Document Detail

Associations between cardiac target organ damage and microvascular dysfunction: the role of blood pressure.
MedLine Citation:
PMID:  20216092     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Microvascular dysfunction may be an early precursor of cardiovascular disease (CVD). Increased left ventricular mass (LVM), concentric left ventricular remodelling and increased left atrial size are the factors that could predict future CVD. We investigated whether microvascular dysfunction was associated with these cardiac measures. METHODS AND RESULTS: Laser Doppler fluximetry of skin vessels was used to study associations with risk factors and echocardiographic measurements of LVM, relative wall thickness (RWT), and left atrial size in 305 people (aged 40-65 years; 117 with type 2 diabetes). Flow in response to a 3-min arterial occlusion was measured. Postischaemic peak flow responses were categorized into three distinct groups: slow rise to peak (normal), nondominant early peak group (mildly abnormal) and a dominant early peak (abnormal). Those with a dominant early peak had higher blood pressure (P = 0.001), weight (P = 0.001), fasting glucose (P = 0.001) and prevalence of diabetes (P = 0.02). LVM (P = 0.01), RWT (P < 0.001) and left atrial size (P < 0.001) were greater with worsening postischaemic peak flow responses. Differences in LVM between postischaemic response groups were accounted for by blood pressure (BP). However, differences in BP and other CVD risk factors did not account for the greater RWT and left atrial size observed in the more adverse peak response groups [geometric mean of RWT [95% confidence interval (CI)] 0.40 (0.38-0.41) vs. 0.41 (0.40-0.42) vs. 0.43 (0.41-0.45), P = 0.007; left atrial size 36.1 (35.4-36.1) vs. 37.4 (36.8-38.0) vs. 38.7 (37.5-40.0), P = 0.002 for normal vs. mildly abnormal vs. abnormal respectively]. CONCLUSION: An abnormal microcirculatory cutaneous peak flow response following ischaemia is associated with adverse cardiac remodelling, independent of CVD risk factors including blood pressure.
William D Strain; Nish Chaturvedi; Alun Hughes; Petros Nihoyannopoulos; Christopher J Bulpitt; Chakravarthi Rajkumar; Angela C Shore
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-16     Completed Date:  2010-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  952-8     Citation Subset:  IM    
Institute of Biomedical and Clinical Science, Peninsula NIHR Clinical Research Facility, Peninsula Medical School, University of Exeter, Exeter, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Blood Pressure / physiology*
Diabetes Mellitus, Type 2 / physiopathology*
Diabetic Angiopathies / physiopathology*
Hypertension / physiopathology
Hypertrophy, Left Ventricular / pathology,  physiopathology
Ischemia / physiopathology
Laser-Doppler Flowmetry
Microcirculation / physiology*
Middle Aged
Risk Factors
Skin / blood supply*
Ventricular Remodeling / physiology
Grant Support
//British Heart Foundation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  A mechanism for salt-sensitive hypertension: abnormal dietary sodium-mediated vascular response to a...
Next Document:  Congenital Diarrheal Disorders: Improved Understanding of Gene Defects Is Leading to Advances in Int...