Pulse transit times to the capillary bed evaluated by laser Doppler flowmetry.

The pulse transit time (PTT) of a wave over a specified distance along a blood vessel provides a simple non-invasive index that can be used for the evaluation of arterial distensibility. Current methods of measuring the PTT determine the propagation times of pulses only in the larger arteries. We have evaluated the pulse arrival time (PAT) to the capillary bed, through the microcirculation, and have investigated its relationship to the arterial PAT to a fingertip. To do so, we detected cardiac-induced pulse waves in skin microcirculation using laser Doppler flowmetry (LDF). Using the ECG as a reference, PATs to the microcirculation were measured on the four extremities of 108 healthy subjects. Simultaneously, PATs to the radial artery of the left index finger were obtained from blood pressure recordings using a piezoelectric sensor. Both PATs correlate in similar ways with heart rate and age. That to the microcirculation is shown to be sensitive to local changes in skin perfusion induced by cooling. We introduce a measure for the PTT through the microcirculation. We conclude that a combination of LDF and pressure measurements enables simultaneous characterization of the states of the macro and microvasculature. Information about the microcirculation, including an assessment of endothelial function, may be obtained from the responses to perturbations in skin perfusion, such as temperature stress or vasoactive substances.