we can consider skin microcirculation disorders as a biomarker of cardiovascular events. METHODS Group 1 consisted of healthy volunteers (n = 31); group 2 (n = 42) consisted of patients with diseases that increase the risk of cardiovascular events; group 3 (n = 39) included patients with the history of cardiovascular events. Skin microcirculation measurement was performed using laser Doppler flowmetry during the heating test. RESULTS LDF parameters reflecting the rapid response of microcirculation to heating ("Slope 120 s" and "Slope 180 s") significantly differed in three groups (p < 0.05). A decrease in the "Slope 180 s" parameter less than 0.5 PU/s is associated with cardiovascular events (sensitivity 69.2%, specificity 66.7%; the area under the ROC curve, 0.667; 95% confidence interval [CI], 0.545-0.788, p = 0.01). Multivariable logistic regression analysis revealed that "Slope 180 s≤0.5 PU/s" was significantly related to cardiovascular events (adjusted odds ratio = 3.9, p = 0.019, CI 95% 1.2-12). CONCLUSIONS Reduced reactivity of the skin microcirculation may be useful as a biomarker of severe damage to the cardiovascular system and is promising as a risk factor for cardiovascular events.
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Affiliation(s)
- P A Glazkova
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - D A Kulikov
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation.,Moscow Region State University, Mytishchi, Russian Federation
| | - A A Glazkov
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - S A Terpigorev
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - D A Rogatkin
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - G G Shekhyan
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - K A Krasulina
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - A V Kulikov
- Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Russian Federation
| | - M B Makmatov-Rys
- Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation
| | - F N Paleev
- National medical research center of cardiology of the Ministry of healthcare of the Russian Federation, Moscow, Russian Federation
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Dillon GA, Greaney JL, Shank S, Leuenberger UA, Alexander LM. AHA/ACC-defined stage 1 hypertensive adults do not display cutaneous microvascular endothelial dysfunction. Am J Physiol Heart Circ Physiol 2020; 319:H539-H546. [PMID: 32734817 DOI: 10.1152/ajpheart.00179.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) redefined stage 1 hypertension to systolic blood pressure (BP) 130-139 mmHg or diastolic BP 80-89 mmHg; however, the degree to which microvascular endothelial dysfunction is evident in adults with stage 1 hypertension remains equivocal. We tested the hypotheses that cutaneous microvascular endothelial dysfunction would be present in adults with stage 1 hypertension (HTN1) compared with normotensive adults (NTN; BP <120/<80 mmHg) but would be less severe compared with adults with stage 2 hypertension (HTN2; systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) and that this graded impairment would be mediated by reductions in nitric oxide (NO)-dependent dilation. This retrospective analysis included 20 NTN (5 men; 45-64 yr; BP 94-114/60-70 mmHg), 22 HTN1 (11 men; 40-74 yr; BP 110-134/70-88 mmHg), and 44 HTN2 (27 men; 40-74 yr; BP 128-180/80-110 mmHg). BP and nocturnal dipping status were also assessed using 24-h ambulatory BP monitoring. Red cell flux (laser Doppler flowmetry) was measured during intradermal microdialysis perfusion of acetylcholine (ACh; 10-10 to 10-1M) alone and concurrently with the nonspecific nitric oxide (NO) synthase inhibitor NG-nitro-l-arginine methyl ester (l-NAME; 15 mM). ACh-induced dilation was impaired in HTN2 (P < 0.01), but not in HTN1 (P = 0.85), compared with NTN. Furthermore, reductions in NO-dependent dilation were evident in HTN2 (P < 0.01) but not in HTN1 (P = 0.76). Regardless of BP, endothelium-dependent dilation was impaired in nondippers (nighttime drop in systolic BP <10%) compared with dippers (nighttime drop in systolic BP ≥10%, P < 0.05). In conclusion, functional impairments in NO-mediated endothelium-dependent dilation were not evident in HTN1. However, regardless of BP classification, the lack of a nocturnal dip in BP was associated with blunted endothelium-dependent dilation.NEW & NOTEWORTHY This is the first study to pharmacologically assess the mechanistic regulation of endothelial function in adults with hypertension, classified according to the 2017 clinical guidelines set for by the American Heart Association (AHA) and American College of Cardiology (ACC). Compared with that in normotensive adults, nitric oxide-mediated endothelium-dependent dilation is impaired in adults with stage 2, but not stage 1, hypertension. Adults lacking a nighttime dip in blood pressure demonstrated reductions in endothelium-dependent dilation.
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Affiliation(s)
- Gabrielle A Dillon
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Jody L Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Department of Kinesiology, University of Texas Arlington, Arlington, Texas
| | - Sean Shank
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Urs A Leuenberger
- Department of Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania
| | - Lacy M Alexander
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
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Clough GF, Kuliga KZ, Chipperfield AJ. Flow motion dynamics of microvascular blood flow and oxygenation: Evidence of adaptive changes in obesity and type 2 diabetes mellitus/insulin resistance. Microcirculation 2018; 24. [PMID: 27809397 DOI: 10.1111/micc.12331] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
An altered spatial heterogeneity and temporal stability of network perfusion can give rise to a limited adaptive ability to meet metabolic demands. Derangement of local flow motion activity is associated with reduced microvascular blood flow and tissue oxygenation, and it has been suggested that changes in flow motion activity may provide an early indicator of declining, endothelial, neurogenic, and myogenic regulatory mechanisms and signal the onset and progression of microvascular pathophysiology. This short conference review article explores some of the evidence for altered flow motion dynamics of blood flux signals acquired using laser Doppler fluximetry in the skin in individuals at risk of developing or with cardiometabolic disease.
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Affiliation(s)
| | - Katarzyna Z Kuliga
- Faculty of Medicine, University of Southampton, Southampton, UK.,Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - Andrew J Chipperfield
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
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Kuliga KZ, Gush R, Clough GF, Chipperfield AJ. Time-dependent Behavior of Microvascular Blood Flow and Oxygenation: a Predictor of Functional Outcomes. IEEE Trans Biomed Eng 2017; 65:1049-1056. [DOI: 10.1109/tbme.2017.2737328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bruning RS, Kenney WL, Alexander LM. Altered skin flowmotion in hypertensive humans. Microvasc Res 2014; 97:81-7. [PMID: 24418051 DOI: 10.1016/j.mvr.2014.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 12/11/2013] [Accepted: 01/01/2014] [Indexed: 01/10/2023]
Abstract
Essential hypertensive humans exhibit attenuated cutaneous nitric oxide (NO)-dependent vasodilation. Using spectral analysis (fast Fourier transformation) we aimed to characterize the skin flowmotion contained in the laser-Doppler flowmetry recordings during local heating-induced vasodilation before and after concurrent pharmacological inhibition of nitric oxide synthase (NOS) in hypertensive and age-matched normotensive men and women. We hypothesized that hypertensive subjects would have lower total power spectral densities (PSDs), specifically in the frequency intervals associated with intrinsic endothelial and neurogenic control of the microvasculature. Furthermore, we hypothesized that NOS inhibition would attenuate the endothelial frequency interval. Laser-Doppler flowmetry recordings during local heating experiments from 18 hypertensive (MAP: 108±2mmHg) and 18 normotensive (MAP: 88±2mmHg) men and women were analyzed. Within site NO-dependent vasodilation was assessed by perfusion of a non-specific NOS inhibitor (N(G)-nitro-l-arginine methyl ester; l-NAME) through intradermal microdialysis during the heating-induced plateau in skin blood flow. Local heating-induced vasodilation increased total PSD for all frequency intervals (all p<0.001). Hypertensives had a lower total PSD (p=0.03) and absolute neurogenic frequency intervals (p<0.01) compared to the normotensives. When normalized as a percentage of total PSD, hypertensives had reduced neurogenic (p<0.001) and augmented myogenic contributions (p=0.04) to the total spectrum. NOS inhibition decreased total PSD (p<0.001) for both groups, but hypertensives exhibited lower absolute endothelial (p<0.01), neurogenic (p<0.05), and total PSD (p<0.001) frequency intervals compared to normotensives. These data suggest that essential hypertension results in altered neurogenic and NOS-dependent control of skin flowmotion and support the use of spectral analysis as a non-invasive technique to study vasoreactivity.
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Affiliation(s)
- R S Bruning
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802-6900, USA
| | - W L Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802-6900, USA
| | - L M Alexander
- Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802-6900, USA.
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