Microvascular and Macrovascular Response in Healthy and Critically Ill

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 30 March 2026 | Viewed by 1658

Special Issue Editors


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Guest Editor
Department of Intensive Care Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
Interests: intensive care; critical illness; shock; mechanical ventilation; microcirculation; glycocalyx; hemodynamics; fluid responsiveness; cardiovascular responsiveness; aerobic and anaerobic exercise

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Guest Editor
Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania
Interests: environmental extreme and performance; cold stress; heat stress; thermal therapy; neuromuscular performance; calorie restriction; metabolic health; immune system; athletic performance; heart rate variability

Special Issue Information

Dear Colleagues,

The cardiovascular response, encompassing both macrovascular and microvascular components, represents the function of the cardiovascular system as it adjusts to various stimuli that can disrupt normal homeostasis. For the healthy, these stimuli can include a variety of external factors and exercises and various maneuvers, such as passive leg raising, etc. Specific maneuvers or strategies help to assess macrovascular and microvascular reactivity, preload responsiveness, and help to adapt the body to ischaemia/reperfusion and stress in future. Studies show that cardiovascular fitness or adaptation to ischaemia/reperfusion can reduce mortality from all causes.

In various diseases, including those seen in critically ill patients, it is also essential to assess the macrovascular and microvascular reactivity (reserve) and response to various treatment. Research on methods for determining fluid responsiveness, as well as the effects of remote ischemic conditioning, constitutes an important aspect of this topic.

The main aim of the current topic is to collect articles (original research, communications, reviews, and brief reports) addressing state-of-the-art information on microvascular or macrovascular responses to various, acute, or chronic stimuli (external factors, exercise, pharmacological factors, various maneuvers, remote ischemic conditioning, and others) in healthy people and patients with various diseases, including those who are critically ill. Articles addressing (i) microcirculation, endothelial glycocalyx, endothelial function, peripheral perfusion, body temperature and systemic hemodynamic response to external factors, exercise, pharmacologic factors, various maneuvers, remote ischemic conditioning or adaptations, and other stimuli in healthy patients and those with various diseases, including critical illnesses; (ii) knowledge of microvascular, peripheral perfusion, and macrovascular response and its evaluation methods (video microscopy/glycocalyx, plethysmography, laser Doppler flowmetry, eye digital fundus camera, body temperature gradient, etc.) in healthy patients and those with disease, including critical illnesses; (iii) therapies or strategies based on personalized modulation of microcirculation, endothelium, body temperature, and/or systemic hemodynamic are welcome and will be considered for publication.

Prof. Dr. Andrius Pranskunas
Prof. Dr. Marius Brazaitis
Guest Editors

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Keywords

  • microcirculation
  • glycocalyx
  • peripheral perfusion
  • systemic hemodynamic
  • body temperature
  • dynamic maneuvers
  • remote ischemic conditioning
  • exercise
  • adaptation

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Published Papers (3 papers)

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Research

14 pages, 1467 KiB  
Article
GSNO as a Modulator of Vascular Tone in Human Saphenous Veins: Potential Implications for Graft Spasm
by Deniz Kaleli Durman, Nurdan Dağtekin, Erkan Civelek, Taner İyigün, Önder Teskin and Birsel Sönmez Uydeş Doğan
Life 2025, 15(7), 1139; https://doi.org/10.3390/life15071139 - 19 Jul 2025
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Abstract
S-nitrosoglutathione (GSNO), a promising S-nitrosothiol, has been recognized for its ability to modulate vascular tone through its vasodilatory, antiplatelet, and antiproliferative effects. However, data on its vasodilatory effects in human vessels remain limited, and its mechanisms of action have yet to be fully [...] Read more.
S-nitrosoglutathione (GSNO), a promising S-nitrosothiol, has been recognized for its ability to modulate vascular tone through its vasodilatory, antiplatelet, and antiproliferative effects. However, data on its vasodilatory effects in human vessels remain limited, and its mechanisms of action have yet to be fully elucidated. In this study, we aimed to investigate the vasorelaxant effect of GSNO and its underlying mechanisms, with particular focus on the soluble guanylate cyclase (sGC)/nitric oxide (NO) pathway and potassium channels in isolated human saphenous veins (SVs) obtained from patients undergoing coronary artery bypass grafting (CABG). GSNO (10−8–10−4 M) produced concentration-dependent relaxations in SV rings precontracted with phenylephrine. These relaxations were unaffected by NO synthase inhibition with L-NAME (10−4 M, 30 min) or NO scavenging with PTIO (10−4 M, 30 min), but were significantly reduced by the sGC inhibitor, ODQ (10−5 M, 30 min). Inhibition of ATP-sensitive (glibenclamid; 10−5 M, 30 min.), high-conductance Ca2+-activated (charybdotoxin; 10−7 M, 30 min), small-conductance Ca2+-activated (apamin; 10−6 M, 30 min), or voltage-dependent (4-aminopyridine; 10−3 M, 30 min) potassium channels did not alter the maximum relaxant responses to GSNO. Furthermore, pretreatment with GSNO (10−4 M, 30 min) significantly attenuated both the contractile response and sensitivity to phenylephrine. Collectively, these findings demonstrate that GSNO exerts acute vasorelaxant and modulatory effects in human SV primarily via cGMP-dependent mechanisms, highlighting its potential as a local therapeutic agent for preventing graft spasm in CABG. Full article
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12 pages, 1072 KiB  
Article
Effects of Remote Ischemic Conditioning on Cardiovascular Responsiveness in Healthy Individuals
by Inga Kiudulaite, Jelena Cesarskaja, Mante Eidininkiene, Zivile Pranskuniene and Andrius Pranskunas
Life 2025, 15(6), 842; https://doi.org/10.3390/life15060842 - 23 May 2025
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Abstract
The remote ischemic conditioning (RIC)-induced changes in systemic hemodynamics or circulatory reactivity are unclear. Therefore, we aimed to evaluate the effect of a single bout of RIC on the passive leg raising (PLR)-induced cardiovascular response. This prospective study included 36 healthy volunteers (median [...] Read more.
The remote ischemic conditioning (RIC)-induced changes in systemic hemodynamics or circulatory reactivity are unclear. Therefore, we aimed to evaluate the effect of a single bout of RIC on the passive leg raising (PLR)-induced cardiovascular response. This prospective study included 36 healthy volunteers (median age: 24 years). Systemic hemodynamic indices were assessed through the following sequential steps: with the participant in a supine position, during the first PLR maneuver, before RIC, after RIC, during the second PLR maneuver, and with the participant in a supine position. The perfusion index (PI) was measured during PLR before and after RIC. We found no significant differences before and after RIC in the proportion of responders during PLR (participants with stroke volume (SV) change ≥ 10%, 61% vs. 47%, p = 0.180). There was a strong correlation between SV changes during the two PLR tests (rs = 0.80, p < 0.001). PLR significantly increased the PI before and after RIC. However, there was no significant difference before and after RIC in the PLR-induced PI changes (p = 0.944). Our findings suggest that a single bout of RIC has no effect on PLR-induced cardiovascular responses in terms of changes in systemic hemodynamic and peripheral perfusion indices. Full article
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12 pages, 3278 KiB  
Article
Diabetes Differentially Affects Vascular Reactivity in Isolated Human Arterial and Venous Bypass Grafts
by Aylin Vidin Şen, Birsel Sönmez Uydeş Doğan, Uğur Kısa, Cevdet Uğur Koçoğulları, Önder Teskin and Fatoş İlkay Alp Yıldırım
Life 2025, 15(3), 454; https://doi.org/10.3390/life15030454 - 13 Mar 2025
Viewed by 626
Abstract
Arterial and venous graft spasm can occur during harvesting or immediately after coronary artery bypass grafting (CABG), leading to increased perioperative morbidity and affecting graft patency rates. Bypass grafts harvested from diabetic patients are particularly prone to spasm. This study aimed to elucidate [...] Read more.
Arterial and venous graft spasm can occur during harvesting or immediately after coronary artery bypass grafting (CABG), leading to increased perioperative morbidity and affecting graft patency rates. Bypass grafts harvested from diabetic patients are particularly prone to spasm. This study aimed to elucidate the functional characteristics of human bypass grafts for the internal mammary artery (IMA) and saphenous vein (SV), from both diabetic and non-diabetic patients, and to determine how diabetes affected their responses to spasmogenic and relaxant agents. SV and IMA graft rings isolated from diabetic and non-diabetic patients during CABG were placed in an isolated organ bath system. Contractions to potassium chloride (10–100 mM) and phenylephrine (10−8–10−4 M) were evaluated, and relaxation responses to acetylcholine (10−9–10−4 M) and sodium nitroprusside (10−8–10−4 M) were assessed to evaluate endothelial and smooth muscle function, respectively. We observed increased responses to phenylephrine, an alpha-1 adrenoceptor agonist, in both IMAs and SVs, as well as an increased responses to potassium chloride, a non-receptor agonist, in SVs in diabetic patients compared to non-diabetic patients. We did not observe any deterioration in endothelium-dependent relaxations in either SV or IMA grafts under diabetic conditions. This study is the first to demonstrate that diabetes exacerbates potassium chloride-induced contractions in human SV grafts. Understanding the differences in potassium chloride-induced contraction profiles between arterial and venous grafts is essential in optimizing graft spasm management and improving the patency rates of bypass grafts. Full article
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