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Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes


Climie, RED and Picone, DS and Blackwood, S and Keel, SE and Qasem, A and Rattigan, S and Sharman, JE, Pulsatile interaction between the macro-vasculature and micro-vasculature: proof-of-concept among patients with type 2 diabetes, European Journal of Applied Physiology, 118, (11) pp. 2455-2463. ISSN 1439-6319 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 Springer-Verlag GmbH Germany, part of Springer Nature

DOI: doi:10.1007/s00421-018-3972-2


Purpose: It is widely thought that excess pulsatile pressure from increased stiffness of large central arteries (macro-vasculature) is transmitted to capillary networks (micro-vasculature) and causes target organ damage. However, this hypothesis has never been tested. We sought to examine the association between macro- and micro-vasculature waveform features in patients with type 2 diabetes (i.e., those with elevated stiffness; T2D) compared with non-diabetic controls.

Methods: Among 13 T2D (68  6 years, 39% male) and 15 controls (58  11 years, 40% male) macro-vascular stiffness was determined via aortic pulse wave velocity (aPWV) and macro-vascular waveforms were measured using radial tonometry. Forearm micro-vascular waveforms were measured simultaneously with macro-vascular waveforms via low power laser Doppler fluxmetry. Augmentation index (AIx) was derived on macro- and micro-vascular waveforms. Target organ damage was assessed by estimated glomerular filtration rate (eGFR) and central retinal artery equivalent (CRAE).

Results: aPWV was higher among T2D (9.3  2.5 vs 7.5  1.4m/s, p = 0.046). There was an obvious pulsatile micro-vascular waveform with qualitative features similar to macro-vasculature pressure waveforms. In all subjects, macro- and micro-vasculature AIx were significantly related (r = 0.43, p = 0.005). In T2D alone, micro-vasculature AIx was associated with eGFR (r = -0.63, p = 0.037), whereas in controls, macro-vasculature AIx and AP were associated with CRAE (r = -0.58, p = 0.025 and r = -0.61, p = 0.015).

Conclusions: Macro- and micro-vasculature waveform features are related; however, micro-vasculature features are more closely related to markers of target organ damage in T2D. These findings are suggestive of a possible interaction between the macro- and micro-circulation.

Item Details

Item Type:Refereed Article
Keywords:aorta, arterial stiffness, blood pressure, physiology
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Endocrinology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Climie, RED (Dr Rachel Climie)
UTAS Author:Picone, DS (Dr Dean Picone)
UTAS Author:Blackwood, S (Ms Sarah Blackwood)
UTAS Author:Rattigan, S (Professor Stephen Rattigan)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:128122
Year Published:2018
Web of Science® Times Cited:11
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-09-04
Last Modified:2019-03-25

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