Microcirculation and atherothrombotic parameters in prolactinoma patients: a pilot study Anne Q. ReuwerBrigitte M. SondermeijerSuzanne BattjesRogier van Zijderveld •

Abstract Atherothrombosis is a multifactorial process,governed by an interaction between the vessel wall, hemo-dynamic factors and systemic atherothrombotic risk factors.Recent in vitro, human ex vivo and animal studies haveimplicated the hormone prolactin as an atherothromboticmediator. To address this issue, we evaluated the anatomyand function of various microvascular beds as well asplasma atherothrombosis markers in patients with elevatedprolactin levels. In this pilot study, involving 10 prolacti-noma patients and 10 control subjects, sidestream dark field(SDF) imaging revealed a marked perturbation of the sub-lingual microcirculation in prolactinoma patients comparedto control subjects, as attested to by significant changes inmicrovascular flow index (2.74 ± 0.12 vs. 2.91 ± 0.05,respectively; P = 0.0006), in heterogeneity index (0.28[IQR 0.18–0.31] vs. 0.09 [IQR 0.08–0.17], respectively;P = 0.002) and lower proportion of perfused vessels (90 ±4.0%vs.95 ± 3.0%,respectively; P = 0.016).Intheretina,fluorescein angiography (FAG) confirmed these data, sinceprolactinoma patients more often have dilatated perifovealcapillaries. In plasma, prolactinoma patients displayedseveral pro-atherogenic disturbances, including a higherendogenous thrombin potential and prothrombin levels aswell as decreased HDL-cholesterol levels. Prolactinomapatients are characterized by microvascular dysfunction aswell as plasma markers indicating a pro-atherothromboticstate. Further studies are required to assess if prolactin iscausally involved in atherothrombotic disease.Keywords Prolactinoma Microcirculation CoagulationP. H. Bisschop Inflammation AtherothrombosisIntroductionAtherothrombosis, the basis of cardiovascular disease,results from a complex interplay of hemodynamic changes,coagulation changes, inflammatory activation as well aschanges in vessel wall function and structure [1, 2]. Vari-ous endocrine hormones have been suggested to be asso-ciated with an increased risk of cardiovascular disease(CVD) [3]. Although prolactin was originally identified as