title: Evaluation of microvascular structure in humans: a 'state-of-the-art' document of the Working Group on Macrovascular and Microvascular Alterations of the Italian Society of Arterial Hypertension.
abstract: The evaluation of microvascular structure is, in general, not an easy task. Among the methods that may be applied to humans, plethysmographic evaluation of small arteries and wire or pressure micromyography were extensively used in the last decades. The media-to-lumen ratio of small arteries evaluated by micromyography was demonstrated to possess a strong prognostic significance; however, its extensive evaluation is limited by the local invasiveness of the assessment. Noninvasive approaches were then proposed, including capillaroscopy, which provides information about microvascular rarefaction. Recently, the interest of investigators was focused on the retinal microvascular bed. In particular, a noninvasive measurement of the wall-to-lumen ratio of retinal arterioles using scanning laser Doppler flowmetry has been introduced.Recent data suggest a rather good agreement between this approach and micromyographic measurements, generally considered the gold standard approach. Therefore, the evaluation of microvascular structure is progressively moving from bench to bedside, and it could represent, in the immediate future, an evaluation to be performed in all hypertensive patients, in order to obtain a better stratification of cardiovascular risk.
authors.affiliation: aDepartment of Clinical and Experimental Medicine, University of Pisa, Pisa bDepartment of Clinical and Molecular Medicine, Division of Cardiology, Sant'Andrea Hospital, Sapienza University of Rome, Rome cClinica Medica, University of Milano-Bicocca and IRCCS Multimedica, Sesto San Giovanni, Milan dDepartment of Angiocardioneurology, IRCCS Neuromed, Pozzilli (IS) eDepartment of Molecular Medicine, 'Sapienza' University, Rome fDepartment of Medicine and Surgery, University of Salerno, Salerno gIstituto Auxologico Italiano, Ospedale San Luca, Milan hClinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
authors.forename: Agostino
authors.initials: A
authors.lastname: Virdis
authors.forename: Carmine
authors.initials: C
authors.lastname: Savoia
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lembo
authors.forename: Carmine
authors.initials: C
authors.lastname: Vecchione
authors.forename: Gino
authors.initials: G
authors.lastname: Seravalle
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.forename: Enrico Agabiti
authors.initials: EA
authors.lastname: Rosei
authors.forename: Damiano
authors.initials: D
authors.lastname: Rizzoni
mesh_terms: D001160:Arterioles / Q000648:ultrastructure*; D002318:Cardiovascular Diseases / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D017078:Laser-Doppler Flowmetry / Q000379:methods*; D020678:Microscopic Angioscopy; D009213:Myography / Q000379:methods; D012171:Retinal Vessels / Q000648:ultrastructure*; D012307:Risk Factors