Fedorovich Andrey A, Rogoza Anatoly N, Chikhladze Novella M
New Diagnostic Methods Department, Russian Cardiology Research and Production Complex, 3-rd Cherepkovskaya Street, 15-a, Moscow 121552, Russia; Laboratory of Physiology and Biomechanics Cardiorespiratory System, Institute of Bio-Medical Problems, Russian Academy of Sciences, Khoroshevskoye Shosse, 76-a, Moscow 123007, Russia.
New Diagnostic Methods Department, Russian Cardiology Research and Production Complex, 3-rd Cherepkovskaya Street, 15-a, Moscow 121552, Russia.
Microvasc Res. 2014 May;93:105-13. doi: 10.1016/j.mvr.2014.04.005. Epub 2014 Apr 24.
The aim of the study was to evaluate the vasomotor activity of skin precapillary arterioles, depending on the condition of blood outflow from the capillary bed in patients with essential arterial hypertension (AH). The study included 30 normotensive subjects (NT) and 63 patients with AH, who were tested with a laser Doppler flowmetry with wavelet analysis of blood flow oscillations on the right forearm and ambulatory blood pressure monitoring (ABPM) on the left shoulder. Antihypertensive therapy was stopped for all patients 14 days prior to the experiment or AH was diagnosed for the first time. The hypertensive patients were divided into 2 groups, depending on the amplitude of the respiratory blood flow oscillations in skin microvessels. The first group included 30 patients without blood outflow violations of the capillary bed (AHVN), the second group consisted of 33 patients with various intensity of functional disorders in venular sector of microvasculature (AHVS). If the value of the amplitude of blood flow oscillations can be related to the tone" definition, then AHVN patients have a significant increase in neurogenic component of vascular tone (p<0.002) and violation of microvessel vasomotor endothelial function (p=0.065) in regard to NT, and AHVS patients to NT have a significant reduction of myogenic component tone of precapillary arterioles (p<0.05). AHVN patients compared to AHVS patients have a higher precapillary arteriolar tone due to endothelial (p<0.01), neurogenic (p<0.01) and myogenic (p<0.01) components of the vascular tone. Despite the lower values of the precapillary arteriolar tone, AHVS patients have higher BP values both at daytime (p<0.0005), and in nocturnal hours (p<0.05), and the functional state of venular sector is connected with nocturnal BP reduction. Obtained results indicate that hypertensive patients can have significant differences in the functional state of microvessels. The assessment of the initial skin microvasculatory regulatory mechanism status could potentially be useful for individual choice of antihypertensive therapy.
本研究的目的是评估原发性动脉高血压（AH）患者皮肤毛细血管前微动脉的血管舒缩活动，这取决于毛细血管床的血液流出情况。该研究纳入了30名血压正常的受试者（NT）和63名AH患者，对他们进行了右前臂激光多普勒血流仪检测及血流振荡的小波分析，以及左肩动态血压监测（ABPM）。在实验前14天，所有患者停止抗高血压治疗，或者对首次诊断为AH的患者进行上述检测。根据皮肤微血管中呼吸性血流振荡的幅度，将高血压患者分为2组。第一组包括30名毛细血管床血液流出无异常的患者（AHVN），第二组由33名微血管小静脉段存在不同程度功能障碍的患者（AHVS）组成。如果血流振荡幅度的值可与“张力”定义相关，那么与NT相比，AHVN患者血管张力的神经源性成分显著增加（p<0.002），微血管血管舒缩内皮功能受损（p=0.065）；与NT相比，AHVS患者毛细血管前微动脉的肌源性成分张力显著降低（p<0.05）。与AHVS患者相比，AHVN患者由于血管张力的内皮（p<0.01）、神经源性（p<0.01）和肌源性（p<0.01）成分，其毛细血管前微动脉张力更高。尽管AHVS患者毛细血管前微动脉张力值较低，但他们白天（p<0.0005）和夜间（p<0.05）的血压值更高，且小静脉段的功能状态与夜间血压降低有关。所得结果表明，高血压患者微血管的功能状态可能存在显著差异。评估初始皮肤微血管调节机制状态可能有助于个体化选择抗高血压治疗方案。
