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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Cardiovasc. Med. | doi: 10.3389/fcvm.2019.00169

Measuring the interaction between the macro- and microvasculature

 Rachel Climie1, 2, 3, 4*, Antonio Gallo5, 6, Dean Picone4, Nicole Di Lascio7, Thomas T. Van Sloten8,  Andrea Guala9, 10,  Bernhard Hametner11,  Christopher C. Mayer11 and  Rosa Maria Bruno1, 2*
  • 1INSERM U970 Paris-Centre de Recherche Cardiovasculaire (PARCC), France
  • 2Université Paris Descartes, France
  • 3Baker Heart and Diabetes Institute, Australia
  • 4Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Australia
  • 5Hôpitaux Universitaires Pitié Salpêtrière, France
  • 6INSERM U1146 Laboratoire d'Imagerie Biomédicale, France
  • 7Institute of Clinical Physiology, Italian National Research Council, Italy
  • 8Maastricht University, Netherlands
  • 9Vall d'Hebron Research Institute (VHIR), Spain
  • 10Vall d'Hebron University Hospital, Spain
  • 11Austrian Institute of Technology (AIT), Austria

Structural and functional dysfunction in both the macro- and microvasculature are a feature of essential hypertension. In a healthy cardiovascular system, the elastic properties of the large arteries ensure that pulsations in pressure and flow generated by cyclic left ventricular contraction are dampened, so that less pulsatile pressure and flow are delivered at the microvascular level. However, in response to ageing, hypertension and other disease states, arterial stiffening limits the buffering capacity of the elastic arteries, thus exposing the microvasculature to increased pulsatile stress. This is thought to be particularly pertinent to high flow / low resistance organs such as the brain and kidney, which may be sensitive to excess pressure and flow pulsatility, damaging capillary networks and resulting in target organ damage. In this review, we describe the clinical relevance of the pulsatile interaction between the macro- and microvasculature and summarize current methods for measuring the transmission of pulsatility between the two sites.

Keywords: methods, microvascular, Macrovascular, Wave Intensity Analysis, Brain, Kidney, Retina

Received: 17 Sep 2019; Accepted: 07 Nov 2019.

Copyright: © 2019 Climie, Gallo, Picone, Di Lascio, Van Sloten, Guala, Hametner, Mayer and Bruno. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Rachel Climie, INSERM U970 Paris-Centre de Recherche Cardiovasculaire (PARCC), Paris, 75015, Île-de-France, France, rachel.climie@inserm.fr
Dr. Rosa Maria Bruno, INSERM U970 Paris-Centre de Recherche Cardiovasculaire (PARCC), Paris, 75015, Île-de-France, France, rosam.bruno@gmail.com