Perturbation of the microvascular glycocalyx and perfusion in infants after cardiopulmonary bypass

Abstract Objective Perturbation of the endothelial glycocalyx is discussed in the pathogenesis of complications related to cardiopulmonary bypass. We evaluated the effects of cardiopulmonary bypass on the microcirculation and the microvascular endothelial glycocalyx of infants undergoing surgery for congenital cardiac defects. Methods The microcirculation was visualized at the ear conch using Sidestream dark field imaging before surgery (T0), after…

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Side-by-Side Alterations in Glycocalyx Thickness and Perfused Microvascular Density During Acute Microcirculatory Alterations in Cardiac Surgery

Abstract Objectives Endothelial glycocalyx injury causes microcirculatory perfusion disturbances in experimental studies, but the relevance in a clinical setting remains unknown. We investigated whether glycocalyx dimensions are reduced after onset of CPB and whether this is associated with alterations in microvascular perfusion. Methods The current observational study included 36 patients undergoing cardiac surgery without or with CPB, using either…

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The impact of periodontal disease treatment on endothelium of sublingual microvessels

Abstract The intactness degree of glycocalyx and the thickness of endothelium layer in sublingual microvessels was determined by means of darkfield microscopy and GlycoCheck RI software in 35 patients (19 men and 16 women, aged 35 to 65 years) with chronic generalized severe periodontitis before and after anti-inflammatory and surgical treatment. The patients were divided into two groups. The…

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Protocol for intraoperative assessment of the human cerebrovascular glycocalyx

Abstract Introduction Adequate functioning of the blood–brain barrier (BBB) is important for brain homoeostasis and normal neuronal function. Disruption of the BBB has been described in several neurological diseases. Recent reports suggest that an increased permeability of the BBB also contributes to increased seizure susceptibility in patients with epilepsy. The endothelial glycocalyx is coating the luminal side of the…

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Early detection of left ventricular dysfunction in first-degree relatives of diabetic patients by myocardial deformation imaging: The role of endothelial glycocalyx damage

Abstract Background First-degree relatives of type-2 diabetes patients (FDR) present insulin resistance. We investigated whether FDR and dysglycaemic subjects demonstrate abnormal endothelial glycocalyx and LV deformation during postprandial hyperglycemia. Methods We studied 40 FDR with normal oral glucose test (OGTT), 40 subjects with abnormal OGTT (dysglycaemic) and 20 subjects with normal OGTT without parental history of diabetes (normoglycaemic). At…

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Improvement of arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 after optimization of antidiabetic medication

Background: Arterial stiffness is associated with increased risk for cardiovascular disease. The purpose of this study is to investigate the arterial stiffness and myocardial deformation in patients with poorly controlled diabetes mellitus type 2 before and after glycemic control by optimal medication. Methods: In 50 patients with uncontrolled type 2 diabetes(age:52±10years)and 25 controls of similar age and sex and…

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Effects of varenicline and nicotine replacement therapy on arterial elasticity, endothelial glycocalyx and oxidative stress during a 3-month smoking cessation program

Abstract Background and aims The effects of medically-aided smoking cessation on vascular function and oxidative stress are not fully clarified. Methods One hundred eighty-eight current smokers were randomized to varenicline or nicotine replacement treatment (NRT) for a 3-month period. We assessed: (a) augmentation index (Aix) and pulse wave velocity (PWV); (b) perfusion boundary region (PBR) of sublingual microvasculature (range:5–25…

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Non-invasive assessment of microvascular dysfunction in patients with microvascular angina

Abstract Background We aimed to evaluate the microvascular function in patients with microvascular angina (MVA) by assessing 1) the endothelial glycocalyx barrier properties using sublingual microscopy, and 2) the myocardial perfusion reserve using cardiovascular magnetic resonance (CMR) imaging. Methods Sublingual microscopy was performed in 13 MVA patients (angina pectoris, ST-depression on treadmill testing, normal coronary angiogram) and compared with…

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The Measurement of the Endothelial Glycocalyx as a New Biomarker of Endothelial Derangement in Systemic Sclerosis: A Challenge for the Future

Article Excerpt In systemic sclerosis (SSc), the involvement of the vascular system dictates the fate of the patient. In recent decades, significant attention has been devoted to understanding the mechanisms involved in the derangement of the endothelium of the microvascular system in SSc. In this perspective, many papers have investigated the consistency of endothelial markers to disclose the ongoing…

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