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01-11-2018 | Original Article

Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes

Authors: Rachel E. D. Climie, Dean S. Picone, Sarah Blackwood, Stuart E. Keel, Ahmad Qasem, Stephen Rattigan, James E. Sharman

Published in: European Journal of Applied Physiology | Issue 11/2018

Abstract

Purpose

It is widely thought that excess pulsatile pressure from increased stiffness of large central arteries (macro-vasculature) is transmitted to capillary networks (micro-vasculature) and causes target organ damage. However, this hypothesis has never been tested. We sought to examine the association between macro- and micro-vasculature waveform features in patients with type 2 diabetes (i.e., those with elevated stiffness; T2D) compared with non-diabetic controls.

Methods

Among 13 T2D (68 ± 6 years, 39% male) and 15 controls (58 ± 11 years, 40% male) macro-vascular stiffness was determined via aortic pulse wave velocity (aPWV) and macro-vascular waveforms were measured using radial tonometry. Forearm micro-vascular waveforms were measured simultaneously with macro-vascular waveforms via low power laser Doppler fluxmetry. Augmentation index (AIx) was derived on macro- and micro-vascular waveforms. Target organ damage was assessed by estimated glomerular filtration rate (eGFR) and central retinal artery equivalent (CRAE).

Results

aPWV was higher among T2D (9.3 ± 2.5 vs 7.5 ± 1.4 m/s, p = 0.046). There was an obvious pulsatile micro-vascular waveform with qualitative features similar to macro-vasculature pressure waveforms. In all subjects, macro- and micro-vasculature AIx were significantly related (r = 0.43, p = 0.005). In T2D alone, micro-vasculature AIx was associated with eGFR (r = − 0.63, p = 0.037), whereas in controls, macro-vasculature AIx and AP were associated with CRAE (r = − 0.58, p = 0.025 and r = − 0.61, p = 0.015).

Conclusions

Macro- and micro-vasculature waveform features are related; however, micro-vasculature features are more closely related to markers of target organ damage in T2D. These findings are suggestive of a possible interaction between the macro- and micro-circulation.

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Title: Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes
Authors: Rachel E. D. Climie
Dean S. Picone
Sarah Blackwood
Stuart E. Keel
Ahmad Qasem
Stephen Rattigan
James E. Sharman
Publication date: 01-11-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Applied Physiology / Issue 11/2018
Print ISSN: 1439-6319
Electronic ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-018-3972-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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