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Abstract

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 ± 1.4 m/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 Type:	Article
Authors/Creators:	Climie, RED and Picone, DS and Blackwood, S and Keel, SE and Qasem, A and Rattigan, S and Sharman, JE
Keywords:	aorta, arterial stiffness, blood pressure, physiology
Journal or Publication Title:	European Journal of Applied Physiology
Publisher:	Springer-Verlag
ISSN:	1439-6319
DOI / ID Number:	https://doi.org/10.1007/s00421-018-3972-2
Copyright Information:	Copyright 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Related URLs:	Google Scholar: Picone, DS UTAS Profile: Rattigan, S Google Scholar: Sharman, JE UTAS Profile: Sharman, JE
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