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Zharkikh EV, Loktionova YI, Fedorovich AA, Gorshkov AY, Dunaev AV. Assessment of Blood Microcirculation Changes after COVID-19 Using Wearable Laser Doppler Flowmetry. Diagnostics (Basel) 2023; 13:diagnostics13050920. [PMID: 36900064 PMCID: PMC10000665 DOI: 10.3390/diagnostics13050920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
The present work is focused on the study of changes in microcirculation parameters in patients who have undergone COVID-19 by means of wearable laser Doppler flowmetry (LDF) devices. The microcirculatory system is known to play a key role in the pathogenesis of COVID-19, and its disorders manifest themselves long after the patient has recovered. In the present work, microcirculatory changes were studied in dynamics on one patient for 10 days before his disease and 26 days after his recovery, and data from the group of patients undergoing rehabilitation after COVID-19 were compared with the data from a control group. A system consisting of several wearable laser Doppler flowmetry analysers was used for the studies. The patients were found to have reduced cutaneous perfusion and changes in the amplitude-frequency pattern of the LDF signal. The obtained data confirm that microcirculatory bed dysfunction is present in patients for a long period after the recovery from COVID-19.
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Affiliation(s)
- Elena V. Zharkikh
- Research and Development Center of Biomedical Photonics, Orel State University, Komsomolskaya 95, Orel 302026, Russia
- Correspondence:
| | - Yulia I. Loktionova
- Research and Development Center of Biomedical Photonics, Orel State University, Komsomolskaya 95, Orel 302026, Russia
| | - Andrey A. Fedorovich
- Research and Development Center of Biomedical Photonics, Orel State University, Komsomolskaya 95, Orel 302026, Russia
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Petroverigsky 10, Moscow 101990, Russia
| | - Alexander Y. Gorshkov
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of the Russian Federation, Petroverigsky 10, Moscow 101990, Russia
| | - Andrey V. Dunaev
- Research and Development Center of Biomedical Photonics, Orel State University, Komsomolskaya 95, Orel 302026, Russia
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Kralj L, Lenasi H. Wavelet analysis of laser Doppler microcirculatory signals: Current applications and limitations. Front Physiol 2023; 13:1076445. [PMID: 36741808 PMCID: PMC9895103 DOI: 10.3389/fphys.2022.1076445] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/28/2022] [Indexed: 01/21/2023] Open
Abstract
Laser Doppler flowmetry (LDF) has long been considered a gold standard for non-invasive assessment of skin microvascular function. Due to the laser Doppler (LD) microcirculatory signal's complex biological and physiological context, using spectral analysis is advisable to extract as many of the signal's properties as feasible. Spectral analysis can be performed using either a classical Fourier transform (FT) technique, which has the disadvantage of not being able to localize a signal in time, or wavelet analysis (WA), which provides both the time and frequency localization of the inspected signal. So far, WA of LD microcirculatory signals has revealed five characteristic frequency intervals, ranging from 0.005 to 2 Hz, each of which being related to a specific physiological influence modulating skin microcirculatory response, providing for a more thorough analysis of the signals measured in healthy and diseased individuals. Even though WA is a valuable tool for analyzing and evaluating LDF-measured microcirculatory signals, limitations remain, resulting in a lack of analytical standardization. As a more accurate assessment of human skin microcirculation may better enhance the prognosis of diseases marked by microvascular dysfunction, searching for improvements to the WA method is crucial from the clinical point of view. Accordingly, we have summarized and discussed WA application and its limitations when evaluating LD microcirculatory signals, and presented insight into possible future improvements. We adopted a novel strategy when presenting the findings of recent studies using WA by focusing on frequency intervals to contrast the findings of the various studies undertaken thus far and highlight their disparities.
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Affiliation(s)
- Lana Kralj
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Helena Lenasi
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia,*Correspondence: Helena Lenasi,
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Korolev AI, Fedorovich AA, Gorshkov AY, Dadaeva VA, Omelyanenko KV, Chashchin MG, Drapkina OM. Structural and functional state of various parts of skin microcirculation at an early stage of hypertension in working-age men. Microvasc Res 2023; 145:104440. [PMID: 36150473 DOI: 10.1016/j.mvr.2022.104440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/05/2022] [Accepted: 09/16/2022] [Indexed: 02/03/2023]
Abstract
STUDY PURPOSE To conduct a cross-sectional study on the structural and functional characteristics of various parts of skin microcirculation in working-age men with newly diagnosed hypertension (HTN). MATERIALS AND METHODS The study included 118 male participants (ages 30 to 60) who were not regularly taking any medicine, had no medical complaints, and subjectively considered themselves healthy at the time of study. All participants underwent a cross-sectional comprehensive medical examination. The following tests were performed: complete blood count, biochemical blood tests, video capillaroscopy (VCS), laser Doppler flowmetry (LDF) and photoplethysmography (PPG) on the left hand fingers, determination of flow-mediated vasodilation of the brachial artery, echocardiography, ultrasound of extracranial and femoral arteries, 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM data, the participants were divided into two equal groups called a control group(CG) and a hypertension group(HG). There were 59 participants with normal BP in CG, and 59 participants with newly diagnosed HTN in HG. RESULTS Nailfold VCS of the ring finger revealed no significant differences between the groups at the level of exchange microvessels. According to LDF data, there was no decrease in tissue perfusion and signs of an increase in the activity of endothelial, neurogenic, and myogenic regulation of the tone of precapillary arterioles in the HTN group. According to PPG of the index finger, in contrast to CG, HTN participants had significantly higher values of the following parameters: normalized augmentation index (Alp75) - 3.8 % and - 5.25 % (p < 0.005), stiffness index (SI) - 7.6 m/s and 7.35 m/s (p < 0.05), reflection index (RI) - 36.5 % and 28.4 % (p < 0.005), respectively. DISCUSSION Working-age men in the early stage of HTN have neither capillary rarefaction nor an increase in the tone of skin precapillary arterioles. The largest contribution to peripheral vascular resistance in the onset of HTN is most likely made by large muscular arterioles, in which the neurogenic regulation of vascular tone predominates.
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Affiliation(s)
- A I Korolev
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia.
| | - A A Fedorovich
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia; Institute of Biomedical Problems, Russian Academy of Sciences, Khoroshyovskoe sh., 76, building 4, Moscow 123007, Russia
| | - A Yu Gorshkov
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia
| | - V A Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia; Peoples' Friendship University of Russia, Miklukho-Maklaya str., 6, Moscow 117198, Russia
| | - K V Omelyanenko
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia
| | - M G Chashchin
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia
| | - O M Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, Petroverigsky per., 10, building 3, Moscow 101990, Russia
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Fedorovich A, Loktionova Y, Zharkikh E, Gorshkov A, Korolev A, Dadaeva V, Drapkina O, Zherebtsov E. Skin microcirculation in middle-aged men with newly diagnosed arterial hypertension according to remote laser Doppler flowmetry data. Microvasc Res 2022; 144:104419. [DOI: 10.1016/j.mvr.2022.104419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 08/02/2022] [Indexed: 10/31/2022]
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Korolev AI, Fedorovich AA, Gorshkov AY, Dadaeva VA, Kim OT, Omelyanenko KV, Mikhaylova MA, Vasilyev DK, Dzhioeva ON, Akasheva DU, Drapkina OM. Parameters of cutaneous microvasculature in men of working age with newly diagnosed arterial hypertension. Clin Hemorheol Microcirc 2021; 80:373-387. [PMID: 34719487 DOI: 10.3233/ch-211292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate structural and functional features of cutaneous microvasculature in men of working age with newly diagnosed arterial hypertension (AH). MATERIALS AND METHODS The study included 161 apparently healthy men from 30 to 60 years, who underwent a comprehensive examination of cardiovascular system "from the heart to the capillaries". Control group (CG) included 60 normotensive men. AH group included 101 men with elevated BP. RESULTS There is no rarefaction of the capillary bed and latent fluid retention in the interstitial space in the skin in men with AH. No data were obtained for increased endothelial, neurogenic and myogenic tone of resistive cutaneous precapillary arterioles in AH group, but a decrease in the perfusion efficiency of the endothelial and myogenic mechanisms of tissue perfusion modulation was noted. CONCLUSION Obtained results allow making the assumption that metabolic disorders at the level of capillaries that are of a systemic nature prevail in men with the onset of AH.
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Affiliation(s)
- A I Korolev
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - A A Fedorovich
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia.,FSBI SRC RF "Institute of Biomedical Problems" RAS, Moscow, Russia
| | - A Yu Gorshkov
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - V A Dadaeva
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - O T Kim
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - K V Omelyanenko
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - M A Mikhaylova
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - D K Vasilyev
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - O N Dzhioeva
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - D U Akasheva
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
| | - O M Drapkina
- FSBI "National Health and Research Center of Preventive Healthcare" of the Ministry of Health of Russia, Moscow, Russia
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Mechanisms of Venoarteriolar Reflex in Type 2 Diabetes with or without Peripheral Neuropathy. BIOLOGY 2021; 10:biology10040333. [PMID: 33920825 PMCID: PMC8071175 DOI: 10.3390/biology10040333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022]
Abstract
Simple Summary Postural changes induce arteriolar vasoconstriction in response to an increase in venous pressure in the limbs known as the venoarteriolar reflex (VAR). Previous studies reported that skin blood perfusion is impaired during the VAR in persons with type 2 diabetes mellitus (T2DM) with or without peripheral neuropathy, compared to control subjects. The aim of this study is to investigate the underlying mechanisms of the VAR in T2DM, with and without peripheral neuropathy. This study provides evidence that confirmed neuropathy alters the VAR by an alteration of the neurogenic response to leg dependency. Abstract The aim of this study is to investigate the underlying mechanisms of the venoarteriolar reflex (VAR) in type 2 diabetes mellitus (T2DM), with and without peripheral neuropathy. Laser Doppler flowmetry (LDF) recordings were performed on the medial malleus and dorsal foot skin, before and during leg dependency in healthy controls, in persons with obesity, in those with T2DM, in those with T2DM and subclinical neuropathy, and in those with T2DM and confirmed neuropathy. LDF recordings were analyzed with the wavelet transform to evaluate the mechanisms controlling the flowmotion (i.e., endothelial nitric oxide-independent and -dependent, neurogenic, myogenic, respiratory and cardiac mechanisms). Skin blood perfusion decreased throughout leg dependency at both sites. The decrease was blunted in persons with confirmed neuropathy compared to those with T2DM alone and the controls. During leg dependency, total spectral power increased in all groups compared to rest. The relative contribution of the endothelial bands increased and of the myogenic band decreased, without differences between groups. Neurogenic contribution decreased in controls, in persons with obesity and in those with T2DM, whereas it increased in subclinical- and confirmed neuropathy. In conclusion, this study provides evidence that confirmed diabetic neuropathy alters the VAR through the neurogenic response to leg dependency.
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Body Position Affects Capillary Blood Flow Regulation Measured with Wearable Blood Flow Sensors. Diagnostics (Basel) 2021; 11:diagnostics11030436. [PMID: 33806328 PMCID: PMC7999838 DOI: 10.3390/diagnostics11030436] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/24/2021] [Accepted: 02/24/2021] [Indexed: 11/17/2022] Open
Abstract
In this study we demonstrate what kind of relative alterations can be expected in average perfusion and blood flow oscillations during postural changes being measured in the skin of limbs and on the brow of the forehead by wearable laser Doppler flowmetry (LDF) sensors. The aims of the study were to evaluate the dynamics of cutaneous blood perfusion and the regulatory mechanisms of blood microcirculation in the areas of interest, and evaluate the possible significance of those effects for the diagnostics based on blood perfusion monitoring. The study involved 10 conditionally healthy volunteers (44 ± 12 years). Wearable laser Doppler flowmetry monitors were fixed at six points on the body: two devices were fixed on the forehead, on the brow; two were on the distal thirds of the right and left forearms; and two were on the distal thirds of the right and left lower legs. The protocol was used to record three body positions on the tilt table for orthostatic test for each volunteer in the following sequence: (a) supine body position; (b) upright body position (+75°); (c) tilted with the feet elevated above the head and the inclination of body axis of 15° (−15°, Trendelenburg position). Skin blood perfusion was recorded for 10 min in each body position, followed by the amplitude–frequency analysis of the registered signals using wavelet decomposition. The measurements were supplemented with the blood pressure and heart rate for every body position analysed. The results identified a statistically significant transformation in microcirculation parameters of the average level of skin blood perfusion and oscillations of amplitudes of neurogenic, myogenic and cardiac sensors caused by the postural changes. In paper, we present the analysis of microcirculation in the skin of the forehead, which for the first time was carried out in various positions of the body. The area is supplied by the internal carotid artery system and can be of particular interest for evaluation of the sufficiency of blood supply for the brain.
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Reynès C, Vinet A, Maltinti O, Knapp Y. Minimizing the duration of laser Doppler flowmetry recordings while maintaining wavelet analysis quality: A methodological study. Microvasc Res 2020; 131:104034. [DOI: 10.1016/j.mvr.2020.104034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
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9
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Konschake W, Lutze S, Haase H, Jünger M, Arnold A. Analysis of pigmented skin lesions and malignant melanoma by Laser Doppler flowmetry - Report of different cases and further analysis by a neuronal network. Clin Hemorheol Microcirc 2020; 76:525-533. [PMID: 32924991 DOI: 10.3233/ch-200876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dermatoscopy is successfully used for the early diagnosis of suspicious skin lesions, however, correct diagnosis depends on training. There is evidence that wavelet analysis by Laser Doppler flowmetry (LDF) can identify malignant melanomas by their hypervascularization and changes in the capillary morphology. OBJECTIVE To show the capability of LDF in the distinction of melanomas and benign pigmented skin lesions based on data collected over 16 years. METHODS Evaluation of pigmented skin lesions was based on clinical information. The LDF measurements were taken. The suspect lesion was excised afterwards for histological work-up. Four case reports are presented. Data collected over 16 years was processed into a neuronal network to estimate the dignity of the lesion. RESULTS A total of 517 suspicious lesions were analyzed by LDF. In the histological work-up, 114 lesions turned out to be melanomas, whereas 403 benign naevi were secured. Specificity to detect melanomas was good based on the clinical information. The LDF increases the sensitivity of melanoma detection, which is also illustrated in four case reports. CONCLUSION In addition to clinical parameters, such as color and border, information from the LDF can help in the diagnosis of malignant melanomas. The LDF provides information on the vascularization of the skin lesion.
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Affiliation(s)
- Wolfgang Konschake
- Department of Dermatology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Stine Lutze
- Department of Dermatology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Hermann Haase
- Department of Dermatology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Michael Jünger
- Department of Dermatology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Andreas Arnold
- Department of Dermatology, Universitätsmedizin Greifswald, Greifswald, Germany
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Pettersen EM, Avdal J, Hisdal J, Torp H, Seternes A. Validation of a novel ultrasound Doppler monitoring device (earlybird) for detection of microvascular circulatory changes. Clin Hemorheol Microcirc 2019; 74:429-440. [PMID: 31743988 DOI: 10.3233/ch-190707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE In this proof-of-concept study we aim to validate a novel ultrasound Doppler monitoring device for evaluating microcirculation (earlybird) against LDF and pulsed Doppler. METHODS In ten healthy subjects, we measured microcirculatory function at rest and during different autonomic tests (forced respiration, isometric exercise, Valsalva maneuver and cold pressor). Earlybird, LDF and pulsed Doppler were recorded simultaneously. We performed a ZNCC to determine correlation. RESULTS The curves for earlybird and LDF or pulsed Doppler correlates visually well. Overall median ZNCC 0.87 (interquartile range 0.77 -0.91) between the LDF and earlybird measurements, and 0.90 (0.82 - 0.95) for pulsed Doppler and earlybird. Median ZNCC for baseline and each provocation test for earlybird against LDF and pulsed Doppler were calculated; baseline: LDF 0.87 (0.73 - 0.97) pulsed Doppler 0.91 (0.81 - 0.94), forced respiration: LDF 0.87 (0.28 - 0.90) pulsed Doppler 0.90 (0.85 - 0.96), isometric exercise: LDF 0.82 (0.59 - 0.90) pulsed Doppler 0.87 (0.68 - 0.94), Valsalva maneuver: LDF 0.88 (0.82 - 0.91) pulsed Doppler 0.94 (0.92 - 0.97) and cold pressor: LDF 0.90 (0.85 - 0.95) pulsed Doppler 0.89 (0.65 - 0.94). CONCLUSION Earlybird records vasoconstrictions in healthy subjects as well as LDF and pulsed Doppler.
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Affiliation(s)
- Erik Mulder Pettersen
- Department of Surgery, Sørlandet Sykehus Kristiansand, Kristiansand, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jørgen Avdal
- Department of Circulation and Medical Imaging, CIUS/NTNU/St. Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jonny Hisdal
- Department of Vascular Surgery, Section of Vascular Investigations, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Hans Torp
- Department of Circulation and Medical Imaging, CIUS/NTNU/St. Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway
| | - Arne Seternes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Vascular Surgery, St. Olavs Hospital, Trondheim, Norway
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Grambow E, Dau M, Sandkühler NA, Leuchter M, Holmer A, Klar E, Weinrich M. Evaluation of peripheral artery disease with the TIVITA® Tissue hyperspectral imaging camera system. Clin Hemorheol Microcirc 2019; 73:3-17. [DOI: 10.3233/ch-199215] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Eberhard Grambow
- Department for General, Visceral, Vascular and Transplantation Surgery, University Medical Center Rostock, Rostock, Germany
| | - Michael Dau
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| | - Niels Arne Sandkühler
- Department for General, Visceral, Vascular and Transplantation Surgery, University Medical Center Rostock, Rostock, Germany
| | - Matthias Leuchter
- Department for General, Visceral, Vascular and Transplantation Surgery, University Medical Center Rostock, Rostock, Germany
| | | | - Ernst Klar
- Department for General, Visceral, Vascular and Transplantation Surgery, University Medical Center Rostock, Rostock, Germany
| | - Malte Weinrich
- Department for General, Visceral, Vascular and Transplantation Surgery, University Medical Center Rostock, Rostock, Germany
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12
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Vosseler M, El Shazly A, Parker JD, Münzel T, Gori T. Resting and recruitable endothelial function - Evidence of two distinct circadian patterns. Clin Hemorheol Microcirc 2019; 74:139-146. [PMID: 31322551 DOI: 10.3233/ch-190587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Evidence of a circadian rhythm in endothelium-dependent vasomotor function, with a nadir in Flow-Mediated Dilation (FMD) in the early morning hours, has been previously reported. These changes have been proposed to be one of the mechanisms explaining the circadian pattern in the incidence of cardiovascular events. We set out to investigate the circadian rhythm of FMD, low-flow mediated dilation (L-FMC) and sympathetic vascular tone. METHODS AND RESULTS 10 young healthy male volunteers (mean age, 28.9±3.7 years) underwent measurements of radial artery endothelium-dependent FMD and L-FMC at 8AM, 2PM and 8PM on the same day. Sympathetic vascular tone was assessed with laser Doppler and Fourier transform analysis. Compared with 2PM and 8PM, FMD decreased markedly in the early morning (2.9±3.4%; 6.2±2.9%; 6.0±4.0%; P = 0.007). In contrast, L-FMC was maximal at 8AM, decreased significantly at 2PM, and returned to higher values at 8PM (-5.1±1.3%; -2.7±2.0%; -4.6±2.2%; P = 0.030), such that the composite endpoint of endothelial function (sum of FMD+L-FMC) was not significantly different among timepoints. Vascular sympathetic tone was maximal early in the morning and lowest in the evening (P = 0.014) without a correlation with the changes in FMD or L-FMC. CONCLUSIONS Endothelial responsiveness (FMD) and basal tone (L-FMC) appear to follow different circadian rhythms, with an impaired responsiveness in the early morning and a nadir in baseline tone in the early afternoon.
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Affiliation(s)
- Markus Vosseler
- Kardiologie 1, University Medical Center Mainz, Germany and DZHK, Standort Rhein-Main, Germany
| | - Ahmed El Shazly
- Kardiologie 1, University Medical Center Mainz, Germany and DZHK, Standort Rhein-Main, Germany
| | - John D Parker
- Department of Cardiology, Mount Sinai Hospital, Toronto, Canada
| | - Thomas Münzel
- Kardiologie 1, University Medical Center Mainz, Germany and DZHK, Standort Rhein-Main, Germany
| | - Tommaso Gori
- Kardiologie 1, University Medical Center Mainz, Germany and DZHK, Standort Rhein-Main, Germany
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Bagno A, Martini R. Bridging the gap between basic research on microcirculation and clinical world: The translational marriage between engineering and medicine. Clin Hemorheol Microcirc 2018; 71:357-363. [PMID: 29865047 DOI: 10.3233/ch-180415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The words "Translational" and "Medicine" have been recently coupled to indicate a combination of disciplines, resources, expertise, and techniques aimed at enhancing prevention, diagnosis, and therapies. As stated in 2015 by the European Society for Translational Medicine, translational medicine is "an interdisciplinary branch of the biomedical field supported by three main pillars: benchside, bedside and community". By definition, Translational Medicine is a highly interdisciplinary field, which gathers several specialties aimed at improving the global healthcare system.With regard to the assessment of the microcirculatory function, it is worthwhile to mention the growing interest from both basic research and clinical practice. Microcirculation is where the exchange of substances between blood and tissues takes place. Thus, it plays a key role in the pathophysiology of many diseases. Nonetheless, a gap does exist between the theoretical analysis of the microcirculatory function and its clinical exploitation. This gap can be due to the weak dissemination of analytical methods and theoretical results within the clinical community, which also delays the establishment of specific operative guidelines.This paper aims at encouraging, and possibly accelerating, the translation of basic research outcomes on microcirculatory function assessment into clinical applications.
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Affiliation(s)
- Andrea Bagno
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Romeo Martini
- UOC of Angiology, Azienda Ospedale Università di Padova, Padova, Italy
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