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

Abstract

VIEWPOINTCommentary on Viewpoint: The human cutaneous circulation as a model of generalized microvascular functionDimitris Tousoulis, Kyriakoula Marinou, and Christodoulos StefanadisDimitris Tousoulis, Kyriakoula Marinou, and Christodoulos StefanadisPublished Online:01 Jul 2008https://doi.org/10.1152/japplphysiol.00165.2008This is the final version - click for previous versionMoreSectionsPDF (28 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat EVALUATING CUTANEOUS MICROCIRCULATION IN HUMANS: IS EXTRAPOLATION TO CARDIAC MICROCIRCULATION VALID?to the editor: Holowatz et al. (3) supported that the study of cutaneous microcirculation vasoreactivity (and especially the functional status of microvascular endothelium), provides important information regarding systemic microcirculation, including coronary microcirculation. But is this really valid? As cutaneous circulation is highly reactive to metabolic, thermal, and nervous stimuli, how easily can we study its vasoreactivity to an NO specific stimuli? And how similar is the pathophysiology of cutaneous and cardiac microcirculations?The widely used methods evaluating endothelial function in conduit arteries (e.g., flow mediated dilation in the brachial artery; Ref. 4) or forearm resistance vessels (by gauge-strain plethysmography; Ref. 4) are strongly correlated with endothelial function in coronary arteries (1) and most importantly, they predict clinical outcome in several populations (2). On the other hand, the vasoactive response of cutaneous microcirculation is not correlated with these markers of endothelial function in conduit arteries (5).As Holowatz et al. (3) stated, cutaneous vasoreactivity is impaired early in the progression of hypertensive vascular disease, despite the fact that it does not contribute significantly to the total increase of systemic vascular resistance, leading to hypertension. However, it remains to be proven whether the evaluation of vasoreactivity in cutaneous microcirculation may provide information regarding systemic peripheral microcirculation. Further clinical studies are required to determine this important issue and, most importantly, to validate the predictive value of the method for the clinical outcome in humans.REFERENCES1 Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 26: 1235–1241, 1995.Crossref | PubMed | ISI | Google Scholar2 Brevetti G, Silvestro A, Schiano V, Chiariello M. Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive value of flow-mediated dilation to ankle-brachial pressure index. Circulation 108: 2093–2098, 2003.Crossref | PubMed | ISI | Google Scholar3 Holowatz LA, Thompson-Torgerson CS, Kenney LW. Viewpoint: The human cutaneous circulation as a model of generalized microvascular function. J Appl Physiol; doi:10.1152/japplphysiol.00858.2007.Link | ISI | Google Scholar4 Tousoulis D, Antoniades C, Stefanadis C. Evaluating endothelial function in humans: a guide to invasive and non-invasive techniques. Heart 91: 553–558, 2005.Crossref | PubMed | ISI | Google Scholar5 Shamim-Uzzaman QA, Pfenninger D, Kehrer C, et al. Altered cutaneous microvascular responses to reactive hyperaemia in coronary artery disease: a comparative study with conduit vessel responses. Clin Sci (Lond) 103: 267–273, 2002.Crossref | PubMed | ISI | Google ScholarAUTHOR NOTESAddress for reprint requests and other correspondence: D. Tousoulis, Hippokration Hospital, Cardiology Dept., 5th Floor, Athens Univ. Medical School, Vasilissis Sofias 114, 115 28, Ampelokipi, Athens-Greece (e-mail: [email protected]) Download PDF Previous Back to Top Next FiguresReferencesRelatedInformationCited ByIntroducing the Highlighted Topic seriesAndré De Troyer and Martin J. Tobin1 July 2009 | Journal of Applied Physiology, Vol. 107, No. 1 More from this issue > Volume 105Issue 1July 2008Pages 379-379 Copyright & PermissionsCopyright © 2008 the American Physiological Societyhttps://doi.org/10.1152/japplphysiol.00165.2008PubMed18292302History Published online 1 July 2008 Published in print 1 July 2008 Metrics