Vascular pathophysiology
28 important questions on Vascular pathophysiology
What is essential hypertension?
What are the layers of a blood vessel wall?
Fibrous elements (elastin, collagen)
Smooth muscle (especially in arterials)
Connective tissue
Adipose tissue (surrounding the vessel)
What are differences in the vessel walls of arteries and veins?
- Elastic elements are mainly present in arteries and arterioles, but also in larger veins.
- Smooth muscle is thick in arteries and arterioles
- Connective tissue more in larger vessels
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What are factors acting on vessels that influence their function?
- Metabolic factors: more local, dominant in tissues (regulated at capillary level: e.g. when you're thinking hard, more blood is going to your brain)
What is called a 'fatty streak'?
How is an atherosclerotic plaque formed?
What is a hallmark of early endothelial dysfunction?
What are the normal endothelial functions?
- Resistance/flow
- Angiogenesis
- Barrier function
- Inflammation
- Thrombosis
What enzyme synthesizes NO, and by what molecules is this regulated?
What could be an indication of abnormal endothelial function?
What aspect of blood vessels can predict cardiovascular disease?
In the case of ischemia, what mechanisms causes the dilatation of colleterals?
What are resistance arteries?
What metabolic and neuronal signals are vasodilators?
- ↓ O2 levels
- ↑ CO2 levels
- Prostaglandines
- Nitric oxide (NO)
Neuronal:
- ↓ sympathetic tone
What metabolic/myogenic and neuronal/hormonal factors are vasoconstrictors?
Myogenic: stretch
Neuronal: ↑ sympathetic tone
Hormonal:
- Angiotensin
- Antidiuretic hormone
- (Nor)epinephrine
What kind of mechanisms are metabolic or myogenic mechanisms for regulation of vascular diameter, and neuronal or hormonal mechanisms?
Neuronal/hormonal: extrinsic mechanisms: maintain mean arterial pressure, redistribute blood during exercise and thermoregulation.
What four things are new targets for detecting and treating cardiovascular disease (and specifically microvascular disease)?
- Impaired eNOS signaling
- Obesity/ectopic fat
- Liver disease
- Low-grade inflammation
What normally happens to the circulation after a meal, and how is this response regulated?
- This response is regulated by insulin & adipose tissue.
What does insulin do to the circulation?
- which is normally a balance.
What does an excess in adipose tissue (like in obesity) cause to the circulation?
- and factors that stimulate ET-1 production,
- so excess in adipose tissue causes more vasoconstriction.
So in obesity NO production goes down, resulting in more vasoconstriction. What does this cause to the heart?
- which results in stiffening of the muscle.
So endothelial dysfunction is linked to stiffening of the muscle.
Via which factor is the impairment of the beneficial effect of cardiac microvascular endothelial cells on cardiomyocyte function regulated?
What does insulin resistance also cause in the muscles?
- With insulin resistance in human obesity, high levels of insulin do not cause increased muscle perfusion.
How is local fat around the vessels called?
In what people is PVAT present more, and what does it cause?
- and it causes impaired perfusion, more insulin resistance and cardiovascular disease.
In pre-symptomatic T2D, what problems already exist?
What are three causes of microvascular dysfunction?
- Hyperglycemia
- Impaired endothelial signaling (eNOS) by fatty acids
- Ectopic accumulation, inflammation, and altered paracrine functioning of adipose tissue
What can be used in the future for the diagnosis and therapy of T2D in the future?
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