Houben Alfons J H M, Martens Remy J H, Stehouwer Coen D A
Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands; and
CARIM School for Cardiovascular Diseases and.
J Am Soc Nephrol. 2017 Dec;28(12):3461-3472. doi: 10.1681/ASN.2017020157. Epub 2017 Sep 13.
Microvascular dysfunction (MVD) is considered a crucial pathway in the development and progression of cardiometabolic and renal disease and is associated with increased cardiovascular mortality. MVD often coexists with or even precedes macrovascular disease, possibly due to shared mechanisms of vascular damage, such as inflammatory processes and oxidative stress. One of the first events in MVD is endothelial dysfunction. With the use of different physiologic or pharmacologic stimuli, endothelium-dependent (micro)vascular reactivity can be studied. This reactivity depends on the balance between various mediators, including nitric oxide, endothelin, and prostanoids, among others. The measurement of microvascular (endothelial) function is important to understand the pathophysiologic mechanisms that contribute to MVD and the role of MVD in the development and progression of cardiometabolic/renal disease. Here, we review a selection of direct, noninvasive techniques for measuring human microcirculation, with a focus on methods, interpretation, and limitations from the perspective of chronic cardiometabolic and renal disease.
微血管功能障碍（MVD）被认为是心脏代谢和肾脏疾病发生发展的关键途径，且与心血管死亡率增加相关。MVD常与大血管疾病共存，甚至先于大血管疾病出现，这可能是由于血管损伤的共同机制，如炎症过程和氧化应激。MVD最早出现的事件之一是内皮功能障碍。通过使用不同的生理或药理刺激，可以研究内皮依赖性（微）血管反应性。这种反应性取决于多种介质之间的平衡，包括一氧化氮、内皮素和前列腺素等。微血管（内皮）功能的测量对于理解导致MVD的病理生理机制以及MVD在心脏代谢/肾脏疾病发生发展中的作用至关重要。在此，我们回顾了一系列用于测量人体微循环的直接、非侵入性技术，重点从慢性心脏代谢和肾脏疾病的角度探讨方法、解读及局限性。
