[Study of cutaneous microcirculation using the laser-Doppler method in syndrome X].

Aim of the study was to verify the relationship between syndrome X and generalized microangiopathy. Three groups of patients were selected: Group A, 11 patients with typical syndrome X; Group B, 8 patients with atypical chest pain; Group C, 12 control normal subjects. Microvascular circulation was investigated with a laser Doppler Periflux PF3 at rest (15 min); during ischemia (3 min); during post-ischemic hyperemia on the plantar side of the big toe (where arterovenous anastomoses are particularly abundant) and on the dorsum of the foot (where these anastomoses are very scanty). During each recording we calculated: the mean flux value (FV); the mean concentration of moving blood cells (CMBC); the FV/CMBC ratio (which is related to the flow velocity); the mean percent increase of the three parameters during hyperemia. Patients with syndrome X as compared to the other subjects showed: 1) a significantly higher FV/CMBC ratio at rest and during hyperemia both on the plantar side of the big toe (respectively p = 0.01 and 0.015) and on the dorsum of the foot (respectively p = 0.011 and 0.006). These findings suggest a higher flow velocity in microvascular circulation; significantly lower percent increase of FV and CMBC during hyperemia in the plantar side of the big toe (respectively p = 0.04 and 0.014) but not on the dorsum. The increase of flow velocity at rest and low vasodilatatory reserve after ischemia in an area which is rich of arterovenous anastomoses in patients with syndrome X might be explained by the presence of a basal arterovenous hyperstomia.