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Cífková R, Harazny JM, Bruthans J, Wohlfahrt P, Krajčoviechová A, Lánská V, Gelžinský J, Mateřánková M, Mareš Š, Filipovský J, Mayer O, Schmieder RE. Reference values of retinal microcirculation parameters derived from a population random sample. Microvasc Res 2020; 134:104117. [PMID: 33245956 DOI: 10.1016/j.mvr.2020.104117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/21/2020] [Accepted: 11/21/2020] [Indexed: 11/17/2022]
Abstract
Retinal microcirculation reflects retinal perfusion abnormalities and retinal arterial structural changes at relatively early stages of various cardiovascular diseases. Our objective has been to establish reference values for major functional and structural parameters of retinal microcirculation in a randomly selected urban population sample. A total of 398 randomly selected individuals from an urban population aged 25 to 65 years, resident in Pilsen, Czech Republic, were screened for major cardiovascular risk factors. Retinal microcirculation was assessed using scanning laser Doppler flowmetry (SLDF), with data evaluable in 343 patients. Of this number, complete data were available for 256 individuals free from manifest cardiovascular disease, diabetes and drug treatment for hypertension and/or dyslipidemia, constituting the reference value population. Juxtapapillary retinal capillary blood flow has increased significantly with age whereas vessel and luminal diameters have decreased. No sex differences in retinal microcirculation parameters have been found. Therefore, reference values for retinal microcirculation parameters have been established by age groups. Unattended automated office systolic BP, after adjusting for age, correlated significantly with wall-to-lumen ratio (WLR) and wall thickness (WT). Moreover, after adjusting for age and mean BP, a positive relationship has been found between carotid femoral pulse wave velocity and WT, WLR and wall cross-sectional area, indicating the interaction between micro- and macro-vasculature. In conclusion, our study is the first to provide reference values of retinal microcirculation parameters in a random Caucasian population sample. Our results have shown that, at the population level, the first structural changes in retinal microcirculation are those in lumen diameters. Of note, a close relationship between BP and vascular remodeling of retinal arterioles and between aortic stiffness and WLR of retinal arterioles suggests an interaction between micro- and macro-vasculature.
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Affiliation(s)
- Renata Cífková
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic; Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic.
| | - Joanna M Harazny
- Department of Nephrology and Hypertension, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany; Department of Human Physiology and Pathophysiology, University of Warmia and Mazury, Olsztyn, Poland
| | - Jan Bruthans
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic; 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Peter Wohlfahrt
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic
| | - Alena Krajčoviechová
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic
| | - Věra Lánská
- Medical Statistics Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Július Gelžinský
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Markéta Mateřánková
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Štěpán Mareš
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Jan Filipovský
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Otto Mayer
- 2nd Department of Internal Medicine, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Roland E Schmieder
- Department of Nephrology and Hypertension, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany
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Maruyama T, Kohno H, Ishida K, Ishizaka T, Funabashi N, Kobayashi Y, Matsumiya G. Change of luminal diameter of skeletonized and non-skeletonized radial artery graft at early and late postoperative period. Heart Vessels 2016; 31:474-81. [PMID: 25656931 DOI: 10.1007/s00380-015-0639-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 01/23/2015] [Indexed: 11/21/2022]
Abstract
The radial artery is increasingly used as a second arterial conduit for myocardial revascularization. However, the radial artery is susceptible to vasospasm, which is thought to be the principal cause of graft
failure. The radial artery is harvested as a skeletonized or a non-skeletonized graft, but the effect of different harvesting technique remains unknown. In this study, we compared the early- and mid-term angiographic findings to elucidate its influence on the graft luminal diameter. We harvested 39 radial arteries either as a skeletonized (n = 18) or a non-skeletonized graft (n = 21) using an ultrasonic scalpel. We constructed a composite straight graft by combining a right internal thoracic artery and a radial artery. All the radial artery grafts were sequentially anastomosed to coronary arteries. We measured the diameters of the radial arteries before the operation, within 1 month and 1 year after the operation. At early postoperative period, graft diameter was significantly larger in skeletonized grafts. Graft diameter at the point before the first and the second anastomosis was similar in skeletonized grafts, although that was significantly smaller before the second anastomosis in non-skeletonized grafts. However, 1 year after the operation, the graft diameter was comparable and equally reduced after the first anastomosis in both groups. Skeletonization with an ultrasonic scalpel increases the luminal diameter of the radial artery graft at early postoperative period, which, however, reduces possibly as adaptation to graft flow 1 year after the operation.
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