Email this article Is the microvasculature tone increasing with arterial hypertension?
- Authors: Rogatkin D.A.1, Glazkova P.A.1, Kulikov D.A.1, Glazkov A.A.1, Terpigorev S.A.1, Shekhyan G.G.1, Kozlova K.A.1,2, Makmatov-Rys M.B.1
-
Affiliations:
- Moscow Regional Research and Clinical Institute (MONIKI)
- Lomonosov Moscow State University Diary
- Issue: Vol 47, No 7 (2019)
- Pages: 662-668
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/1200
- DOI: https://doi.org/10.18786/2072-0505-2019-47-073
- ID: 1200
Cite item
Full Text
Abstract
Rationale: An increase in vascular tone is believed to be a major factor leading to arterial hypertension (AH). There are no means for a direct measurement of the vascular tone in clinical practice. Perfusion assessment by laser Doppler flowmetry (LDF) allows for an indirect evaluation of the vascular tone of the microcirculation system. Perfusion is assessed by the change in blood flow per unit of time in the given area. Therefore, this parameter should be inversely correlated with vascular tone. Aim: To compare the forearm skin perfusion measured by LDF in patients with AH and healthy volunteers with normal blood pressure, and to review the feasibility of this parameter for the assessment of the microvasculature tone.
Materials and methods: The study was carried out in two groups: group one, patients with AH (n = 43; age 62 [57; 71] years), and group 2, healthy volunteers without AH (n = 62; age 28 [24; 37] years). The perfusion in the forearm skin was measured by LDF for 2 minutes without any functional tests. "Baseline perfusion” for each subject was calculated as the average perfusion rate in a representative portion of the microcirculatory curve.
Results: Median of basic perfusion in the forearm skin in the patients with AH is significantly higher than that in the normotensive individuals: 4.88 [2.87; 8.98] PU and 3.41 [2.47; 4.99] PU, respectively (p = 0.013). The interquartile range of the baseline perfusion in the control group was chosen as provisional threshold values for the "normal” perfusion level. In 39.5% of patients with AH, their basic perfusion was within the "normal level”; 46.5% of the patients had the baseline perfusion above the "normal level”, which might be due to reduced tone of the peripheral vessels. Only 14.0% of the patients had a decreased level of the basic perfusion.
Conclusion: An increase in the skin perfusion in some patients with AH may indicate a decrease in their peripheral vascular tone, which could be a potential compensatory reaction in response to the rise in blood pressure. The results obtained could have been influenced by the age-related changes in the cardiovascular system, drug therapy, etc. Further studies into the specifics of peripheral vasculature seem reasonable. They can contribute to the understanding of the pathophysiology of AH in a given patient and, in future, could be used to guide a personalized choice of therapy.
About the authors
D. A. Rogatkin
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0002-7755-308X
Dmitry A. Rogatkin - PhD (in Engineering), Head of Laboratory of Medical and Physical Research.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationP. A. Glazkova
Moscow Regional Research and Clinical Institute (MONIKI)
Author for correspondence.
Email: polinikul@mail.ru
ORCID iD: 0000-0002-8830-7503
Polina A. Glazkova - Research Fellow, Laboratory of Medical and Physical Research.
61/2-8 Shchepkina ul., Moscow, 129110, tel.: +7 (495) 681 89 84
Russian FederationD. A. Kulikov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0002-4273-8295
Dmitriy A. Kulikov - MD, PhD, Academic Secretary, Associate Professor, Chair of Endocrinology, Postgraduate Training Faculty.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationA. A. Glazkov
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0001-6122-0638
Alexey A. Glazkov - Research Fellow, Laboratory of Medical and Physical Research.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationS. A. Terpigorev
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0001-5444-5943
Stanislav A. Terpigorev - MD, PhD, Head of Department of Profpathology and Medical Examination; Professor, Chair of Internal Diseases, Postgraduate Training Faculty.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationG. G. Shekhyan
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0003-0442-644X
Grant G. Shekhyan - MD, PhD, Leading Research Fellow, Department of Cardiology; Professor, Chair of Internal Diseases, Postgraduate Training Faculty.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationK. A. Kozlova
Moscow Regional Research and Clinical Institute (MONIKI); Lomonosov Moscow State University Diary
Email: fake@neicon.ru
ORCID iD: 0000-0003-4146-930X
Ksenia A. Kozlova - Laboratory Technician, Department of Clinical and Experimental Research MONIKI; Student, Faculty of Fundamental Medicine Lomonosov MSU.
61/2-8 Shchepkina ul., Moscow, 129110; 1 Leninskie Gory, Moscow, 119991
Russian FederationM. B. Makmatov-Rys
Moscow Regional Research and Clinical Institute (MONIKI)
Email: fake@neicon.ru
ORCID iD: 0000-0002-2506-9202
Michael B. Makmatov-Rys - Senior Laboratory Technician, Department of Clinical and Experimental Research.
61/2-8 Shchepkina ul., Moscow, 129110
Russian FederationReferences
- Williams B, Mancia G, Spiering W, Agabiti Ro-sei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mah-foud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-104. doi: 10.1093/eurheartj/ehy339.
- Всемирная организация здравоохранения. Глобальное резюме по гипертонии. Безмолвный убийца, глобальный кризис общественного здравоохранения. Сердечно-сосудистые заболевания. 04.2013 [Интернет]. Доступно на: http://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/ru/.
- Coffman TM. Under pressure: the search for the essential mechanisms of hypertension. Nat Med. 2011;17(11):1402-9. doi: 10.1038/nm.2541.
- Touyz RM, Alves-Lopes R, Rios FJ, Camargo LL, Anagnostopoulou A, Arner A, Montezano AC. Vascular smooth muscle contraction in hypertension. Cardiovasc Res. 2018;114(4):529-39. doi: 10.1093/cvr/cvy023.
- Bevan JA, Laher I. Pressure and flow-dependent vascular tone. FASEB J. 1991;5(9):2267-73. doi: 10.1096/fasebj.5.9.1860618.
- Matteucci MC, Giordano U, Calzolari A, Riz-zoni G. Total peripheral vascular resistance in pediatric renal transplant patients. Kidney Int. 2002;62(5):1870-4. doi: 10.1046/j.1523-1755.2002.00639.x.
- Шабров АВ, Апресян АГ, Добкес АЛ, Ермолов СЮ, Ермолова ТВ, Манасян СГ, Сердюков СВ. Современные методы оценки эндотелиальной дисфункции и возможности их применения в практической медицине. Рациональная фармакотерапия в кардиологии. 2016;12(6):733-42. doi: 10.20996/1819-6446-2016-12-6-733-742.
- Liu X, El-Mahdy MA, Boslett J, Varadharaj S, Hemann C, Abdelghany TM, Ismail RS, Little SC, Zhou D, Thuy LT, Kawada N, Zweier JL. Cytoglo-bin regulates blood pressure and vascular tone through nitric oxide metabolism in the vascular wall. Nat Commun. 2017;8:14807. doi: 10.1038/ncomms14807.
- Tan CH, Low KA, Schneider-Garces N, Zimmerman B, Fletcher MA, Maclin EL, Chiarelli AM, Gratton G, Fabiani M. Optical measures of changes in cerebral vascular tone during voluntary breath holding and a Sternberg memory task. Biol Psychol. 2016;118:184-94. doi: 10.1016/j.biopsycho.2016.05.008.
- Hubner CA, Schroeder BC, Ehmke H. Regulation of vascular tone and arterial blood pressure: role of chloride transport in vascular smooth muscle. Pflugers Arch. 2015;467(3):605-14. doi: 10.1007/s00424-014-1684-y.
- Miller RR, Vismara LA, Zelis R, Amsterdam EA, Mason DT. Clinical use of sodium nitroprus-side in chronic ischemic heart disease. Effects on peripheral vascular resistance and venous tone and on ventricular volume, pump and mechanical performance. Circulation. 1975;51(2): 328-36. doi: 10.1161/01.cir.51.2.328.
- Куликов ДА, Глазков АА, Ковалева ЮА, Балашова НВ, Куликов АВ. Перспективы использования лазерной допплеровской флоуме-трии в оценке кожной микроциркуляции крови при сахарном диабете. Сахарный диабет. 2017;20(4):279-85. doi: 10.14341/DM8014.
- Lindblad LE, Ekenvall L, Klingstedt C. Neural regulation of vascular tone and cold induced vasoconstriction in human finger skin. J Auton Nerv Syst. 1990;30(2):169-73. doi: 10.1016/0165-1838(90)90141-5.
- Sondermeijer B, Kompa A, Komesa-roff P, Krum H. Effect of exogenous urotensin-II on vascular tone in skin microcirculation of patients with essential hypertension. Am J Hy-pertens. 2005;18(9 Pt 1):1195-9. doi: 10.1016/j.amjhyper.2005.03.748.
- Roustit M, Cracowski JL. Non-invasive assessment of skin microvascular function in humans: an insight into methods. Microcirculation. 2012;19(1): 47-64. doi: 10.1111/j.1549-8719.2011.00129x
- Рогаткин ДА. Физические основы современных оптических методов исследования микрогемодинамики in vivo. Лекция. Медицинская физика. 2017;(4):75-93.
- Mayet J, Hughes A. Cardiac and vascular pathophysiology in hypertension. Heart. 2003;89(9): 1104-9. doi: 10.1136/heart.89.9.1104.
- Глазкова ПА, Терпигорев СА, Куликов ДА, Иванова НА, Глазков АА. Пути повышения диагностической значимости метода лазерной допплеровской флоуметрии при оценке кожной микроциркуляции у пациентов с артериальной гипертензией. Артериальная гипертензия. 2019;25(1):74-83. doi: 10.18705/1607-419X-2019-25-1-74-83.
- Herrington DM, Fan L, Drum M, Riley WA, Puss-er BE, Crouse JR, Burke GL, McBurnie MA, Morgan TM, Espeland MA. Brachial flow-mediated vasodilator responses in population-based research: methods, reproducibility and effects of age, gender and baseline diameter. J Cardiovasc Risk. 2001 ;8(5):319-28. doi: 10.1177/174182670100800512.
- Nippolainen E, Podolian NP, Romashko RV, Kulchin YN, Kamshilin AA. Photoplethysmo-graphic waveform as a function of subject's age. Physics Procedia. 2015;73:214-45. doi: 10.1016/j.phpro.2015.09.164.
Supplementary files
