Cardiol J. 2011;18(1):26-32.
Fractal analysis has been shown to be capable of characterizing irregular time series generated in non-linear systems. Fluctuations in skin flow signals have a fractal nature, but to date there has been no analysis of subjects with hypertension. The aim of this study is to assess the fractal dimensions of skin microcirculation flows in subjects with a familial predisposition or newly diagnosed hypertension.
A four-minutes rest flow (RF), minimal flow (BZ) during three-minutes ischemia and eight-minutes heat flow (HF) were recorded (using laser Doppler flowmetry) in patients with untreated hypertension, and in normotensives with no [NT(-)] or with a familial predisposition to hypertension [NT(+)]. Average one-minute surface areas under the curve of flow records and box dimensions (D) were calculated. Anova Kruskall-Wallis, c2 statistic and multivariate reverse regression analysis were used for calculation.
We studied 70 people (average age 36.1 ± 10.3 years, 39 men). Hypertensives (n = 31) had significantly higher values of both clinical blood pressure and 24-hour ambulatory blood pressure, body mass index, glucose, triglycerides and insulin than the NT(-), (n = 17) and NT(+), (n = 22) groups. Mean values of flows and surface area under the curve of RF, BZ, HF records, D RF and D HF were comparable in studied groups, but D BZ differed (1.13 ± ± 0.05 vs 1.15 ± 0.05 vs 1.11 ± 0.05, respectively; p = 0.04). A family history of hypertension, insulin level and variability of 24-hour diastolic blood pressure were significant predictors of D BZ lower values in the multiple regression model.
Subjects with a familial predisposition to hypertension reveal altered homeodynamics of microvascular flow, with diminished chaotic ischemic flow.
分形分析已被证明能够描述非线性系统中产生的不规则时间序列。皮肤血流信号的波动具有分形性质,但迄今为止,尚未对高血压患者进行分析。本研究旨在评估具有家族易感性或新诊断为高血压的患者的皮肤微循环流量的分形维数。
使用激光多普勒流量仪记录未经治疗的高血压患者和无高血压家族史的正常血压者[NT(-)]或有高血压家族史的正常血压者[NT(+)]的四分钟休息流量 (RF)、三分钟缺血期间的最小流量 (BZ) 和八分钟热流量 (HF)。计算流量记录的平均一分钟表面积和盒维数 (D)。采用方差分析 Kruskal-Wallis、c2 统计和多元反向回归分析进行计算。
我们研究了 70 人(平均年龄 36.1 ± 10.3 岁,39 名男性)。与 NT(-)(n = 17)和 NT(+)(n = 22)组相比,高血压患者(n = 31)的临床血压和 24 小时动态血压、体重指数、血糖、甘油三酯和胰岛素均显着升高。RF、BZ、HF 记录的流量和曲线下面积、RF 的 D 和 HF 的 D 的平均值在研究组中是可比的,但 BZ 的 D 不同(分别为 1.13 ± ± 0.05、1.15 ± 0.05 和 1.11 ± 0.05;p = 0.04)。高血压家族史、胰岛素水平和 24 小时舒张压变异性是多元回归模型中 BZ 值降低的显着预测因子。
有高血压家族史的患者表现出微血管血流的自主神经功能障碍,缺血性混沌流量减少。