Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion

Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion

Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper...

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Main Authors: Lee, Dae Hyun, Dane, Martijn J. C., van den Berg, Bernard M., Boels, Margien G. S., van Teeffelen, Jurgen W., de Mutsert, Renée, den Heijer, Martin, Rosendaal, Frits R., van der Vlag, Johan, van Zonneveld, Anton Jan, Vink, Hans, Rabelink, Ton J.
Format: Online
Language:English
Published: Public Library of Science 2014
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015985/
id pubmed-4015985
recordtype oai_dc
spelling pubmed-40159852014-05-14 Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion Lee, Dae Hyun Dane, Martijn J. C. van den Berg, Bernard M. Boels, Margien G. S. van Teeffelen, Jurgen W. de Mutsert, Renée den Heijer, Martin Rosendaal, Frits R. van der Vlag, Johan van Zonneveld, Anton Jan Vink, Hans Rabelink, Ton J. Research Article Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study) includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals). Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF) imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion) and perfused boundary region (PBR), a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43–2.86 µm), was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: −0.034; 95% confidence interval: −0.037 to −0.031). We conclude that microvascular beds with a thick (“healthy”) glycocalyx (low PBR), reflects efficient perfusion of the microvascular bed. In contrast, a thin (“risk”) glycocalyx (high PBR) is associated with a less efficient and defective microvascular perfusion. Public Library of Science 2014-05-09 /pmc/articles/PMC4015985/ /pubmed/24816787 http://dx.doi.org/10.1371/journal.pone.0096477 Text en © 2014 Lee et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Lee, Dae Hyun
Dane, Martijn J. C.
van den Berg, Bernard M.
Boels, Margien G. S.
van Teeffelen, Jurgen W.
de Mutsert, Renée
den Heijer, Martin
Rosendaal, Frits R.
van der Vlag, Johan
van Zonneveld, Anton Jan
Vink, Hans
Rabelink, Ton J.
spellingShingle Lee, Dae Hyun
Dane, Martijn J. C.
van den Berg, Bernard M.
Boels, Margien G. S.
van Teeffelen, Jurgen W.
de Mutsert, Renée
den Heijer, Martin
Rosendaal, Frits R.
van der Vlag, Johan
van Zonneveld, Anton Jan
Vink, Hans
Rabelink, Ton J.
Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
author_facet Lee, Dae Hyun
Dane, Martijn J. C.
van den Berg, Bernard M.
Boels, Margien G. S.
van Teeffelen, Jurgen W.
de Mutsert, Renée
den Heijer, Martin
Rosendaal, Frits R.
van der Vlag, Johan
van Zonneveld, Anton Jan
Vink, Hans
Rabelink, Ton J.
author_sort Lee, Dae Hyun
title Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
title_short Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
title_full Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
title_fullStr Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
title_full_unstemmed Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion
title_sort deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion
description Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study) includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals). Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF) imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion) and perfused boundary region (PBR), a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43–2.86 µm), was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: −0.034; 95% confidence interval: −0.037 to −0.031). We conclude that microvascular beds with a thick (“healthy”) glycocalyx (low PBR), reflects efficient perfusion of the microvascular bed. In contrast, a thin (“risk”) glycocalyx (high PBR) is associated with a less efficient and defective microvascular perfusion.
publisher Public Library of Science
publishDate 2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4015985/
_version_ 1612087391380570112

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