Abstract
The endothelium and the glycocalyx play a pivotal role in regulating microvascular function and perfusion in health and critical illness. It is unknown today, whether aerobic exercise immediately affects dimensions of the endothelial surface layer (ESL) in relation to microvascular perfusion as a physiologic adaption to increased nutritional demands. This monocentric observational study was designed to determine real-time ESL and perfusion measurements of the sublingual microcirculation using sidestream dark field imaging performed in 14 healthy subjects before and after completing a 10 km trial running distance. A novel image acquisition and analysis software automatically analysed the perfused boundary region (PBR), an inverse parameter for red blood cell (RBC) penetration of the ESL, in vessels between 5 and 25 µm diameter. Microvascular perfusion was assessed by calculating RBC filling percentage. There was no significant immediate effect of exercise on PBR and RBC filling percentage. Linear regression analysis revealed a distinct association between change of PBR and change of RBC filling percentage (regression coefficient β: − 0.026; 95% confidence interval − 0.043 to − 0.009; p = 0.006). A single aerobic exercise did not induce a change of PBR or RBC filling percentage. The endothelium of the microvasculature facilitates efficient perfusion in vessels reacting with an increased endothelial surface layer.
Highlights
Microvascular perfusion is adapted to local needs by finetuned adaptive mechanism
2.1 Study design, setting and subjects. This was a monocentric, observational field study to obtain the effect of aerobic exercise on real-time endothelial surface layer (ESL) and perfusion measurements of the sublingual microcirculation in 14 healthy adults
Secondary endpoints were perfused boundary region (PBR) of the sublingual microvasculature graded according to vessel size, red blood cell (RBC) filling percentage as a parameter for microvascular perfusion and change of the mentioned parameters between post-exercise and baseline
Summary
Microvascular perfusion is adapted to local needs by finetuned adaptive mechanism. In this context, the endothelial glycocalyx and the endothelium play a pivotal role in. Clinical studies using intravital microscopy of the sublingual microvasculature have been conducted to assess the ESL in various medical conditions and critical care states [9,10,11,12,13,14]. These measurements were performed in patients and controls either in-hospital or in a laboratory setting. Rapid changes of ESL dimensions may occur To this date, it is unknown whether aerobic exercise immediately affects dimensions of the endothelial surface layer and hereby adapts local tissue perfusion. We tested the feasibility of postexercise on-site measurements to elucidate alternative scenarios for intravital microscopy other than an in-hospital or a laboratory setting
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