Investigation of the endothelium-dependent mechanism of microvascular tone regulation in patients with severe acute pancreatitis

Objective. To study the endothelium-dependent mechanism(s) of microvascular tone regulation using wavelet analysis of skin temperature fluctuations in patients with severe acute pancreatitis (AP). Materials and methods. 22 patients with severe AP were examined. The control group included 12 healthy individuals. Microcirculation was assessed using «Microtest» device (Perm, Russia) during contralateral cold test. The amplitudes of RMS oscillations were calculated in the endothelial frequency range in four time periods: before the cold test, during it, and within 3 and 6 minutes after it. Results. In healthy subjects the amplitudes of skin temperature oscillations significantly decreased during the test, and increased after exposure to cold. In severe AP the initial amplitudes of the skin temperature oscillations were lower than in healthy volunteers. There were no statistically significant changes to cold test and after it. The cluster analysis revealed 3 types of reactions of microcirculation. The first type is characterized by a decrease in the amplitudes of skin temperature oscillations during the cold test and recovery to baseline values within 3 minutes after it. The second type is characterized by a lack of reaction to cold exposure as well as after its completion. In the third type, the increase of oscillation amplitudes was observed in response to cold exposure and 3 minutes after it. Conclusion. Patients with severe AP have abnormally low activity of endothelium-dependent vascular tone regulation accompanied by severe disorders of vasoconstriction and vasodilation. Our study confirms the possibility of using wavelet analysis of low-frequency temperature fluctuations to study the mechanisms of microvascular tone regulation in patients with severe AP.

острый тяжелый панкреатит, эндотелиальная дисфункция, вейвлет-анализ колебаний кожной температуры, acute pancreatitis, endothelial dysfunction, skin temperature fluctuations

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