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J Appl Physiol 105: 382, 2008; doi:10.1152/japplphysiol.90316.2006
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LETTER TO THE EDITOR

Commentary on Viewpoint: The human cutaneous circulation as a model of generalized microvascular function

TO THE EDITOR: Atherosclerosis begins at an early age, probably initially with a defect or injury of the arterial endothelial protective function and progresses with structural remodeling in the microcirculation. There are several noninvasive measurement techniques to assess vascular function that are associated with cardiovascular outcomes, including arterial pulse wave velocity, applanation tonometry, and carotid intima media thickness (1). These noninvasive techniques provide information about the functional and structural vascular changes at the level of aorta, muscular conduit arteries, the peripheral branches, and a little about microvascular components (3, 5). In recent years, several techniques (i.e., transcutaneous oxygen tension, photo-plethysmography, vital capillaroscopy, orthogonal polarization spectral imaging, iontophoresis, intradermal microdialysis, laser-Doppler flowmetry) have been developed to study the function of the microcirculation (1, 4). The microcirculatory flow changes on variations in concentrations of hormones, blood gases, physical factors like temperature and pressure, and it is controlled by autonomous nervous system as well. These stimuli increase or decrease the microvascular perfusion by regulating vasoconstriction or vasodilatation of the arterioles. Dysfunction of the microcirculation occurs in multiple tissue beds long before the onset of atherosclerotic symptoms. Impaired microcirculatory vasodilatation has been shown to occur in chronic inflammatory disease including peripheral vascular disease, hypertension, chronic renal failure, diabetes mellitus, hypercholesterolemia and obesity (1, 2, 4). In conclusion, although there are some limitations (i.e., minimally invasive, the control mechanisms of cutaneous vascular responses are complex), the cutaneous circulation is an important method for assessing the mechanisms of microcirculatory function and dysfunction.

FOOTNOTES


Address for reprint requests and other correspondence: M. Yildiz, Cardiology, Internal Medicine and Physiology, Dept. of Cardiology, Kartal Kosuyolu Yüksek Ihtisas Educational and Research Hospital, Istanbul, Turkey (e-mail: mustafayildiz{at}yahoo.com)

REFERENCES

  1. Abularrage CJ, Sidawy AN, Aidinian G, Singh N, Weiswasser JM, Arora S. Evaluation of the microcirculation in vascular disease. J Vasc Sur 42: 574–581, 2005.[CrossRef]
  2. Holowatz LA, Thompson-Torgerson CS, Kenney WL. Viewpoint: The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol; doi:10.1152/japplphysiol.00858.2007.[Free Full Text]
  3. Imura R, Yamamoto K, Kanamori K, Mikami T, Yasuda H. Noninvasive ultrasonic measurement of the elastic properties of the human abdominal aorta. Cardiovasc Res 20: 208–214, 1986.[Abstract/Free Full Text]
  4. Stewart J, Kohen A, Brouder D, Rahim F, Adler S, Garrick R, Goligorsky MS. Noninvasive interrogation of microvasculature for signs of endothelial dysfunction in patients with chronic renal failure. Am J Physiol Heart Circ Physiol 287: H2687–H2696, 2004.[Abstract/Free Full Text]
  5. Yildiz M, Altun A, Ozbay G. Assessment of arterial distensibility in patients with cardiac syndrome X. Angiology 58: 458–462, 2007.[Abstract/Free Full Text]

Mustafa Yildiz
 Cardiology, Internal Medicine and Physiology, Department of Cardiology, Kartal Kosuyolu Yüksek Ihtisas Educational and Research Hospital, Istanbul, Turkey





This Article
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