Vasomotion and blood flow regulation in hamster skeletal muscle microcirculation: A theoretical and experimental study

Distinct roles of red-blood-cell-derived and wall-derived mechanisms in metabolic regulation of blood flow

OBJECTIVE

A theoretical model is used to analyze combinations of RBC-derived and wall-derived (RBC-independent) mechanisms for metabolic blood flow regulation, with regard to their oxygen transport properties.

METHODS

Heterogeneous microvascular network structures are derived from observations in rat mesentery and hamster cremaster. The effectiveness of metabolic blood flow regulation using combinations of RBC-dependent and RBC-independent mechanisms is simulated in these networks under conditions of reduced oxygen delivery and increased oxygen demand.

RESULTS

Metabolic regulation by a wall-derived mechanism results in higher predicted total blood flow rate and number of flowing vessels, and lower tissue hypoxic fraction, than regulation by combinations of RBC-derived and wall-derived signals. However, a combination of RBC-derived and wall-derived signals results in a higher predicted median tissue P_O2 than either mechanism acting alone.

CONCLUSIONS

Model results suggest complementary roles for RBC-derived and wall-derived mechanisms of metabolic flow regulation, with the wall-derived mechanism responsible for avoiding hypoxia, and the RBC-derived mechanism responsible for maintaining P_O2 levels high enough for optimal tissue function.

Cerebrovascular Smooth Muscle Cells as the Drivers of Intramural Periarterial Drainage of the Brain

The human brain is the organ with the highest metabolic activity but it lacks a traditional lymphatic system responsible for clearing waste products. We have demonstrated that the basement membranes of cerebral capillaries and arteries represent the lymphatic pathways of the brain along which intramural periarterial drainage (IPAD) of soluble metabolites occurs. Failure of IPAD could explain the vascular deposition of the amyloid-beta protein as cerebral amyloid angiopathy (CAA), which is a key pathological feature of Alzheimer's disease. The underlying mechanisms of IPAD, including its motive force, have not been clarified, delaying successful therapies for CAA. Although arterial pulsations from the heart were initially considered to be the motive force for IPAD, they are not strong enough for efficient IPAD. This study aims to unravel the driving force for IPAD, by shifting the perspective of a heart-driven clearance of soluble metabolites from the brain to an intrinsic mechanism of cerebral arteries (e.g., vasomotion-driven IPAD). We test the hypothesis that the cerebrovascular smooth muscle cells, whose cycles of contraction and relaxation generate vasomotion, are the drivers of IPAD. A novel multiscale model of arteries, in which we treat the basement membrane as a fluid-filled poroelastic medium deformed by the contractile cerebrovascular smooth muscle cells, is used to test the hypothesis. The vasomotion-induced intramural flow rates suggest that vasomotion-driven IPAD is the only mechanism postulated to date capable of explaining the available experimental observations. The cerebrovascular smooth muscle cells could represent valuable drug targets for prevention and early interventions in CAA.

Automated quantification of microvascular perfusion

OBJECTIVE

Changes in microvascular perfusion have been reported in many diseases, yet the functional significance of altered perfusion is often difficult to determine. This is partly because commonly used techniques for perfusion measurement often rely on either indirect or by-hand approaches.

METHODS

We developed and validated a fully automated software technique to measure microvascular perfusion in videos acquired by fluorescence microscopy in the mouse gastrocnemius. Acute perfusion responses were recorded following intravenous injections with phenylephrine, SNP, or saline.

RESULTS

Software-measured capillary flow velocity closely correlated with by-hand measured flow velocity (R²  = 0.91, P < 0.0001). Software estimates of capillary hematocrit also generally agreed with by-hand measurements (R²  = 0.64, P < 0.0001). Detection limits range from 0 to 2000 μm/s, as compared to an average flow velocity of 326 ± 102 μm/s (mean ± SD) at rest. SNP injection transiently increased capillary flow velocity and hematocrit and made capillary perfusion more steady and homogenous. Phenylephrine injection had the opposite effect in all metrics. Saline injection transiently decreased capillary flow velocity and hematocrit without influencing flow distribution or stability. All perfusion metrics were temporally stable without intervention.

CONCLUSIONS

These results demonstrate a novel and sensitive technique for reproducible, user-independent quantification of microvascular perfusion.

Laser Speckle Imaging of Rat Pial Microvasculature during Hypoperfusion-Reperfusion Damage

The present study was aimed to in vivo assess the blood flow oscillatory patterns in rat pial microvessels during 30 min bilateral common carotid artery occlusion (BCCAO) and 60 min reperfusion by laser speckle imaging (LSI). Pial microcirculation was visualized by fluorescence microscopy. The blood flow oscillations of single microvessels were recorded by LSI; spectral analysis was performed by Wavelet transform. Under baseline conditions, arterioles and venules were characterized by blood flow oscillations in the frequency ranges 0.005-0.0095 Hz, 0.0095-0.021 Hz, 0.021-0.052 Hz, 0.052-0.150 Hz and 0.150-0.500 Hz. Arterioles showed oscillations with the highest spectral density when compared with venules. Moreover, the frequency components in the ranges 0.052-0.150 Hz and 0.150-0.500 were predominant in the arteriolar total power spectrum; while, the frequency component in the range 0.150-0.500 Hz showed the highest spectral density in venules. After 30 min BCCAO, the arteriolar spectral density decreased compared to baseline; moreover, the arteriolar frequency component in the range 0.052-0.150 Hz significantly decreased in percent spectral density, while the frequency component in the range 0.150-0.500 Hz significantly increased in percent spectral density. However, an increase in arteriolar spectral density was detected at 60 min reperfusion compared to BCCAO values; consequently, an increase in percent spectral density of the frequency component in the range 0.052-0.150 Hz was observed, while the percent spectral density of the frequency component in the range 0.150-0.500 Hz significantly decreased. The remaining frequency components did not significantly change during hypoperfusion and reperfusion. The changes in blood flow during hypoperfusion/reperfusion caused tissue damage in the cortex and striatum of all animals. In conclusion, our data demonstrate that the frequency component in the range 0.052-0.150 Hz, related to myogenic activity, was significantly impaired by hypoperfusion and reperfusion, affecting cerebral blood flow distribution and causing tissue damage.

Age, waist circumference, and blood pressure are associated with skin microvascular flow motion: the Maastricht Study

OBJECTIVE

Skin microvascular flow motion (SMF)--blood flow fluctuation attributed to the rhythmic contraction and dilation of arterioles--is thought to be an important component of the microcirculation, by ensuring optimal delivery of nutrients and oxygen to tissue and regulating local hydraulic resistance. There is some evidence that SMF is altered in obesity, type 2 diabetes mellitus, and hypertension. Nevertheless, most studies of SMF have been conducted in highly selected patient groups, and evidence how SMF relates to other cardiovascular risk factors is scarce. Therefore, the aim of the present study was to examine in a population-based setting which cardiovascular risk factors are associated with SMF.

METHODS

We measured SMF in 506 participants of the Maastricht Study without prior cardiovascular event. SMF was investigated using Fourier transform analysis of skin laser Doppler flowmetry at rest within five frequency intervals in the 0.01-1.6-Hz spectral range. The associations with SMF of the cardiovascular risk factors age, sex, waist circumference, total-to-high-density lipoprotein cholesterol, fasting plasma glucose, 24-h SBP, and cigarette smoking were analysed by use of multiple linear regression analysis.

RESULTS

Per 1 SD higher age, waist circumference and 24-h SBP, SMF was 0.16 SD higher [95% confidence interval (CI) 0.07, 0.25; P < 0.001), -0.14 SD lower (95% CI -0.25, -0.04; P = 0.01), and 0.16 SD higher (95% CI 0.07, 0.26; P < 0.001), respectively, in fully adjusted analyses. We found no significant associations of sex, fasting plasma glucose levels, total-to-high-density lipoprotein cholesterol ratio, or pack years of smoking with SMF.

CONCLUSION

Age and 24-h SBP are directly, and waist circumference is inversely associated with SMF in the general population. The exact mechanisms underlying these findings remain elusive. We hypothesize that flow motion may be an important component of the microcirculation by ensuring optimal delivery of nutrients and oxygen to tissue and regulating local hydraulic resistance not only under physiological conditions but also under pathophysiological conditions when microcirculatory perfusion is reduced, such as occurs with ageing and higher blood pressure. In addition, obesity may result in an impaired flow motion with negative effects on the delivery of nutrients and oxygen to tissue and local hydraulic resistance.

Functional sympatholysis and sympathetic escape in a theoretical model for blood flow regulation

A mathematical simulation of flow regulation in vascular networks is used to investigate the interaction between arteriolar vasoconstriction due to sympathetic nerve activity (SNA) and vasodilation due to increased oxygen demand. A network with 13 vessel segments in series is used, each segment representing a different size range of arterioles or venules. The network includes five actively regulating arteriolar segments with time-dependent diameters influenced by shear stress, wall tension, metabolic regulation, and SNA. Metabolic signals are assumed to be propagated upstream along vessel walls via a conducted response. The model exhibits functional sympatholysis, in which sympathetic vasoconstriction is partially abrogated by increases in metabolic demand, and sympathetic escape, in which SNA elicits an initial vasoconstriction followed by vasodilation. In accordance with experimental observations, these phenomena are more prominent in small arterioles than in larger arterioles when SNA is assumed to act equally on arterioles of all sizes. The results imply that a mechanism based on the competing effects on arteriolar tone of SNA and conducted metabolic signals can account for several observed characteristics of functional sympatholysis, including the different responses of large and small arterioles.

Capillary recruitment in a theoretical model for blood flow regulation in heterogeneous microvessel networks

In striated muscle, the number of capillaries containing moving red blood cells increases with increasing metabolic demand. This phenomenon, termed capillary recruitment, has long been recognized, but its mechanism has been unclear. Here, a theoretical model for metabolic blood flow regulation in a heterogeneous network is used to test the hypothesis that capillary recruitment occurs as a result of active control of arteriolar diameters, combined with unequal partition of hematocrit at diverging microvascular bifurcations. The network structure is derived from published observations of hamster cremaster muscle in control and dilated states. The model for modulation of arteriolar diameters includes length-tension characteristics of vascular smooth muscle and responses of smooth muscle tone to myogenic, shear-dependent, and metabolic stimuli. Blood flow is simulated including nonuniform hematocrit distribution. Convective and diffusive oxygen transport in the network is simulated. Oxygen-dependent metabolic signals are assumed to be conducted upstream from distal vessels to arterioles. With increasing oxygen demand, arterioles dilate, blood flow increases, and the numbers of flowing arterioles and capillaries, as defined by red blood cell flux above a small threshold value, increase. Unequal hematocrit partition at diverging bifurcations contributes to recruitment and enhances tissue oxygenation. The results imply that capillary recruitment, as observed in the hamster cremaster preparations, can occur as a consequence of local control of arteriolar tone and the resulting nonuniform changes in red blood cell fluxes, and provide an explanation for observations of sequential recruitment of individual capillaries in response to modulation of terminal arteriolar diameter.

Theoretical comparison of wall-derived and erythrocyte-derived mechanisms for metabolic flow regulation in heterogeneous microvascular networks

The objective of this study is to compare the effectiveness of metabolic signals derived from erythrocytes and derived from the vessel wall for regulating blood flow in heterogeneous microvascular networks. A theoretical model is used to simulate blood flow, mass transport, and vascular responses. The model accounts for myogenic, shear-dependent, and metabolic flow regulation. Metabolic signals are assumed to be propagated upstream along vessel walls via a conducted response. Arteriolar tone is assumed to depend on the conducted metabolic signal as well as local wall shear stress and wall tension, and arteriolar diameters are calculated based on vascular smooth muscle mechanics. The model shows that under certain conditions metabolic regulation based on wall-derived signals can be more effective in matching perfusion to local oxygen demand relative to regulation based on erythrocyte-derived signals, resulting in higher extraction and lower oxygen deficit. The lower effectiveness of the erythrocyte-derived signal is shown to result in part from the unequal partition of hematocrit at diverging bifurcations, such that low-flow vessels tend to receive a reduced hematocrit and thereby experience a reduced erythrocyte-derived metabolic signal. The model simulations predict that metabolic signals independent of erythrocytes may play an important role in local metabolic regulation of vascular tone and flow distribution in heterogeneous microvessel networks.

Spontaneous oscillations in a model for active control of microvessel diameters

A new theory is presented for the origin of spontaneous oscillations in blood vessel diameters that are observed experimentally in the microcirculation. These oscillations, known as vasomotion, involve timevarying contractions of the vascular smooth muscle in the walls of arterioles. It is shown that such oscillations can arise as a result of interactions between the mechanics of the vessel wall and the dynamics of the active contraction of smooth muscle cells in response to circumferential tension in the wall. A theoretical model is developed in which the diameter and the degree of activation in a vessel are dynamic variables. The model includes effects of wall shear stress and oxygen-dependent metabolic signals on smooth muscle activation and is applied to a single vessel and to simplified network structures. The model equations predict limit cycle oscillations for certain ranges of parameters such as wall shear stress, arterial pressure and oxygen consumption rate. Predicted characteristics of the oscillations, including their sensitivity to arterial pressure, are consistent with experimental observations.

Informational dynamics of vasomotion in microvascular networks: a review

Vasomotion refers to spontaneous oscillation of small vessels observed in many microvascular beds. It is an intrinsic phenomenon unrelated to cardiac rhythm or neural and hormonal regulation. Vasomotion is found to be particularly prominent under conditions of metabolic stress. In spite of a significant existent literature on vasomotion, its physiological and pathophysiological roles are not clear. It is thought that modulation of vasomotion by vasoactive substances released by metabolizing tissue plays a role in ensuring optimal delivery of nutrients to the tissue. Vasomotion rhythms exhibit a great variety of temporal patterns from regular oscillations to chaos. The nature of vasomotion rhythm is believed to be significant to its function, with chaotic vasomotion offering several physiological advantages over regular, periodic vasomotion. In this article, we emphasize that vasomotion is best understood as a network phenomenon. When there is a local metabolic demand in tissue, an ideal vascular response should extend beyond local microvasculature, with coordinated changes over multiple vascular segments. Mechanisms of information transfer over a vessel network have been discussed in the literature. The microvascular system may be regarded as a network of dynamic elements, interacting, either over the vascular anatomical network via gap junctions, or physiologically by exchange of vasoactive substances. Drawing analogies with spatiotemporal patterns in neuronal networks of central nervous system, we ask if properties like synchronization/desynchronization of vasomotors have special significance to microcirculation. Thus the contemporary literature throws up a novel view of microcirculation as a network that exhibits complex, spatiotemporal and informational dynamics.

A polymeric micro-optical interface for flow monitoring in biomicrofluidics

We describe design and miniaturization of a polymeric optical interface for flow monitoring in biomicrofluidics applications based on polydimethylsiloxane technology, providing optical transparency and compatibility with biological tissues. Design and ray tracing simulation are presented as well as device realization and optical analysis of flow dynamics in microscopic blood vessels. Optics characterization of this polymeric microinterface in dynamic experimental conditions provides a proof of concept for the application of the device to two-phase flow monitoring in both in vitro experiments and in vivo microcirculation investigations. This technology supports the study of in vitro and in vivo microfluidic systems. It yields simultaneous optical measurements, allowing for continuous monitoring of flow. This development, integrating a well-known and widely used optical flow monitoring systems, provides a disposable interface between live mammalian tissues and microfluidic devices making them accessible to detectionprocessing technology, in support or replacing standard intravital microscopy.

Blood velocity pulse quantification in the human conjunctival pre-capillary arterioles

Axial red blood cell velocity pulse was quantified throughout its period by high speed video microcinematography in the human eye. In 30 conjunctival precapillary arterioles (6 to 12 microm in diameter) from 15 healthy humans, axial velocities ranged from 0.4 (the minimum of all the end diastolic values) to 5.84 mm/s (the maximum of all the peak systolic values). With the velocity pulse properly quantified, two parameters can be estimated: (1) the average velocity of the pulse during a cardiac cycle AVV (average velocity value) and (2) the magnitude of the pulsation using Pourcelot's resistive index RI. These parameters are important for the estimation of other hemodynamic parameters such as the average volume flow and the average shear stress. The results of this study revealed that the AVV in the human precapillary arterioles ranged between 0.52 and 3.26 mm/s with a mean value for all microvessels of 1.66 mm/s+/-0.11(SE). The RI ranged between 35.5% and 81.8% with a mean value of 53.1%+/-2.2. Quantitative information was obtained for the first time on the velocity pulse characteristics just before the human capillary bed.

Microcirculation in preterm infants: profound effects of patent ductus arteriosus

OBJECTIVES

To assess potential effects of a hemodynamically significant persistent ductus arteriosus (sPDA) in the skin microcirculation in preterm neonates.

STUDY DESIGN

In 25 patients (<32 weeks of gestation; birth weight <1250 g) with sPDA (n = 13) or no significant PDA (non-sPDA; n = 12) functional vessel density and vessel diameters were investigated prospectively. Sidestream dark field imaging was performed in the skin of both arms from the third day of life until PDA closure or until day 7 or 8 for the non-sPDA group.

RESULTS

Before PDA treatment, functional vessel density was significantly lower in the sPDA group compared with the non-sPDA group. In the sPDA group, there were significantly fewer large vessels (diameter >20 microm) and significantly more small vessels (diameter <10 microm). After successful PDA treatment, these differences disappeared. In both groups, functional vessel density differed significantly between the left and right arm, persisting even after successful treatment. Regression analysis showed an inverse linear correlation between the hemodynamic echocardiographic findings and functional vessel density (P <.005).

CONCLUSION

sPDA causes major changes in the microcirculation of premature neonates; functional vessel density is reduced, with a shift in perfusion from larger toward smaller vessels. The redistribution of flow might be a compensatory mechanism to preserve physiologic metabolism.

Theoretical models for regulation of blood flow

Blood-flow rate in the normal microcirculation is regulated to meet the metabolic demands of the tissues, which vary widely with position and with time, but is relatively unaffected by changes of arterial pressure over a considerable range. The regulation of blood flow is achieved by the combined effects of multiple interacting mechanisms, including sensitivity to pressure, flow rate, metabolite levels, and neural signals. The main effectors of flow regulation, the arterioles and small arteries, are located at a distance from the regions of tissue that they supply. Flow regulation requires the sensing of metabolic and hemodynamic conditions and the transfer of information about tissue metabolic status to upstream vessels. Theoretical approaches can contribute to the understanding of flow regulation by providing quantitative descriptions of the mechanisms involved, by showing how these mechanisms interact in networks of interconnected microvessels supplying metabolically active tissues, and by establishing relationships between regulatory processes occurring at the microvascular level and variations of metabolic activity and perfusion in whole tissues. Here, a review is presented of previous and current theoretical approaches for investigating the regulation of blood flow in the microcirculation.

Calcium dynamics and vasomotion in arteries subject to isometric, isobaric, and isotonic conditions

In vitro, different techniques are used to study the smooth muscle cells' calcium dynamics and contraction/relaxation mechanisms on arteries. Most experimental studies use either an isometric or an isobaric setup. However, in vivo, a blood vessel is neither isobaric nor isometric nor isotonic, as it is continuously submitted to intraluminal pressure variations arising from heart beat. We use a theoretical model of the smooth muscle calcium and arterial radius dynamics to determine whether results may be considerably different depending on the experimental conditions (isometric, isobaric, isotonic, or cyclic pressure variations). We show that isobaric conditions appear to be more realistic than isometric or isotonic situations, as the calcium dynamics is similar under cyclic intraluminal pressure variations (in vivo-like situation) and under a constant pressure (isobaric situation). The arterial contraction is less pronounced in isotonic than in isobaric conditions, and the vasoconstrictor sensitivity higher in isometric than isobaric or isotonic conditions, in agreement with experimental observations. Interestingly, the model predicts that isometric conditions may generate artifacts like the coexistence of multiple stable states. We have verified this model prediction experimentally using rat mesenteric arteries mounted on a wire myograph and stimulated with phenylephrine.

Impaired local microvascular vasodilatory effects of insulin and reduced skin microvascular vasomotion in obese women

Our study aim is to investigate whether obesity is characterized by an impairment of insulin-mediated vasodilatory effects and by a modification of basal vasomotion in the skin microvasculature. Forty healthy obese and forty healthy lean women were included. Microvascular effects of insulin as compared to a control substance were measured by cathodal iontophoresis combined with laser Doppler flowmetry. Vasomotion was examined by Fourier transform analyses of skin laser Doppler flow at rest. Locally administered insulin, as compared to the control substance, induced a microvascular vasodilatory response in lean (median (interquartile range): 31.6 (17.1-43.9) vs. 22.9 (16.4-36.7) perfusion units, P=0.04), but not in obese women (28.1 (14.4-47.1) vs. 27.5 (17.5-48.2) perfusion units, P=0.7). The relative insulin-induced increase in blood flow corrected for the control substance was higher in lean than obese women (ANOVA for repeated measures F=3.93, P=0.05). The contribution of the total frequency spectrum 0.01-1.6 Hz and of the frequency intervals 0.01-0.02 Hz and 0.02-0.06 Hz (representative of endothelial and neurogenic activity, respectively) to basal microvascular vasomotion was lower in obese than in lean women (P<0.05 for all). These findings show that obesity is characterized by an impaired direct microvascular vasodilatory effect of insulin and by decreased skin microvascular vasomotion in a way that is suggestive for alterations of endothelial and neurogenic activity.

Post-ischaemic peak flow and myogenic flowmotion component are independent variables for skin post-ischaemic reactive hyperaemia in healthy subjects

The aim of this study was to clarify whether the post-ischaemic amplification of skin blood flowmotion (SBF) influences the extent of skin post-ischaemic hyperaemia. Forearm skin perfusion was measured by means of laser Doppler flowmetry (LDF) and forearm SBF was examined using Fourier analysis of LDF signal, under basal conditions and following forearm ischaemia in 50 healthy subjects. Power spectral density (PSD) of SBF total spectrum (0.009-1.6 Hz), as well of the frequency intervals (FI) related to endothelial (0.009-0.02 Hz), sympathetic (0.02-0.06 Hz), myogenic (0.06-0.2 Hz), respiratory (0.2-0.6 Hz) and cardiac (0.6-1.6 Hz) activity was measured in PU(2) (LDF perfusion unit)/Hz. Multiple regression analysis evaluated whether post-ischaemic peak-flow, as an indicator of shear stress, or post-ischaemic SBF independently affected the post-peak-flow hyperaemia calculated as corrected area under the LDF curve (C-AUC). Following ischaemia, we observed a statically significant increase in skin perfusion (from basal of 11.7+/-5.8 PU to peak flow of 62.3+/-41.4 PU, p<0.0000005) and in PSD of SBF total spectrum (p<0.01) as well of the different FI considered (p<0.005 for the endothelial and myogenic FI; p<0.05 for the sympathetic, respiratory and cardiac FI) compared to baseline. Multiple regression analysis showed that peak flow and post-ischaemic SBF component of myogenic origin were significant independent variables for the C-AUC (p=0.0000001 and p=0.009, respectively). These findings suggest that not only increased shear stress but also post-ischaemic amplification of myogenic SBF component independently contributes to the more prolonged phase of post-ischaemic skin re-perfusion in healthy subjects.

Effect of chaotic vasomotion in skeletal muscle on tissue oxygenation

Vasomotion refers to spontaneous variations in the lumen size of small vessels, with a plausible role in regulation of various aspects of microcirculation. We propose a computational model of vasomotion in skeletal muscle in which the pattern of vasomotion is shown to critically determine the efficiency of oxygenation of a muscle fiber. In this model, precapillary sphincters are modeled as nonlinear oscillators. We hypothesize that these sphincters interact via exchange of vasoactive substances. As a consequence, vasomotion is described as a phenomenon associated with a network of nonlinear oscillators. As a specific instance, we model the vasomotion of precapillary sphincters surrounding an active fiber. The sphincters coordinate their rhythms so as to minimize oxygen deficit in the fiber. Our modeling studies indicate that efficient oxygenation of the fiber depends crucially on the mode of interaction among the vasomotions of individual sphincters. While chaotic forms of vasomotion enhanced oxygenation, regular patterns of vasomotion failed to meet the oxygenation demand accurately.

The investigation of skin blood flowmotion: a new approach to study the microcirculatory impairment in vascular diseases?

Skin blood flow oscillation, the so called flowmotion, is a consequence of the arteriolar diameter oscillations, i.e. vasomotion, and it is thought to play a critical role in favoring the optimal distribution of blood flow in the skin microvascular bed. Investigation of skin blood flowmotion, using spectral analysis of the skin laser Doppler flowmetry (LDF) signal, showed different flowmotion waves of endothelial, sympathetic or myogenic mediated vasomotion origin. Using this method in peripheral arterial obstructive disease (PAOD) patients an impairment of all the three flowmotion waves was found at level of the diseased leg following ischemia in the II stage of the disease and basally in critical limb ischemia. In patients with essential arterial hypertension (EHT) forearm skin blood flowmotion showed a post-ischemic impairment of myogenic and sympathetic components in newly diagnosed patients, and of endothelial and sympathetic components in long standing patients. In diabetic patients there was a selective impairment of skin flowmotion wave mediated by sympathetic activity in basal conditions. Investigation of skin blood flowmotion in response to different vasoactive substances demonstrated an important role of nitric oxide (NO) in controlling the endothelial component of vasomotion and an insulin action on smooth muscle cells of skin microvessels. All these data suggest that the study of skin blood flowmotion can become a method to early and easily detect skin microvascular impairment in vascular diseases and to investigate the mechanisms of substances active on skin microvascular bed.

Effects of arterial wall stress on vasomotion

Smooth muscle and endothelial cells in the arterial wall are exposed to mechanical stress. Indeed blood flow induces intraluminal pressure variations and shear stress. An increase in pressure may induce a vessel contraction, a phenomenon known as the myogenic response. Many muscular vessels present vasomotion, i.e., rhythmic diameter oscillations caused by synchronous cytosolic calcium oscillations of the smooth muscle cells. Vasomotion has been shown to be modulated by pressure changes. To get a better understanding of the effect of stress and in particular pressure on vasomotion, we propose a model of a blood vessel describing the calcium dynamics in a coupled population of smooth muscle cells and endothelial cells and the consequent vessel diameter variations. We show that a rise in pressure increases the calcium concentration. This may either induce or abolish vasomotion, or increase its frequency depending on the initial conditions. In our model the myogenic response is less pronounced for large arteries than for small arteries and occurs at higher values of pressure if the wall thickness is increased. Our results are in agreement with experimental observations concerning a broad range of vessels.

Coupling Arterial Windkessel With Peripheral Vasomotion: Modeling the Effects on Low-Frequency Oscillations

Arterial pressure (AP) and heart rate (HR) waves have long been recognized as an important sign of cardiovascular regulation, however, the underlying interactions involving vasomotion, arterial mechanisms and neural regulation have not been clarified. With the aid of simple dynamical models consisting of active peripheral vascular districts (PVDs) fed by a compliant/resistant arterial tree, the relationship between local AP and flow and systemic AP waves were analyzed. A PVD was described as a nonlinear flow regulation loop. Various feedback dynamics were experimented and general properties were focused. The PVDs displayed a region of active flow compensation against pressure changes, in which self-sustained low-frequency (LF, 0.1 Hz) appeared. Oscillations critically depended on parameter, Teq, analogous to a windkessel time constant, proportional to arterial compliances: a value of about 2 s (consistent with a normal pulse pressure) performed a buffering effect essential for LF oscillations in peripheral flow; conversely, stiffer arteries damped LF vasomotion. Two PVDs fed by a common compliance oscillated in phase opposition; the consequent negative interference cancelled systemic AP waves, even in presence of large peripheral oscillations. The partial disruption of phase opposition by a common neural drive oscillating at a LF proximal to that of the PVDs unveiled LF waves in AP. Also, several PVDs with randomly different natural frequencies displayed a tendency to reciprocal cancellation, while a limited neurally induced phase alignment unmasked LF oscillations at systemic level. It is concluded that vasomotion, arterial compliances and, neural drives are all elements which may cooperate in forming AP waves.

Dynamic physiological modeling for functional diffuse optical tomography

Diffuse optical tomography (DOT) is a noninvasive imaging technology that is sensitive to local concentration changes in oxy- and deoxyhemoglobin. When applied to functional neuroimaging, DOT measures hemodynamics in the scalp and brain that reflect competing metabolic demands and cardiovascular dynamics. The diffuse nature of near-infrared photon migration in tissue and the multitude of physiological systems that affect hemodynamics motivate the use of anatomical and physiological models to improve estimates of the functional hemodynamic response. In this paper, we present a linear state-space model for DOT analysis that models the physiological fluctuations present in the data with either static or dynamic estimation. We demonstrate the approach by using auxiliary measurements of blood pressure variability and heart rate variability as inputs to model the background physiology in DOT data. We evaluate the improvements accorded by modeling this physiology on ten human subjects with simulated functional hemodynamic responses added to the baseline physiology. Adding physiological modeling with a static estimator significantly improved estimates of the simulated functional response, and further significant improvements were achieved with a dynamic Kalman filter estimator (paired t tests, n=10, P<0.05). These results suggest that physiological modeling can improve DOT analysis. The further improvement with the Kalman filter encourages continued research into dynamic linear modeling of the physiology present in DOT. Cardiovascular dynamics also affect the blood-oxygen-dependent (BOLD) signal in functional magnetic resonance imaging (fMRI). This state-space approach to DOT analysis could be extended to BOLD fMRI analysis, multimodal studies and real-time analysis.

Analysis of week-to-week variability in skin blood flow measurements using wavelet transforms

The study of skin blood flow responses is confounded by temporal variability in blood flow measurements. Spectral analysis has been shown useful in isolating the effects of distinct control mechanisms on various stimuli in the microcirculatory system. However, the sensitivity of spectral analysis to temporal blood blow variability has not been reported. This study was designed to assess week-to-week variability in blood flow measurements using wavelet-based spectrum analysis. Ten healthy, young subjects (mean age+/-SD, 30.0+/-3.1 years) were recruited into the study. Incremental heating (35-45 degrees C, 1 degrees step min-1) was applied on the skin over the sacrum once per week for three consecutive weeks. Wavelet analysis was used to decompose the laser Doppler blood flow signal into frequency bands determined to be associated with endothelial nitric oxide (0.008-0.02 Hz), neurogenic (0.02-0.05 Hz), myogenic (0.05-0.15 Hz), respiratory (0.15-0.4 Hz), and cardiac (0.4-2.0 Hz) control mechanisms. The results showed that coefficients of variation for the power in each frequency band at baseline are smaller than the coefficients of variation of blood flow at baseline or at maximal blood flow ratio (P<0.05). Myogenic and respiratory frequency bands showed the highest coefficients of variation among the five frequency bands. An increase in power in the endothelial nitric oxide frequency band and a decrease in power in the myogenic frequency band of the maximal blood flow response were reproduced in three consecutive weeks. Our study suggests that wavelet analysis is an effective method to overcome temporal variability in skin blood flow measurements.

Increase in capillary perfusion following low-intensity ultrasound and microbubbles during postischemic reperfusion

OBJECTIVES

We postulated that the increase in shear stress caused by microbubbles in the presence of low-intensity ultrasound increases vasodilation in ischemia/reperfusion.

DESIGN

Prospective, randomized, and blinded experimental study.

SETTING

Research laboratory.

SUBJECTS

Forty hamsters were subjected to ischemia/reperfusion and observed by intravital microscopy.

INTERVENTIONS

Ultrasound (2.5 MHz, 1.3 mechanical index, 2.0 peak pressure) was applied to the hamster cheek pouch in ischemia/reperfusion with and without microbubbles (Levovist or Sono Vue) at baseline (15 mins) and at the beginning (15 mins) of reperfusion after ischemia (30 mins).

MEASUREMENTS AND MAIN RESULTS

Arterial diameter (A2-A3, 38.5 +/- 5.3 microm; A4,15.0 +/- 7.0 microm), red blood cell velocity, wall shear stress, permeability, perfused capillary length, and adherent leukocytes in venules were evaluated. Lipid peroxides were also determined in the systemic blood. Ultrasound and microbubbles in reperfusion significantly increased the diameter (A2-A3 Sono Vue, 33%; Levovist, 53% vs. ischemia/reperfusion, p < .05; A4, Sono Vue, 93%; Levovist, 104% vs. ischemia/reperfusion, p < .05), red blood cell velocity, flow, and shear stress in both A4 and A2-A3 arterioles. Shear stress was significantly higher with Levovist (A2-A3, 105%; A4, 185%) and Sono Vue (A2, 108%; A4, 140% vs. ischemia/reperfusion, p < .05) than ultrasound alone in arterioles. With ischemia/reperfusion, perfused capillary length was reduced significantly, whereas it increased with Levovist and Sono Vue (43%, 41% vs. ischemia/reperfusion p < .05). Lipid peroxides increased early during reperfusion and remained at increased levels throughout reperfusion. Lipid peroxides were unchanged after ultrasound alone or ultrasound with Sono Vue or Levovist during ischemia/reperfusion. With ultrasound there was a significant increase in vascular permeability vs. ischemia/reperfusion. Treatment with Sono Vue (-36%) and Levovist (-57%) decreased permeability vs. ischemia/reperfusion in reperfusion (p < .001). Ischemia/reperfusion had significantly increased leukocyte adhesion. Ultrasound alone (-39%) or with Sono Vue (-64%) and Levovist (-57%) caused smaller increases in leukocyte adhesion than ischemia/reperfusion (p < .05).

CONCLUSIONS

Ultrasound and microbubbles equilibrate microvascular shear stress, thus avoiding the failure of capillary perfusion in postischemic reperfusion.

Microcirculation and Hemorheology

Major experimental and theoretical studies on microcirculation and hemorheology are reviewed with the focus on mechanics of blood flow and the vascular wall. Flow of the blood formed elements (red blood cells (RBCs), white blood cells or leukocytes (WBCs) and platelets) in individual arterioles, capillaries and venules, and in microvascular networks is discussed. Mechanical and rheological properties of the formed elements and their interactions with the vascular wall are reviewed. Short-term and long-term regulation of the microvasculature is discussed; the modes of regulation include metabolic, myogenic and shear-stress-dependent mechanisms as well as vascular adaptation such as angiogenesis and vascular remodeling.

Balance between myogenic, flow-dependent, and metabolic flow control in coronary arterial tree: a model study

Myogenic response, flow-dependent dilation, and direct metabolic control are important mechanisms controlling coronary flow. A model was developed to study how these control mechanisms interact at different locations in the arteriolar tree and to evaluate their contribution to autoregulatory and metabolic flow control. The model consists of 10 resistance compartments in series, each representing parallel vessel units, with their diameters determined by tone depending on either flow and pressure [flow-dependent tone reduction factor (TRF(flow)) x Tone(myo)] or directly on metabolic factors (Tone(meta)). The pressure-Tone(myo) and flow-TRF(flow) relations depend on the vessel size obtained from interpolation of data on isolated vessels. Flow-dependent dilation diminishes autoregulatory properties compared with pressure-flow lines obtained from vessels solely influenced by Tone(myo). By applying Tone(meta) to the four distal compartments, the autoregulatory properties are restored and tone is equally distributed over the compartments. Also, metabolic control and blockage of nitric oxide are simulated. We conclude that a balance is required between the flow-dependent properties upstream and the constrictive metabolic properties downstream. Myogenic response contributes significantly to flow regulation.

Fractal dimensions of laser doppler flowmetry time series

Laser Doppler flowmetry (LDF) provides a non-invasive method of assessing cutaneous perfusion. As the microvasculature under the probe is not defined the measured flux cannot be given absolute units, but the technique has nevertheless proved valuable for assessing relative changes in perfusion in response to physiological stress. LDF signals normally show pronounced temporal variability, both as a consequence of the pulsatile nature of blood flow and local changes in dynamic vasomotor activity. The aim of the present study was to investigate the use of methods of nonlinear analysis in characterizing temporal fluctuations in LDF signals. Data were collected under standardised conditions from the forearm of 16 normal subjects at rest, during exercise and on recovery. Surrogate data was then generated from the original time series by phase randomization. Dispersional analysis demonstrated that the LDF data was fractal with two distinct scaling regions, thus allowing the calculation of a fractal dimension which decreased significantly from 1.23 +/- 0.09 to 1.04 +/- 0.02 during exercise. By contrast, dispersional analysis of the surrogate data showed no scaling region.

Mathematical modelling of responses of cerebral blood vessels to changing intraluminal pressure

The authors have designed a mathematical model to investigate the influences of the physical and chemical properties of the cerebral blood vessel resistance on vessel diameter. The model is based on the way the total tension within the blood vessel walls varies due to specific ions interacting and affecting the vascular smooth muscle cells and the vascular walls. In particular, we shall model a series of calcium sites and derive a generalized equation of the diameter as a function of pressure. The model includes the action of the vascular smooth muscle cells and the elasticity of the vascular walls, the pressure exerted on the walls by the blood and the effect of alterations to their properties within the blood vessel. They are formulated in terms of three parameters: the diameter at zero pressure, the myogenic response as the pressure tends to zero and a term associated with the myogenic tone. All three parameters may be reliably extracted from diameter-pressure measurements. The model was successfully used in quantifying diameter oscillations and dynamic myogenic responses that are frequently observed both in vivo and in vitro. Finally, we tested the model on experimental data obtained from the resistance of cerebral vessels that have been isolated from rats. In particular, we have first shown that the blood vessel characteristics are such that the diameter change due to calcium ion variations is at a maximum value. Second, we have shown that blood flow affects the myogenic response and third, we can explain the affect of ATP on the vessel diameter.

A computational study of the effect of vasomotion on oxygen transport from capillary networks

The objective of this study was to investigate the effect of arteriolar vasomotion on oxygen transport from capillary networks. A computational model was used to calculate blood flow and oxygen transport from a simulated network of striated muscle capillaries. For varying tissue oxygen consumption rates, the importance of the frequency and amplitude of vasomotion-induced blood flow oscillations was studied. The effect of myoglobin on oxygen delivery during vasomotion was also examined. In the absence of myoglobin, it was found that when consumption is high enough to produce regions of hypoxia under steady flow conditions, vasomotion-induced flow oscillations can significantly increase tissue oxygenation and decrease oxygen transport heterogeneity. The largest effect was seen for low-frequency, high-amplitude oscillations (1.5-3 cycles min(-1), 90% of steady-state velocity). By contrast, at physiological tissue myoglobin concentrations, vasomotion did not improve tissue oxygenation. This unexpected finding is due to the buffering effect of myoglobin, suggesting that in highly aerobic muscles short-term storage of oxygen is more important than the possibility of increasing transport through vasomotion.

Regular slow wave flowmotion in skeletal muscle is not determined by nitric oxide and endothelin

In a previous study we showed that the generation of regular slow wave flowmotion (rSWFM, 1-3 cycles per minute) in skeletal muscle of anesthetized rats was related to local changes of arterial pressure and microcirculatory blood flow (MBF), which suggests an involvement of pressure- or flow-induced mechanisms. The present experiments were designed to test the role of flow-dependent endothelial autacoids, such as nitric oxide (NO) and endothelin, in the generation of SWFM. The effects of NO-donor sodium nitroprusside (SNP), the partly NO-dependent metabolite adenosine (ADO), the NO-synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME), and the mixed endothelin receptor blocker bosentan (BOS) were analyzed. MBF and rSWFM were assessed by laser Doppler flowmetry. rSWFM appeared in 7 out of 14 preparations after ADO (200 microg/kg/min), but not after SNP (100 microg/kg/min), L-NAME (30 mg/kg iv), and BOS (10 mg/kg iv). Its occurrence was associated with a significant decrease in arterial pressure to 50 +/- 3% (mean +/- SEM) of the baseline, provided that MBF was not enhanced. When given after induction of rSWFM by a 25% hemorrhage, SNP (50 microg/kg/min) totally abolished rSWFM and ADO (100 microg/kg/min) reduced rSWFM frequency from 2.17 +/- 0.08 to 1.72 +/- 0.08 cycles per minute (cpm) (P < 0.05), whereas the frequency was not affected by the other drugs. ADO, l-NAME (30 mg/kg iv), and BOS (10 mg/kg iv) lead to changes in rSWFM amplitude which showed a drug-independent negative correlation to changes in both MAP and MBF (R(2) = 0.61, multiple regression) in the ranges of 57-176% of MAP before drug application, and 72-120% of MBF, respectively. We conclude that NO and endothelin are not involved in the generation of rSWFM. Our findings strongly suggest that the activity of rSWFM depends on a reduction of vascular wall tension and is inhibited by SNP.