Large Artery Stiffness and Micro-circulation Flashcards

Vocabulary-style flashcards covering the relationship between arterial stiffness, wave reflection, and microvascular health in hypertension and diabetes patients.

Micro-circulatory complications in Diabetes

The clinical issues involving small vessels commonly seen in diabetics, specifically Retinopathy, Stroke, and Nephropathy.

Macrovascular disease in Diabetes

Large vessel conditions resulting in increased CV risk, including Myocardial Infarction (MI), Cardiac failure, and Peripheral Vascular Disease (PVD).

McDonnell et al. (2007) Findings

A study presented in Milan showing that diabetics have significantly higher arterial stiffness (C-F PWV) compared to controls ($P < 0.001$).

UKPDS Study

A study demonstrating that tight BP control was significantly better than tight glycaemic control in reducing microvascular complications.

Large vessel stiffening effect

Increases Mean Arterial Pressure (MAP) and Pulse Pressure (PP), and decreases the buffering capacity of the macrovasculature, allowing high pulsatile flow to reach the microvasculature.

AIx (Augmentation Index)

A measure of wave reflection that may have a potentially beneficial effect by reflecting high pulsatile flow waves away from the micro-circulation.

aPWV (Aortic Pulse Wave Velocity)

A measurement of arterial stiffness taken between the carotid and femoral arteries, often using equipment like SphygmoCor.

Pulsatility Ratio (PR) formula

$$\frac{\text{Peak systolic velocity}}{\text{End diastolic velocity}}$$

Resistance Index (RI) formula

$$\frac{\text{Peak systolic velocity} - \text{End diastolic velocity}}{\text{Peak systolic velocity}}$$

SphygmoCor

The device used to measure Peripheral and Central BP, Augmentation Index (AIx), and Aortic PWV.

Retinal Artery Doppler Ultrasound

A microvascular measurement technique used to determine Retinal Artery Pulsatility Ratio (PR) and Resistance Index (RI).

Protective barrier hypothesis

The theory that increased wave reflection (AIx) may act as a barrier to prevent high pulsatility from travelling to the microvasculature.