ABC | Volume 111, Nº2, August 2018

Editorial Tibiriça et al Novel Perspectives in Cardiology Arq Bras Cardiol. 2018; 111(2):120-121 1. Gutterman DD, Chabowski DS, Kadlec AO, Durand MJ, Freed JK, Ait-Aissa K, et al. The human microcirculation: regulation of flow and beyond. Circ Res. 2016; 118(1)157-72. 2. Durand MJ , Gutterman DD. Diversity in mechanisms of endothelium- dependent vasodilation in health and disease. Microcirculation. 2013; 20(3)239-47. 3. Virdis A, Savoia C, Grassi G, Lembo G, Vecchione C, Seravalle G, et al. 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. J Hypertens. 2014; 32(11)2120-9. 4. Holowatz LA, Thompson-Torgerson CS , KenneyWL. The human cutaneous circulation as a model of generalizedmicrovascular function. J Appl Physiol (1985). 2008; 105(1)370-2. 5. Roustit M , Cracowski JL. 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Quantification of Myocardial Perfusion Reserve Using Dynamic SPECT Imaging in Humans: A Feasibility Study. J Nucl Med. 2013; 54(6)873-9. 11. Cracowski JL , Roustit M. Current methods to assess human cutaneous blood flow: an updated focus on laser-based-techniques. Microcirculation. 2016; 23(5)337-44. 12. Souza EG, De Lorenzo A, HugueninG, Oliveira GM , Tibirica E. Impairment of systemic microvascular endothelial and smooth muscle function in individuals with early-onset coronary artery disease: studies with laser speckle contrast imaging. Coron Artery Dis. 2014; 25(1)23-8. 13. Borges JP, Mendes F, Lopes GO, Sousa AS, Mediano MFF , Tibirica E. Is endothelial microvascular function equally impaired among patients with chronicChagasandischemiccardiomyopathy?IntJCardiol.2018;265:35-37. 14. Verri V, Brandao AA , Tibirica E. Penilemicrovascular endothelial function in hypertensive patients: effects of acute type 5 phosphodiesterase inhibition. Braz J Med Biol Res. 2018; 51(3)e6601. 15. KaracaU, SchramMT, HoubenAJ,Muris DM , Stehouwer CD.Microvascular dysfunction as a link between obesity, insulin resistance and hypertension. Diabetes Res Clin Pract. 2014; 103(3)382-7. 16. IJzermanRG,de JonghRT,BeijkMA,vanWeissenbruchMM,Delemarre-van deWaal HA, Serne EH, et al. Individuals at increased coronary heart disease risk are characterized by an impaired microvascular function in skin. Eur J Clin Invest. 2003; 33(7)536-42. 17. Strauer BE. Significance of coronary circulation in hypertensive heart disease for development and prevention of heart failure. Am J Cardiol. 1990; 65(14)34G-41G. 18. StrainWD,ChaturvediN,HughesA,NihoyannopoulosP,BulpittCJ,Rajkumar C,etal.Associationsbetweencardiactargetorgandamageandmicrovascular dysfunction: the role of blood pressure. J Hypertens. 2010; 28(5)952-8. 19. Tibirica E, Souza EG, De Lorenzo A , Oliveira GM. Reduced systemic microvascular density and reactivity in individuals with early onset coronary artery disease. Microvasc Res. 2015; 97:105-8. 20. ArcêncioL&Evora,PRB.TheLackofclinicalapplicationswouldbethecause of low interest in an endothelial dysfunction classification. Arq Bras Cardiol. 2017; 108(2):97-99 References This is an open-access article distributed under the terms of the Creative Commons Attribution License Change in the microvascular function in the skin has also been shown to correlate with an increased risk of coronary artery disease. 16 In addition, the rarefaction of microcirculation in capillary beds is related to target organ damage, which was suggested by the existence of an association betweenmyocardial disease and the reduction of capillary density, as well as another association between left ventricular hypertrophy and cutaneous microvascular dysfunction, regardless of the level of systemic arterial pressure. 17,18 In a recent study, we demonstrated that cutaneous capillary density, as well as endothelium-dependent capillary recruitment, are reduced in patients with early-onset coronary artery disease. 19 Therefore, the early detection of subclinical cardiovascular disease through the assessment of microcirculatory density and reactivity non-invasive techniques could represent an opportunity for early intervention, and consequently, prevention of cardiovascular events. 20 Moreover, microcirculation assessment could be useful to evaluate the chronic effects of cardiovascular drugs, making it attractive not only in research contexts but also in clinical practice. Thus, we believe that microcirculation assessment will be increasingly employed in cardiovascular practice, both for diagnostic and prognostic purposes and for testing novel therapeutic interventions. 121