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Physiology and Pathophysiology of Microcirculation

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PanVascular Medicine

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Abstract

Microcirculation is the vascular compartments corresponding to vessels, the bore of which ranges from about five to a few hundred μm. Microcirculation possesses four main categories of conduits: arterioles, capillaries, venules, and terminal lymphatic vessels.

Microcirculatory driving pressure decreases from about 10.5–16 kPa (80–120 mmHg) in a supplying arteriole (bore 120 μm) to about 2.7 kPa (20 mmHg) in a draining venule (bore 120 μm).

Microcirculation regulates blood flow distribution within organs, nutrient delivery, transcapillary exchanges, and removal of cell wastes.

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Abbreviations

Active hyperemia:

Local increase in blood flow rate caused by augmented activity of the perfused tissue.

Apparent viscosity (μ app) or effective viscosity :

Viscosity of heterogeneous, non-Newtonian fluid that refers to the computation of the viscosity using the equations derived to calculate the viscosity of a homogeneous, Newtonian fluid (that remains invariant with changing shear rate at constant temperature and pressure). The viscosity is calculated from the Poiseuille law for a given flow rate and tube diameter. The apparent viscosity of blood, a concentrated suspension of mainly red blood capsules, decreases in microvessels (Fahraeus–Lindqvist effect), as the volume fraction close to the tube wall is reduced and the suspended particles do not contact the microvessel wall. This lubrification layer is less viscous than the suspension in the flow core. This phenomenon becomes stronger when the vascular caliber decreases relative to the particle size (i.e., in capillaries).

Autoregulation:

Maintenance of the local blood flow rate despite changes in driving pressure over a limited pressure range.

Fahraeus effect (local Ht < global Ht):

Phenomenon that describes an attenuated average hematocrit (Ht; relative red blood capsule [RBC] concentration) in a steady blood flow in small straight tubes, the diameter of which is lower than 300 μm with respect to that in the upstream reservoir. This effect is generated in the concentration entry length of the tube, as red blood capsules move inside the central region of the tube lumen.

Fahraeus–Lindqvist effect (μ b (d h )):

Effect that describes the apparent blood viscosity dependence on the microvessel hydraulic radius. This effect is observed when the characteristic dimension of a conduit approaches the size of seeded particles such as red blood capsules (7–8 μm) in suspension in the plasma (solvent), which is a tube diameter lower than 300 μm.

Glomerulus:

A capillary network between afferent and efferent arterioles surrounded by the Bowman’s capsule that filters blood with a given glomerular filtration rate. A glomerulus and its Bowman’s capsule constitute a renal corpuscle, the basic renal filtration unit.

Lymphatic capillary:

Conduit that carries interstitial materials back to the blood circulation. Interstitial materials enter lymphatic lumen through loose junctions between adjacent endotheliocytes. Lymphatic capillary localizes close to the blood capillary.

Metabolic response:

Adaptation of the local blood flow to the tissular metabolic rate. Any increase in cell activity elevates the temperature and liberates vasodilators (e.g., adenosine, bradykinin, histamine, and nitric oxide) that, together with a transient decrease in oxygen content and increase in carbon dioxide level, raise locally blood flow. The O2 uptake is correlated with the local microvascular blood flow. The messenger ATP is released in microvessels by red blood capsules at a rate proportional to the decrease in oxygen saturation triggering a conducted response that propagates upstream from the collecting venule through capillaries to the supplying arteriole to raise its caliber and, hence, local blood flow.

Metarteriole:

Short vessel that links an arteriole to a venule, hence shunting the capillary bed.

Myogenic response:

Adjustment of the vasomotor tone that adapts the vascular lumen size, hence the flow resistance, to keep the local blood flow constant, whatever the sensed transmural pressure in an autoregulation range, independently of endothelial influence.

Particle flow:

Flow characterized by a train of particles between which a solvent bolus is entrapped. In capillaries, red blood capsules surrounded by a lubricating plasma layer flow behind each other. When the particle concentration (that refers to the mass of particle per unit volume of solvent, whereas the particle density is the particle mass per unit volume of the particle) is high enough so that interactions between solvent and solute influence flow, only the average motion, and not individual particle movement, is explored. At a constant temperature, the quantities of interest for the solvent and particle are the pressure and the concentration, in addition to the velocity of both phases.

Plasma skimming:

Distributive process in branching sites of a capillary network associated with a core region with flowing red blood capsules and peripheral (near-wall) lubricating plasma layer. It is mainly observed in the kidney. Red blood capsules flow in larger capillaries, whereas only plasma flows in tiny capillaries (bore ~5 μm).

Precapillary sphincter:

Muscular diaphragm at the capillary entrance close to the arteriole that regulates blood flow through the capillary.

Reactive hyperemia:

Increase in supplying blood flow rate associated with the vasodilation occurring after a sudden occlusion of the irrigating artery.

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  1. team INRIA-UPMC-CNRS REO, Laboratoire Jacques-Louis Lions, CNRS UMR 7598, Université Pierre et Marie Curie (Sorbonne Universités), Paris, F-75252, Cedex 05, France

    Marc Thiriet

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  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Thiriet, M. (2015). Physiology and Pathophysiology of Microcirculation. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_24

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