PhD defence E. (Elif) Aribas

Summary:

Over the years, researchers and clinicians have recognized that both micro-and macrovascular damage contributes to cardiovascular disease pathology. Interestingly, most research has focused on only abnormalities in the large coronary arteries, while the vasculature of the heart consists of an extensive network of microvessels. Abnormalities of small vessels have been neglected, partly due to a lack of awareness of this disorder and partly due to technical constraints in assessing and visualizing the coronary microvasculature. Nevertheless, recent research has shown
the importance of microvessels in cardio- and cerebrovascular health.

Microvascular disease is a systemic disorder, a global pathological process throughout the vascular system in the human body. It can present both centrally (for instance, in the heart) and more peripheral in the retinal layer of the eye and the brain. Concomitant microvascular can occur in various organs and areas of the body, with organ-specific manifestation. Microvascular damage in the retina and brain can be visualized or measured as changes in the microvessels in the retinal layer of the eye or structural brain changes in the brain. These more easily accessible
systemic and more peripheral manifestations of microvascular damage can be used as established or surrogate markers of microvascular disease to investigate and assess microvascular function non-invasively, early in the preclinical phase as subclinical markers of microvascular damage.

The main aim of this thesis was to provide more insight into micro-and macrovascular disease and underlying sex-specific mechanisms and risk factors, combining clinical and populationbased data.