Microcirculation最新文献_第3页

Significant Association of Serum Albumin With the Severity of Coronary Microvascular Dysfunction Using Dynamic CZT-SPECT 使用动态 CZT-SPECT 检测血清白蛋白与冠状动脉微血管功能障碍严重程度的关系

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation

Pub Date : 2024-05-01 DOI: 10.1111/micc.12853

Shih-Chieh Chien, Shan-Ying Wang, Cheng-Ting Tsai, Yu-Chien Shiau, Yen-Wen Wu

Objective

Both low serum albumin (SA) concentration and coronary microvascular dysfunction (CMD) are risk factors for the development of heart failure (HF). We hypothesized that SA concentration is associated with myocardial flow reserve (MFR) and implicated in pathophysiological mechanism of HF.

Methods

We retrospectively studied 454 patients undergoing dynamic cardiac cadmium-zinc-telluride myocardial perfusion imaging from April 2018 to February 2020. The population was categorized into three groups according to SA level (g/dL): Group 1: >4, Group 2: 3.5–4, and Group 3: <3.5. Myocardial blood flow (MBF) and myocardial flow reserve (MFR, defined as stress/rest MBF ratio) were compared.

Results

The mean age of the whole cohort was 66.2 years, and 65.2% were men. As SA decreased, stress MBF (mL min⁻¹ g⁻¹) and MFR decreased (MBF: 3.29 ± 1.03, MFR: 3.46 ± 1.33 in Group 1, MBF: 2.95 ± 1.13, MFR: 2.51 ± 0.93 in Group 2, and MBF: 2.64 ± 1.16, MFR: 1.90 ± 0.50 in Group 3), whereas rest MBF (mL min⁻¹ g⁻¹) increased (MBF: 1.05 ± 0.42 in Group 1, 1.27 ± 0.56 in Group 2, and 1.41 ± 0.61 in Group 3). After adjusting for covariates, compared with Group 1, the odds ratios for impaired MFR (defined as MFR < 2.5) were 3.57 (95% CI: 2.32–5.48) for Group 2 and 34.9 (95% CI: 13.23–92.14) for Group 3. The results would be similar if only regional MFR were assessed. The risk prediction for CMD using SA was acceptable, with an AUC of 0.76.

Conclusion

Low SA concentration was associated with the severity of CMD in both global and regional MFR as well as MBF.

目的低血清白蛋白（SA）浓度和冠状动脉微血管功能障碍（CMD）都是心力衰竭（HF）发病的危险因素。我们假设 SA 浓度与心肌血流储备（MFR）相关，并与 HF 的病理生理机制有关。方法我们回顾性研究了 2018 年 4 月至 2020 年 2 月期间接受动态心脏镉锌碲心肌灌注成像的 454 例患者。根据SA水平（g/dL）将人群分为三组：第一组：>4，第二组：3.5-4，第三组：<3.5。比较了心肌血流（MBF）和心肌血流储备（MFR，定义为应激/静息 MBF 比值）。结果整个组群的平均年龄为 66.2 岁，65.2% 为男性。随着 SA 的降低，应激 MBF（mL min-1 g-1）和 MFR 也随之降低（第 1 组 MBF：3.29 ± 1.03，MFR：3.46 ± 1.33；第 2 组 MBF：2.95 ± 1.13，MFR：2.51 ± 0.93；第 3 组 MBF：2.64 ± 1.16，第 3 组 MFR：1.90 ± 0.50），而静息 MBF（毫升 min-1 g-1）增加（第 1 组 MBF：1.05 ± 0.42，第 2 组 1.27 ± 0.56，第 3 组 1.41 ± 0.61）。调整协变量后，与第 1 组相比，第 2 组 MFR 受损（定义为 MFR < 2.5）的几率比为 3.57（95% CI：2.32-5.48），第 3 组为 34.9（95% CI：13.23-92.14）。使用 SA 预测 CMD 的风险是可以接受的，其 AUC 为 0.76。

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引用次数: 0

Vacuolar H+-ATPase in Diabetes, Hypertension, and Atherosclerosis 糖尿病、高血压和动脉粥样硬化中的空泡 H+-ATP 酶

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation

Pub Date : 2024-04-29 DOI: 10.1111/micc.12855

Na Wang, Liwei Ren, A. H. Jan Danser

Vacuolar H⁺-ATPase (V-ATPase) is a multisubunit protein complex which, along with its accessory proteins, resides in almost every eukaryotic cell. It acts as a proton pump and as such is responsible for regulating pH in lysosomes, endosomes, and the extracellular space. Moreover, V-ATPase has been implicated in receptor-mediated signaling. Although numerous studies have explored the role of V-ATPase in cancer, osteoporosis, and neurodegenerative diseases, research on its involvement in vascular disease remains limited. Vascular diseases pose significant challenges to human health. This review aimed to shed light on the role of V-ATPase in hypertension and atherosclerosis. Furthermore, given that vascular complications are major complications of diabetes, this review also discusses the pathways through which V-ATPase may contribute to such complications. Beginning with an overview of the structure and function of V-ATPase in hypertension, atherosclerosis, and diabetes, this review ends by exploring the pharmacological potential of targeting V-ATPase.

空泡 H+-ATPase（V-ATPase）是一种多亚基蛋白复合体，几乎存在于所有真核细胞中。它起着质子泵的作用，因此负责调节溶酶体、内体和细胞外空间的 pH 值。此外，V-ATP 酶还与受体介导的信号传导有关。尽管已有大量研究探讨了 V-ATPase 在癌症、骨质疏松症和神经退行性疾病中的作用，但有关其参与血管疾病的研究仍然有限。血管疾病对人类健康构成重大挑战。本综述旨在阐明 V-ATP 酶在高血压和动脉粥样硬化中的作用。此外，鉴于血管并发症是糖尿病的主要并发症，本综述还讨论了 V-ATP 酶可能导致此类并发症的途径。本综述首先概述了 V-ATPase 在高血压、动脉粥样硬化和糖尿病中的结构和功能，最后探讨了靶向 V-ATPase 的药理潜力。

引用次数: 0

Isolated Fragments of Intact Microvessels: Tissue Vascularization, Modeling, and Therapeutics 完整微血管的分离片段：组织血管化、建模和治疗

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-04-15 DOI: 10.1111/micc.12852

Hannah A. Strobel, Sarah M. Moss, James B. Hoying

The microvasculature is integral to nearly every tissue in the body, providing not only perfusion to and from the tissue, but also homing sites for immune cells, cellular niches for tissue dynamics, and cooperative interactions with other tissue elements. As a microtissue itself, the microvasculature is a composite of multiple cell types exquisitely organized into structures (individual vessel segments and extensive vessel networks) capable of considerable dynamics and plasticity. Consequently, it has been challenging to include a functional microvasculature in assembled or fabricated tissues. Isolated fragments of intact microvessels, which retain the cellular composition and structures of native microvessels, are proving effective in a variety of vascularization applications including tissue in vitro disease modeling, vascular biology, mechanistic discovery, and tissue prevascularization in regenerative therapeutics and grafting. In this review, we will discuss the importance of recapitulating native tissue biology and the successful vascularization applications of isolated microvessels.

微血管几乎与人体的每个组织都密不可分，它不仅提供组织间的灌注，还提供免疫细胞的归宿地、组织动力学的细胞龛以及与其他组织元素的合作互动。微血管本身也是一种微组织，它由多种细胞类型组成，并巧妙地组织成具有相当动态性和可塑性的结构（单个血管段和广泛的血管网络）。因此，在组装或制造的组织中加入功能性微血管一直是一项挑战。完整微血管的分离片段保留了原生微血管的细胞组成和结构，在各种血管化应用中证明是有效的，包括组织体外疾病建模、血管生物学、机理发现以及再生治疗和移植中的组织前血管化。在本综述中，我们将讨论重现原生组织生物学的重要性以及分离微血管的成功血管化应用。

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引用次数: 0

Increased Angio-Derived Index of Microcirculatory Resistance Within a Timeframe of 30–60 days After COVID-19 Infection 在 COVID-19 感染后 30-60 天内，血管衍生的微循环阻力指数增加。

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-03-18 DOI: 10.1111/micc.12851

Lei Dong, Ritai Na, Lang Peng, Xinye Xu

Background and Objectives

Chest pain is a relatively long-term symptom that commonly occurs in patients who have contracted COVID-19. The reasons for these symptoms remain unclear, with coronary microvascular dysfunction (CMD) emerging as a potential factor. This study aimed to assess the presence of CMD in these patients by measuring the angio-derived index of microcirculatory resistance (AMR).

Methods

In this cross-sectional case–control study, patients who had chest pain and a history of COVID-19 infection within the preceding 30 to 60 days were included. The control subjects were patients without COVID-19. Demographic, clinical, and echocardiographic data were recorded. Angiographic images were collected for AMR analysis through an angioplus quantitative flow ratio measurement system. Propensity score matching (PSM) was performed to match the two groups. Multivariate logistic regression was used to examine the association between COVID-19 incidence and the increase in AMR (AMR > 285 mmHg*s/m) after correction for other confounders.

Results

After PSM, there were 58 patients in each group (the mean age was 66.3 ± 9.04 years, and 55.2% were men). The average time between the onset of COVID-19 infection and patient presentation at the hospital for coronary angiography was 41 ± 9.5 days. Moreover, there was no significant difference in the quantitative flow ratio between the two groups. Patients with COVID-19 had a greater mean AMR (295 vs. 266, p = 0.002). Multivariate logistic regression analysis revealed that COVID-19 (OR = 3.32, 95% CI = 1.50–7.60, p = 0.004) was significantly associated with an increase in AMR.

Conclusions

Long-term COVID-19 patients who experience chest pain without evidence of myocardial ischemia exhibit an increase in AMR, and CMD may be one of the reasons for this increase. COVID-19 is an independent risk factor for an increase in AMR.

背景和目的：胸痛是一种相对长期的症状，常见于感染 COVID-19 的患者。出现这些症状的原因尚不清楚，冠状动脉微血管功能障碍（CMD）是一个潜在因素。本研究旨在通过测量血管衍生的微循环阻力指数（AMR）来评估这些患者是否存在CMD：在这项横断面病例对照研究中，纳入了在之前 30 到 60 天内有胸痛和 COVID-19 感染史的患者。对照组为未感染 COVID-19 的患者。研究人员记录了人口统计学、临床和超声心动图数据。收集血管造影图像，通过血管造影定量流量比测量系统进行 AMR 分析。进行倾向得分匹配（PSM）以匹配两组患者。在校正其他混杂因素后，采用多变量逻辑回归法检测 COVID-19 发病率与 AMR（AMR > 285 mmHg*s/m）增加之间的关联：PSM 后，每组有 58 名患者（平均年龄为 66.3 ± 9.04 岁，55.2% 为男性）。从感染 COVID-19 到患者到医院接受冠状动脉造影术的平均时间为 41 ± 9.5 天。此外，两组患者的定量血流比率没有明显差异。COVID-19 患者的平均 AMR 更大（295 对 266，P = 0.002）。多变量逻辑回归分析显示，COVID-19（OR = 3.32，95% CI = 1.50-7.60，p = 0.004）与 AMR 的增加显著相关：结论：长期患有 COVID-19 的胸痛但无心肌缺血证据的患者会出现 AMR 增高，而 CMD 可能是导致 AMR 增高的原因之一。COVID-19是导致AMR增加的一个独立风险因素。

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引用次数: 0

Abstract 摘要

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-03-07 DOI: 10.1111/micc.12846

引用次数: 0

Modeling cerebrovascular responses to assess the impact of the collateral circulation following middle cerebral artery occlusion 建立脑血管反应模型，评估大脑中动脉闭塞后侧支循环的影响。

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-02-14 DOI: 10.1111/micc.12849

Erin Zhao, Jared Barber, Shomita S. Mathew-Steiner, Savita Khanna, Chandan K. Sen, Julia Arciero

Objective

An improved understanding of the role of the leptomeningeal collateral circulation in blood flow compensation following middle cerebral artery (MCA) occlusion can contribute to more effective treatment development for ischemic stroke. The present study introduces a model of the cerebral circulation to predict cerebral blood flow and tissue oxygenation following MCA occlusion.

Methods

The model incorporates flow regulation mechanisms based on changes in pressure, shear stress, and metabolic demand. Oxygen saturation in cerebral vessels and tissue is calculated using a Krogh cylinder model. The model is used to assess the effects of changes in oxygen demand and arterial pressure on cerebral blood flow and oxygenation after MCA occlusion.

Results

An increase from five to 11 leptomeningeal collateral vessels was shown to increase the oxygen saturation in the region distal to the occlusion by nearly 100%. Post-occlusion, the model also predicted a loss of autoregulation and a decrease in flow to the ischemic territory as oxygen demand was increased; these results were consistent with data from experiments that induced cerebral ischemia.

Conclusions

This study highlights the importance of leptomeningeal collaterals following MCA occlusion and reinforces the idea that lower oxygen demand and higher arterial pressure improve conditions of flow and oxygenation.

目的：进一步了解大脑中动脉（MCA）闭塞后脑侧支循环在血流补偿中的作用有助于缺血性脑卒中更有效的治疗发展。本研究引入了一个脑循环模型来预测大脑中动脉闭塞后的脑血流和组织氧合：该模型结合了基于压力、剪应力和代谢需求变化的血流调节机制。使用 Krogh 气瓶模型计算脑血管和组织中的氧饱和度。该模型用于评估 MCA 闭塞后氧需求和动脉压的变化对脑血流和氧饱和度的影响：结果表明，如果侧支血管从 5 条增加到 11 条，闭塞远端区域的血氧饱和度将提高近 100%。闭塞后，随着氧需求的增加，模型还预测缺血区域会失去自动调节功能，血流量也会减少；这些结果与诱导脑缺血的实验数据一致：这项研究强调了MCA闭塞后左脑膜袢的重要性，并强化了降低需氧量和提高动脉压能改善血流和氧合条件的观点。

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引用次数: 0

Sex-specific microvascular and hemodynamic responses to passive limb heating in young adults 青壮年微血管和血液动力学对被动肢体加热的反应具有性别特异性。

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-01-28 DOI: 10.1111/micc.12848

Miranda K. Traylor, Genevieve B. Batman, Kylie N. Sears, Kyndall V. Ransom, Shane M. Hammer, Joshua L. Keller

Objective

We examined sex-specific microvascular reactivity and hemodynamic responses under conditions of augmented resting blood flow induced by passive heating compared to normal blood flow.

Methods

Thirty-eight adults (19 females) completed a vascular occlusion test (VOT) on two occasions preceded by rest with or without passive heating in a randomized, counterbalanced order. Skeletal muscle tissue oxygenation (StO₂, %) was assessed with near-infrared spectroscopy (NIRS), and the rate of desaturation and resaturation as well as maximal StO₂ (StO_2max) and prolonged hypersaturation (area under the curve, StO_2AUC) were quantified. Before the VOT, brachial artery blood flow (BABF), vascular conductance, and relative BABF (BABF normalized to forearm lean mass) were determined. Sex × condition ANOVAs were used. A p-value ≤.05 was considered statistically significant.

Results

Twenty minutes of heating increased BABF compared to the control (102.9 ± 28.3 vs. 36.0 ± 20.9 mL min⁻¹; p < .01). Males demonstrated greater BABF than females (91.9 ± 34.0 vs. 47.0 ± 19.1 mL min⁻¹; p < .01). There was no sex difference in normalized BABF. There were no significant interactions for NIRS-VOT outcomes, but heat did increase the rate of desaturation (−0.140 ± 0.02 vs. −0.119 ± 0.03% s⁻¹; p < .01), whereas regardless of condition, males exhibited greater rates of resaturation and StO_2max than females.

Conclusions

These results suggest that blood flow is not the primary factor causing sex differences in NIRS-VOT outcomes.

目的我们研究了与正常血流相比，在被动加热引起静息血流增加的条件下，不同性别的微血管反应性和血流动力学反应：38名成年人（19名女性）完成了两次血管闭塞测试（VOT），测试前以随机、平衡的顺序进行了休息，同时进行或不进行被动加热。用近红外光谱（NIRS）评估骨骼肌组织氧饱和度（StO2，%），并对去饱和度和再饱和度以及最大 StO2（StO2max）和长时间高饱和度（曲线下面积，StO2AUC）进行量化。在 VOT 之前，测定了肱动脉血流（BABF）、血管传导和相对 BABF（BABF 与前臂瘦体重的归一化）。采用性别×条件方差分析。P值≤.05为具有统计学意义：结果：与对照组相比，加热 20 分钟可增加 BABF（102.9 ± 28.3 vs. 36.0 ± 20.9 mL min-1 ; p -1 ; p -1 ; p 2max than females）：这些结果表明，血流量并不是造成 NIRS-VOT 结果性别差异的主要因素。

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引用次数: 0

Impact of stalling events on microcirculatory hemodynamics in the aged brain 停滞事件对老年大脑微循环血流动力学的影响。

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-01-24 DOI: 10.1111/micc.12845

Mohammad Jamshidi, Thomas Ventimiglia, Patrice Sudres, Cong Zhang, Frédéric Lesage, William Rooney, Daniel Schwartz, Andreas A. Linninger

Objective

The role of cerebral microvasculature in cognitive dysfunction can be investigated by identifying the impact of blood flow on cortical tissue oxygenation. In this paper, the impact of capillary stalls on microcirculatory characteristics such as flow and hematocrit (Ht) in the cortical angioarchitecture is studied.

Methods

Using a deterministic mathematical model to simulate blood flow in a realistic mouse cortex, hemodynamics parameters, including pressure, flow, vessel diameter-adjustable hematocrit, and transit time are calculated as a function of stalling events.

Results

Using a non-linear plasma skimming model, it is observed that Ht increases in the penetrating arteries from the pial vessels as a function of cortical depth. The incidence of stalling on Ht distribution along the blood network vessels shows reduction of RBCs around the tissue near occlusion sites and decreased Ht concentration downstream from the blockage points. Moreover, upstream of the occlusion, there is a noticeable increase of the Ht, leading to larger flow resistance due to higher blood viscosity. We predicted marked changes in transit time behavior due to stalls which match trends observed in mice in vivo.

Conclusions

These changes to blood cell quantity and quality may be implicated in the development of Alzheimer's disease and contribute to the course of the illness.

目的：通过确定血流量对大脑皮层组织氧合的影响，可以研究大脑微血管在认知功能障碍中的作用。本文研究了毛细血管滞留对大脑皮层血管结构中流量和血细胞比容（Ht）等微循环特征的影响：方法：使用确定性数学模型模拟现实小鼠皮层中的血流，计算血流动力学参数，包括压力、流量、血管直径可调血细胞比容和转运时间与滞留事件的函数关系：结果：利用非线性血浆撇取模型观察到，随着皮层深度的增加，从皮层血管穿入动脉的 Ht 也在增加。停滞对沿血网血管 Ht 分布的影响显示，闭塞点附近组织周围的红细胞减少，而堵塞点下游的 Ht 浓度降低。此外，在闭塞点上游，由于血液粘度较高，Ht 明显增加，导致流动阻力增大。我们预测，由于滞流，血流通过时间会发生明显变化，这与在小鼠体内观察到的趋势一致：血细胞数量和质量的这些变化可能与阿尔茨海默氏症的发展有关，并对疾病的进程起着促进作用。

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引用次数: 0

Retinal vascular dynamics: A window for observing an irregular heartbeat. A case report 视网膜血管动力学：观察不规则心跳的窗口。病例报告

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-01-19 DOI: 10.1111/micc.12844

Rebekka Heitmar, Paulus Kirchhoff, Andrew Blann, Konstantin Kotliar

Objective

We aimed to characterize several aspects of retinal vascular dynamics in a patient with arrythmia in order to elicit additional diagnostic information on microvascular dysfunction.

Methods

A 68-year-old male patient with arrythmia and an age- and gender-matched control subject underwent ocular examination including dynamic retinal vessel assessment with flicker light provocation. Retinal vessel diameters were measured continuously following a standard protocol (IMEDOS Systems, Jena, Germany). The data were evaluated using methods of signal analysis.

Results

Retinal vessel response following flicker provocation as well as local structural and functional behavior of retinal vessels were comparable between both individuals. The arrhythmia case demonstrated irregular arterial and venous heart rate (HR) pulsation with an average frequency of 1 Hz. Moreover, the case showed a higher magnitude and larger periods of low-frequency retinal vessel oscillations as well as lower periodicity of both HR pulsations and low-frequency vasomotions.

Conclusions

Besides numerical examination of irregular HR pulsations in case of arrhythmia, from the direct noninvasive assessment of retinal vessel dynamics one can derive more detailed information on microvascular function including the whole spectrum of retinal arterial and venous pulsations and vasomotions. This may have implications for health screening not limited to atrial fibrillation.

我们的目的是描述一名心律失常患者视网膜血管动态的几个方面，以获得有关微血管功能障碍的更多诊断信息。

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引用次数: 0

Men with nonobstructive coronary disease have higher burden of ischemic heart disease detected by cardiopulmonary exercise test 通过心肺运动测试发现，患有非阻塞性冠状动脉疾病的男性患缺血性心脏病的比例更高

IF 2.4 4区医学 Q2 Medicine

Microcirculation

Pub Date : 2024-01-17 DOI: 10.1111/micc.12841

Siyuan Li, Yifang Yuan, Lanting Zhao, Tingting Lv, Fei She, Fang Liu, Yajun Xue, Boda Zhou, Ying Xie, Yu Geng, Ping Zhang

Background

Nonobstructive coronary artery disease (NOCAD), characterized by the presence of myocardial ischemic symptoms and signs without obstructive coronaries, is a common clinical condition, but it is less well understood. Few studies have analyzed the gender differences in inducible myocardial ischemia assessed by cardiopulmonary exercise test (CPET) in NOCAD.

Methods

We conducted a study of 289 NOCAD patients (mean age 60, 56% women) with ischemic symptoms and confirmed ⫹50% coronaries stenoses by coronary angiography who underwent symptom-limited CPET. We assessed ischemic response using predicted % peak VO₂, O₂ pulse trajectory, and exercise ECG test.

Results

Men with NOCAD had significantly lower predicted % peak VO₂ (62% vs. 73%), higher proportions of flattening pattern (16% vs. 2%), and downward patterns of O₂ pulse trajectory (2% vs. 0%) (p < .0001) compared with women. In contrast, women with NOCAD had a higher prevalence of shallow patterns of O₂ pulse trajectory (21% vs. 6%, p < .0001). Men with NOCAD had a higher risk ischemic profile (medium risk: 63% vs. 54%, high risk: 18% vs. 4%, p < .0001). After adjustment, men with NOCAD had significantly lower predicted % peak VO₂ (β −27.4, 95% CI −30.74 to −24.07), higher risk for abnormal O₂ pulse trajectories (OR 4.21, 95% CI 1.93 to 9.19), and myocardial ischemia risk per CPET parameters (OR 3.14, 95% CI 1.78 to 5.54) (p < .0001).

Conclusion

Men with NOCAD had a higher risk profile for ischemic heart disease per CPET. Therefore, they should receive rigorous management and follow-up to prevent cardiovascular events.

非阻塞性冠状动脉疾病（NOCAD）的特征是存在心肌缺血症状和体征，但没有阻塞性冠状动脉，这是一种常见的临床病症，但人们对它的了解较少。很少有研究分析了通过心肺运动测试（CPET）评估非阻塞性冠心病诱发性心肌缺血的性别差异。

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引用次数: 0