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. 2016 Jun 1;310(11):H1479-85.
doi: 10.1152/ajpheart.00136.2016. Epub 2016 Apr 15.

Evidence of microvascular dysfunction in patients with cystic fibrosis

Paula Rodriguez-Miguelez  1 , Jeffrey Thomas  1 , Nichole Seigler  1 , Reva Crandall  2 , Kathleen T McKie  2 , Caralee Forseen  3 , Ryan A Harris  4
Affiliations

Evidence of microvascular dysfunction in patients with cystic fibrosis

Paula Rodriguez-Miguelez et al. Am J Physiol Heart Circ Physiol. .

Abstract

Cystic fibrosis (CF) is a genetic, multisystemic disorder with broad clinical manifestations apart from the well-characterized pulmonary dysfunction. Recent findings have described impairment in conduit vessel function in patients with CF; however, whether microvascular function is affected in this population has yet to be elucidated. Using laser-Doppler imaging, we evaluated microvascular function through postocclusive reactive hyperemia (PORH), local thermal hyperemia (LTH), and iontophoresis with acetylcholine (ACh). PORH [518 ± 174% (CF) and 801 ± 125% (control), P = 0.039], LTH [1,338 ± 436% (CF) and 1,574 ± 620% (control), P = 0.045], and iontophoresis with ACh [416 ± 140% (CF) and 617 ± 143% (control), P = 0.032] were significantly lower in patients with CF than control subjects. In addition, the ratio of PORH to LTH was significantly (P = 0.043) lower in patients with CF (55.3 ± 5.1%) than control subjects (68.8 ± 3.1%). Significant positive correlations between LTH and forced expiratory volume in 1 s (%predicted) (r = 0.441, P = 0.013) and between the PORH-to-LTH ratio and exercise capacity (r = 0.350, P = 0.049) were observed. These data provide evidence of microvascular dysfunction in patients with CF compared with control subjects. In addition, our data demonstrate a complex relationship between microvascular function and classical markers of disease severity (i.e., pulmonary function and exercise capacity) in CF.

Keywords: cystic fibrosis; endothelial function; endothelium-dependent vasodilation; microvascular function.

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Figures

Fig. 1.
Fig. 1.
Experimental setup of microvascular function using a laser-Doppler imager with the occlusion cuff for postocclusive reactive hyperemia and the 2 chambers for local thermal hyperemia (LTH) and acetylcholine (ACh) iontophoresis.
Fig. 2.
Fig. 2.
Typical cutaneous vascular flux assessment using a laser-Doppler imager with baseline and responses for postocclusive reactive hyperemia (PORH), local thermal hyperemia (LTH), and iontophoresis with ACh. PU, perfusion units.
Fig. 3.
Fig. 3.
Postocclusive reactive hyperemia (PORH) response normalized to maximal hyperemia during local thermal hyperemia (LTH). Values are means ± SD. *Significantly different from controls.
See this image and copyright information in PMC

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