Total Vascular Volume Research Articles

Modelling vascular reactivity to investigate the basis of the relationship between cerebral blood volume and flow under CO 2 manipulation

Changes in cerebral blood flow ( f) and vascular volume ( v) are of major interest in mapping cerebral activity and metabolism, but the relation between them currently lacks a sufficient theoretical basis. To address this we considered three models: a uniform reactive tube model (M1); an extension of M1 that includes passive arterial inflow and venous volume (M2); and a more anatomically plausible model (M3) consisting of 19 compartments representing the whole range of vascular sizes and respective CO 2 reactivities, derived from literature data. We find that M2 cannot be described as the simple scaling of a tube law, but any divergence from a linear approximation is negligible within the narrow physiological range encountered experimentally. In order to represent correctly the empirically observed slope of the overall v– f relationship, the reactive bed should constitute about half of the total vascular volume, thus including a significant fraction of capillaries and/or veins. Model M3 demonstrates systematic variation of the slope of the v– f relationship between 0.16 and 1.0, depending on the vascular compartment under consideration. This is further complicated when other experimental approaches such as flow velocity are used as substitute measurements. The effect is particularly large in microvascular compartments, but when averaged with larger vessels the variations in slope are contained within 0.25 to 0.55 under conditions typical for imaging methods. We conclude that the v– f relationship is not a fixed function but that both the shape and slope depend on the composition of the reactive volume and the experimental methods used.

Expression of inhibitor of apoptosis proteins and their relationships with clinicopathologic prognostic factors in breast cancer

BACKGROUND AND METHODS: Abnormal circulating endothelial cell (CEC) and circulating progenitor cell (CPC) numbers are present in cancer, but their relationship with angiogenesis, apoptosis, vascular biology, and prognosis is unclear. We prospectively studied 160 patients with breast cancer and 63 age-matched controls free of breast cancer, measuring CECs (CD45−/CD146+/CD34+) and CPCs (CD45−/CD133+/CD34+) by flow cytometry and plasma markers of endothelial damage/dysfunction (von Willebrand factor), apoptosis (Fas/Fas-L) and angiogenesis (vascular endothelial growth factor [VEGF], angiogenin) by ELISA. These were compared with clinicopathophysiologic features and the Nottingham Prognostic Index (NPI). An additional blood sample was taken 6 to 8 weeks after surgery from 15 women to test the effect of tumor removal. RESULTS: CECs were significantly higher in the NPI poor prognostic group compared with moderate and good prognostic groups, and the cancer-free controls, whereas CPCs were lower in the poor prognosis group (both P < .05). Levels of von Willebrand factor, VEGF, angiogenin, and Fas-L (but not soluble Fas) were abnormal in breast cancer compared with controls (P < .05), with no relationship to prognosis groups. VEGF (P = .04) and angiogenin (P = .001) were markedly different after surgery. In multivariate analysis, vascular invasion (P < .05) and tumor size (P < .001) were independently associated with CECs. CPCs did not significantly associate with NPI in a linear regression model; age (P < .05) was a negative predictor, whereas Her-2 status (P < .05) positively predicted CPCs. After adjustment, no variable independently predicted CPC levels. CONCLUSIONS: CECs and CPCs demonstrate a strong relationship with NPI groups, but only CECs positively predict higher NPI scores and correlate with tumor invasiveness and size, possibly reflecting total tumor vascular volume.

Erythropoietin as a Volume-Regulating Hormone: An Integrated View

The intravascular volume consists of 40% to 45% red cells. Their production is controlled predominantly by erythropoietin (EPO), a hormone that is secreted particularly when tissue hypoxia is present. Because of this high percentage of the total intravascular volume the question comes to mind that, in addition to hypoxia, can volume-regulation mechanisms, known to be responsible for the maintenance of plasma volume, modulate EPO secretion when the total vascular volume changes? Indeed, there is evidence that in situations in which the intravascular volume or specifically the intrathoracic volume is altered, EPO secretion is affected. EPO secretion increases when the intrathoracic volume decreases 24 hours after water immersion or after endurance exercise when a negative water balance prevails. A head-down tilt on the other side induces central engorgement leading to a decrease of EPO concentrations. Under these experimental conditions no hypoxia was seen, supporting the idea that a volume stimulus outgoing from intrathoracic parts of the circulation modulated EPO secretion. Further observations from the clinical side are needed to support these ideas and the consequences need to be implemented into clinical practice.

Classification of Tc-99m DTPA perfusion time-activity curves in renal transplant recipients

IMPAIRMENT OF CIRCULATION is an early event in the course of allograft dysfunction and usually precedes functional derangement. Consequently, assessment of perfusion in the early posttransplantation period is of the utmost importance. The count rates over the graft in intravenous angiography with radiolabeled agents depend on the vascular transit of the radiotracer and the total vascular volume of the kidney. Both radionuclide imaging and Doppler ultrasonography (DUS) have proven diagnostic value in the evaluation of renal transplant perfusion. In normal-functioning grafts, perfusion time-activity curves derived from Tc99m-DTPA scans show a peak and a plateau, a pattern that is not demonstrated when tubular agents are used. The aims of this study were to classify perfusion time-activity curves on Tc-99m DTPA renal scans based on the peak and plateau pattern and to correlate each pattern with biopsy results.

Dominant events that modulate mass transfer coefficient of oxygen in cerebral cortex.

Recently, a model of cerebral oxygen delivery was described (J Appl Physiol 85:554) which yields a relationship similar to that used to depict substrate transport across the endothelium. Because the endothelium is not a diffusion barrier for oxygen, the permeability surface area product was replaced by an effective mass transfer coefficient term for oxygen, D. The cerebral metabolic rate of oxygen utilization (CMRO2) was linked to cerebral blood flow (CBF) and volume (CBV) through properties that modify the vessel-to-tissue oxygen tension giving rise to changes in D. Changes in the value of D were correlated with changes in CBF, CMRO2, and CBV as measured using NMR methods in a 48 microL volume of the cerebral cortex of anesthetized rats at different levels of activity. We conclude that the changes in total vascular volume (i.e., swelling or shrinking of the capillary bed) contributes < 5% to changes in D, whereas variations in the number of hematic vs. plasmatic capillaries, or intra-capillary stacking vs. unpacking of erythrocytes, or increase vs. decrease of dissolved oxygen in the tissue (i.e., processes which modify vessel-to-tissue oxygen tension) contribute(s) > 95% to changes in D.

Analysis of the pressor response to the K + channel inhibitor 4-aminopyridine

The cardiovascular response to the K + channel inhibitor 4-aminopyridine in anaesthetized rats was analysed. 4-Aminopyridine produced a biphasic pressor response. First, it increased blood pressure, total peripheral vascular resistance, cardiac output and stroke volume. Nitric oxide synthase (NOS) inhibitor augmented the tension response; reserpine, phentolamine, propranolol, scopolamine, atropine, adrenalectomy, indomethacin, angiotensin AT 1 and endothelin ET A receptor antagonists had no effect. Subsequently, heart rate increased, but total peripheral vascular resistance was no longer elevated. Reserpine and propranolol abolished the tachycardia. An elevated late tension occurred after propranolol and NOS inhibitor but not reserpine or phentolamine+NOS inhibitor. The peripherally acting 3,4-diaminopyridine produced similar responses. 4-Aminopyridine contracted isolated aortic rings also after denudation. These results are compatible with that the immediate tension response resulted from closure of vascular smooth muscle K + channels, and that closure of presynaptic K + channels in peripheral sympathetic nerves subsequently activated noradrenaline release, β-adrenoceptors and tachycardia, while nitric oxide counter-acted a concomitant α-adrenergic vasoconstriction.

Progression of coronary atherosclerosis quantified by analysis of 3-D reconstruction of left coronary arteries

Objectives: Quantitative measurements on three-dimensional (3-D) reconstructed coronary trees permit accurate evaluation of vascular volumes, lengths and diameters. We applied this technique to investigate diffuse luminal narrowing in patients with the clinical manifestation of progressive atherosclerosis. Methods: In 13 patients who presented repeatedly for coronary angioplasty (at least 4 years of invasive follow-up), left coronary arteries were reconstructed in 3-D from biplane coronary angiograms. Mean diameter, cross-sectional areas, total length, and volume were calculated for segments and branches. Five patients without coronary artery disease served as controls. Results: Patients with progressive coronary atherosclerosis demonstrated a significant reduction of total vascular volumes, mean diameters and cross-sectional areas at the initial investigation when compared with controls. Progressive luminal shrinkage occurred during follow-up (−0.04±0.13 mm per year and per segmental diameter). The progress of luminal narrowing in patients with coronary artery disease is related to the number of coronary risk factors and the duration of follow-up. Conclusion: Quantitative measurements on 3-D reconstructed coronary trees are a useful investigative tool for the assessment of progression of coronary atherosclerosis.

Effects of thrombin and of the phospholipase C inhibitor, D609, on the vascularity of the chick chorioallantoic membrane

Microvascular corrosion casting was used to assess the effects of thrombin and D609, a phospholipase C inhibitor, on the vascularity of the chick embryo chorioallantoic membrane (CAM). Discs containing vehicle, thrombin or D609 were placed on the CAM of fertilized white Leghorn eggs on Day 9 of gestation and vascularity was assessed on Day 11. Thrombin caused significant increases in the numbers (43%), diameters (5%) and lengths (17%), of both pre- and postcapillaries (first-order vessels by centripetal ordering). Conversely, D609 caused a decrease in the numbers (27%), lengths (12%) and diameters (8%) of first-order vessels. D609 decreased the total vascular volume of first- to third-order vessels by 32%, whereas thrombin increased vascular volume by 27%. Additionally, thrombin increased capillary plexus density by 6%, whereas D609 decreased capillary plexus density by 3%. These findings provide a quantitative assessment of changing vascularity in the chick CAM—a model assay system in the development of pro- and antiangiogenic agents.

Effects of hypoxia on pulmonary microvascular volume.

To determine the effects of alveolar hypoxia on pulmonary microvascular volume, X-ray microfocal angiographic images of isolated perfused dog lung lobes were obtained during passage of a bolus of radiopaque contrast medium during both normoxic (alveolar gas, 15% O(2), 6% CO(2), and 79% N(2)) and hypoxic (3% O(2), 6% CO(2), and 91% N(2)) conditions. Regions of interest (ROIs) over the lobar artery and vein at low magnification and a feeding artery ( approximately 500 microm diameter) and the nearby microvasculature (vessels smaller than approximately 50 microm) at high magnification were identified, and X-ray absorbance vs. time curves were acquired under both conditions from the same ROIs. The total pulmonary vascular volume was calculated from the flow and the mean transit time for the contrast medium passage from the lobar artery to lobar vein. The fractional changes in microvascular volume were determined from the areas under the high-magnification X-ray absorbance curves. Hypoxia decreased lobar volume by 13 +/- 3% (SE) and regional microvascular volume by 26 +/- 4% (SE). Given the morphometry of the lung vasculature, these results suggest that capillary volume was decreased by hypoxia.

Splanchnic vessels

Splanchnic vessels

Harmonic hepatic US with microbubble contrast agent: initial experience showing improved characterization of hemangioma, hepatocellular carcinoma, and metastasis.

To characterize blood flow in focal hepatic lesions with harmonic ultrasonographic (US) imaging and a microbubble contrast agent. Thirty patients with known hepatic masses were examined after injection of a perfluorocarbon microbubble agent. Tumor vascularity was assessed with continuous, harmonic gray-scale imaging with a low mechanical index (MI). Tumor vascular volume was assessed with brief, high-MI insonation called interval-delay imaging, which caused microbubble destruction. As the total contrast agent volume in the liver reflects the total vascular volume, quantitation of lesion enhancement relative to normal hepatic enhancement helped determine the vascular volume of the tumor relative to that of normal parenchyma. Low-MI continuous harmonic imaging showed lesional vessels in hepatocellular carcinomas, minimal or no vessels in hemangiomas, and variable vascularization in metastases. High-MI interval-delay imaging showed greater enhancement in hepatocellular carcinomas than in normal liver (P <.02) and showed less enhancement in hemangiomas than in normal liver (P <.02). Enhancement in metastases was greater in the margins than in the center; as a result, the lesions appeared smaller (P <.03) and less well defined on the interval-delay images. Contrast-enhanced harmonic imaging appears superior to conventional Doppler US for hepatic mass characterization. Low-MI continuous and high-MI interval-delay imaging can help assess tumor vascular pattern and microvascular volume.

Quantitative studies of the vasculature of the carotid body in the chronically hypoxic rat.

The carotid bodies of rats made chronically hypoxic by breathing 12% O2 in a normobaric chamber (inspired PO2 91 mmHg) were compared with those of controls. Serial 5-microm sections of the organs were examined using an interactive image analysis system. The total volume of the carotid bodies was increased by 64%. The total vascular volume rose by 103% and was likely due to an increase in size of the large vessels (>12 microm lumen diameter) because the small vessel (5-12 microm lumen diameter) volume did not increase significantly while the small vessel density tended to decrease. The extravascular volume was increased by 57%. Expressed as a percentage of the total volume of the organ, the total vascular volume did not change, but the small vessel volume was significantly decreased from 7.83 to 6.06%. The large vessel volume must therefore have been increased. The proportion occupied by the extravascular volume was virtually unchanged (84 vs 82%). In accordance with these findings, the small vessel endothelial surface area per unit carotid body volume was diminished from 95.2 to 76.5 mm-1, while the extravascular area per small vessel was increased from 493 to 641 microm(2) or by 30%. In conclusion, the enlargement of the carotid body in chronic hypoxia is most likely due to an increase in total vascular volume, mainly involving the "large" vessels, and to an increase in extravascular volume. This is in contrast to our previously published findings indicating that in the spontaneous insulin-dependent diabetic rat the enlargement of the carotid body is due solely to an increase in extravascular volume.

Arterial versus venous changes in vascular capacitance during nitroprusside infusion: a vascular modelling study

The distributions of nitroprusside (NP) induced changes in vascular capacitance, arterial versus venous, are unknown. We measured canine ileal arterial and venous pressures and total (isolated loop) vascular volumes (scintigraphy), before and during NP infusion. NP sufficient to decrease perfusion pressure by 30% increased total vascular volume to 111 +/- 3% (+/- SEM) of control (p < 0.01). Increasing flow to restore perfusion pressure increased volume 4% more (p < 0.01). Assuming a two-compartment model and on the basis of the literature data, changes in venous capacitance were estimated and compared with arterial capacitance. During constant-flow perfusion, NP increased venous volume by 10.0% (vs. 18.1%, arterial). When flow was increased to restore pressure, venous volume increased by another 3.7% (vs. 2.6%, arterial). Assuming an original arterial to venous volume ratio of 133/1033, the final, constant-pressure increase in venous volume was almost 4 times the arterial increase. In conclusion, the increase in vascular volume during NP infusion was due primarily to similar-magnitude, active increases in venous and arterial capacitances (i.e., rightward shifts in pressure-volume relations). However, as venous volume is so much larger than arterial, the NP-induced increase in venous volume was greater.

The carotid body of the spontaneous insulin-dependent diabetic rat.

The carotid bodies from adult spontaneous insulin-dependent diabetic rats (strain BB/S) were perfusion-fixed at normal arterial blood pressure with 3% phosphate-buffered glutaraldehyde and compared with the organs from control rats (strain BB/Sc) prepared in the same way. Serial 5-micron sections were cut, stained, and using an interactive image analysis system, were analysed to determine the volumes of the carotid body and its vascular and extravascular compartments. There was no evidence of systemic arterial disease in the carotid stem arteries in either group of animals, and the microvasculature of the organs appeared normal by light microscopy. The volume of the carotid body was unchanged 3 months after the onset of diabetes but was increased at 6 months. The total vascular volume of the organ was unchanged, but the volume of the small vessels (5-12 microns) was increased. In the control group the small vessels comprised 5% of the total volume of the carotid body, or about 44% of the vascular compartment. The percentage of small vessels increased at 3 months in the diabetic group, but had returned to normal at 6 months. The extravascular volume followed the same pattern as the total carotid body volume and so did not change appreciably when expressed as a percentage of the total volume of the organ. The increase in size of the carotid body in diabetic rats is due, therefore, to an augmented extravascular volume. In one diabetic specimen the carotid sinus nerve showed signs of diabetic neuropathy, axonal swelling and intramyelinic oedema. The clinical implications of these results are discussed.

Significance of mat and shoe softness during prolonged work in upright position: based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions

The aim of the investigation was to study the significance of mat and shoe softness during prolonged work in an upright position based on some physiological, biomechanical and comfort measurements related to the lower extremities and the low back. Eight healthy female volunteers performed 2 h of simulated standing and 2 h of standing/walking work tasks in the laboratory using four combinations of soft shoes, clogs, soft mat and concrete. Thus, each subject performed a total of eight 2 h work tests. The following parameters were measured pre-experimentally and one or more times during 2 h: total foot volume, vascular volume and interstitial volume of the left foot, EMG from the lumbar paraspinals, movement of centre of gravity (only during standing), biomechanical heel impact (only during standing/walking), perceived discomfort in lumbar back, legs and feet, whole body oxygen uptake, arterial blood pressure and heart rate. Using soft shoes rather than clogs during standing/walking work implies approximately a halving of the foot oedema formation and the heel impact. The effects due to the introduction of the soft mat are negligible. The local circulatory responses in the feet and the EMG-signs of paravertebral muscle fatigue are larger during standing compared to standing/walking work. The two investigated work types in this study differ regarding exposures as well as responses. Thus, it is recommended to shift between these postures and seated work during the working hours to improve job exposures.

An interpretation of 14C-urea and 14C-primidone extraction in isolated rabbit lungs.

We measured the venous concentration versus time curves of 14C-urea and 14C-primidone after rapid bolus injections of a vascular reference indicator, fluorescein isothiocyanate dextran, and one of the two 14C-labeled indicators in isolated rabbit lungs perfused with Krebs-Ringer bicarbonate solution containing 4.5% bovine serum albumin at flow rates (F) of 6.67, 3.33, 1.67, and 0.83 ml/sec and with nearly constant microvascular pressure and total lung vascular volume. When we calculated the permeability-surface area product, PS, from the 14C-urea and 14C-primidone outflow curves using the Crone model, the estimates of the PS product were directly proportional to F. However, the fractional change in the PS with flow was different for the two indicators. We also estimated the PS from the same 14C-urea and 14C-primidone data using an alternative model that includes perfusion heterogeneity, estimated in a previous study, and flow-limited and barrier-limited extravascular volumes accessible to both urea and primidone. This model was able to fit the outflow curves of either 14C-urea or 14C-primidone at all four flows studied with one flow-independent PS for each indicator. The ability of the new model to explain the 14C-urea and 14C-primidone data with no flow-dependent change in PS suggests that a change in PS with F estimated using other models such as the Crone model is not sufficient for capillary surface area recruitment.

The effects of maternal aerobic exercise on human placental development: Placental volumetric composition and surface areas

The histomorphometry of term placentae from women who exercised regularly throughout either the first half or all of pregnancy was compared to that of placentae from matched controls to determine if regular exercise during pregnancy produced histomorphometric evidence of altered development and transport capacity. Conventional stereological techniques were used to estimate placental volumetric composition, surface areas, and villous and vascular configurations in the three groups. Exercise confined to early pregnancy increased the parenchymal component of the placenta, total vascular volume and site-speck capillary volume and surface area. Exercise throughout pregnancy increased these and multiple other histomorphometric parameters associated with the rate of placental perfusion and transfer function. However, significant changes were confined to villi >80 μm in diameter. The localization of both the timing of the stimulus and the anatomical sites affected indicates that regular, sustained exercise modifies placental development primarily in early and mid pregnancy. We speculate that the lack of significant changes in the structure and configuration of the smaller villi indicates that other adaptive mechanisms, such as increased rates of placental blood flow, must be well developed by the latter portion of the mid-trimester and adequately maintain fetal oxygenation and substrate delivery throughout the third trimester.

Estimation of the pulmonary capillary transport function in isolated rabbit lungs.

Recently, we presented a method for estimating the pulmonary capillary volume and transport function based on the use of a reference indicator and two or more indicators that rapidly equilibrate (radially) with the tissue (i.e., the concentrations in the vascular and extravascular spaces at a given axial location are in equilibrium) during transit through the capillaries in a bolus-injection indicator dilution method (S. H. Audi, G. S. Krenz, J. H. Linehan, D. A. Rickaby, and C. A. Dawson. J. Appl. Physiol. 77:332-351, 1994). The objectives of the present study were 1) to determine whether [14C]diazepam and [3H]alfentanil equilibrate sufficiently rapidly between the vascular space and tissue and with sufficiently different pulmonary extra-vascular mean residence times to be used in a single bolus to estimate the pulmonary capillary volume and transport function using this method and 2) to estimate the pulmonary capillary volume and transit time distribution in isolated perfused rabbit lungs. Both [14C]diazepam and [3H]alfentanil were found to be rapidly equilibrating indicators by the criteria that, over a wide range of flow rates, their respective venous effluent concentration curves were nearly congruent on a time scale normalized to the lung mean transit time for the reference indicator (fluorescein isothiocyanate dextran). In addition, at a given plasma albumin concentration, [14C]diazepam had a significantly longer extravascular mean residence time than [3H]alfentanil, e.g., at 6% plasma albumin concentration, the extravascular mean residence time of [14C]diazepam was more than twice that of [3H]alfentanil. On average, the estimated pulmonary capillary volume for a 2.7-kg was approximately 4.2 ml or approximately 44% of the total pulmonary vascular volume (9.5 ml). The relative dispersion of the pulmonary capillary transport function of the rabbit was approximately 90%.

The vascular site of action of hypoxia in the neonatal pig lung.

To determine the vascular site(s) of action of hypoxia in the neonatal pig, isolated lungs were perfused at a constant flow rate and left atrial pressure; arterial, venous, and double occlusions were performed. The distribution of the total pulmonary vascular resistance and the total dynamic vascular compliance were calculated using a model of the pulmonary circulation consisting of upstream, central, and downstream compliances and resistances upstream and downstream of central compliance. In addition, the static vascular compliance was measured by venous followed by arterial occlusion, and the total vascular volume was measured by dye-dilution. In this preparation during control conditions alveolar PO2 = 12 +/- 2 kPa), total pulmonary vascular resistance was nearly evenly divided between resistance upstream and downstream of double occlusion pressure and total dynamic vascular compliance was concentrated mainly in the central compliance (7% upstream compliance, 82% central compliance, and 11% downstream compliance). Hypoxia (alveolar PO2 = 4 +/- 1 kPa) increased both resistance upstream of double occlusion pressure (p < 0.005) and resistance downstream of double occlusion pressure (p < 0.02) and decreased central compliance (p < 0.005). Hypoxia also decreased total pulmonary blood volume (p < 0.02). These results suggest that in the pulmonary vasculature of the neonatal pig, hypoxia results mainly in 1) arterial constriction as evidenced by a large increase in upstream resistance and a decrease in total pulmonary blood volume and 2) a smaller but significant venous constriction. This venous constriction may have implications in the pathogenesis and therapy of pulmonary vascular diseases associated with hypoxia such as postasphyxial lung disease and bronchopulmonary dysplasia.

A T.E.M. stereological analysis of blood vessels and nerves in marmoset periodontal ligament following endodontics and magnetic incisor extrusion.

Maxillary incisor fracture is a common dental injury. It is frequently treated by endodontic therapy, orthodontic extrusion, and a retention period. The aim of the study was to mimic this regime and stereologically quantify the vascular and neural reconstitution of the periodontal ligament (PDL). Ten marmosets (Callithrix jacchus) had the right maxillary incisor crown removed, root canal treatment, and magnetic incisor root extrusion of 1.2 mm. After incisor retention for 9 weeks, the animals were perfusion fixed for electron microscopy. The incisor PDL was sectioned at 250 micron intervals from the cervical to apical region and recorded for stereological evaluation. Further evaluations were conducted with a two-way analysis of covariance using program 3V of the BMDP-81 statistical software package. The total luminal PDL vascular volume was statistically unchanged. An increased occurred in the mean number of venous capillaries from 0.07 +/- 0.3 to 0.17 +/- 0.3 per 560 microns 2 of PDL (P < 0.05). Vessel wall and luminal volume of post-capillary-sized venules decreased from 1.64 to 1.03 per cent, and 5.32 to 3.04 per cent (P < 0.05), respectively. Mean luminal and abluminal diameters for post-capillary-sized venules were reduced (P < 0.05). Myelinated and unmyelinated axons showed no significant change in volume (Vv), length (Lv), or surface (Sv) densities. Axon number/unit, PDL area, and mean diameters demonstrated no statistical differences. Since the PDL demonstrated almost complete morphological re-establishment of the microvascular and axon systems, it is considered that this clinical treatment is a justifiable rationale.