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

Author

Listed:
  • Dae Hyun Lee
  • Martijn J C Dane
  • Bernard M van den Berg
  • Margien G S Boels
  • Jurgen W van Teeffelen
  • Renée de Mutsert
  • Martin den Heijer
  • Frits R Rosendaal
  • Johan van der Vlag
  • Anton Jan van Zonneveld
  • Hans Vink
  • Ton J Rabelink
  • for the NEO study group

Abstract

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.

Suggested Citation

  • Dae Hyun Lee & Martijn J C Dane & Bernard M van den Berg & Margien G S Boels & Jurgen W van Teeffelen & Renée de Mutsert & Martin den Heijer & Frits R Rosendaal & Johan van der Vlag & Anton Jan van Zo, 2014. "Deeper Penetration of Erythrocytes into the Endothelial Glycocalyx Is Associated with Impaired Microvascular Perfusion," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
  • Handle: RePEc:plo:pone00:0096477
    DOI: 10.1371/journal.pone.0096477
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    References listed on IDEAS

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    1. Korn, E.L. & Graubard, B.I., 1991. "Epidemiologic studies utilizing surveys: Accounting for the sampling design," American Journal of Public Health, American Public Health Association, vol. 81(9), pages 1166-1173.
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