Skin microhemodynamics in patients with obliterating atherosclerosis of lower extremities arteries and diabetes mellitus type 2
https://doi.org/10.24884/1682-6655-2019-18-2-28-34
Abstract
Introduction. Chronic tissue ischemia appeared due to obliterating atherosclerosis of lower extremities arteries (OALEA) enhances diabetic microangiopathy making prognosis worse. Due to fundamental biological importance of microcirculation (MC), the study of tissue blood flow in case of this pathology receives huge theoretical value.
Purpose of the study was to reveal features of skin MC in patients with diabetes mellitus type II (DM) with OALEA in comparison with the same group of patients without DM.
Material and methods. The study involved 111 males with claudication IIB stage and ancle-brachial index (ABI) ≤0.85, which were randomized into two groups equal in age and main clinical and anamnesis data (Gr.1 –without DM (n=77) and Gr.2 – with DM (n=34)). Skin MC was examined using Laser Doppler Flowmetry.
Results. Patients with DM had statistically important lowering of blood flow oscillatory amplitude in myogenic (34,5 %) and endothelial (27,8 %) frequency ranges in comparison with the alternative group. Together with the growth of myogenic tone (63,5 [38,6; 123,4] vs 43,6 [28,9; 75,0] u), it reflects depression of vasolytic features and constriction of precapillary segment of the bloodstream. The study revealed significant limitation (18,9 %) of nutritional blood flow and increase of the intensity of arterial and venous bypass grafting in patients of Gr.2 (2,6 [1,8; 4,0 vs 2,0 [1,2; 3,0] u) in Gr. 1.
Conclusion. The studied patients had monotype MC alterations. However, they are more pronounced in patients with DM; it worsens the disease prognosis.
About the Authors
N. N. Streltsova
Tyumen Cardiology Research Center – Branch of Tomsk National Research Medical Center of the Russian Academy of Sciences
Russian Federation
Streltsova Nina N. – Scientific researcher, Department of Arterial Hypertension and Coronary Insufficiency of Scientific Division of Clinical Cardiology
Russian Federation
Streltsova Nina N. – Scientific researcher, Department of Arterial Hypertension and Coronary Insufficiency of Scientific Division of Clinical Cardiology
A. P. Vasilev
Tyumen Cardiology Research Center – Branch of Tomsk National Research Medical Center of the Russian Academy of Sciences
Russian Federation
Vasilyev Alexander P. – MD, PhD, Scientific Head of Arterial Hypertension and Coronary Insufficiency Department of Scientific Division of Clinical Cardiology
Russian Federation
Vasilyev Alexander P. – MD, PhD, Scientific Head of Arterial Hypertension and Coronary Insufficiency Department of Scientific Division of Clinical Cardiology
V. V. Todosiichuk
Tyumen Cardiology Research Center – Branch of Tomsk National Research Medical Center of the Russian Academy of Sciences
Russian Federation
Todosiichuk Viktor V. – leading Researcher Laboratory of instrumental diagnostics Tyumen Cardiology Research Center
Russian Federation
Todosiichuk Viktor V. – leading Researcher Laboratory of instrumental diagnostics Tyumen Cardiology Research Center
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Review
For citations:
Streltsova N.N., Vasilev A.P., Todosiichuk V.V. Skin microhemodynamics in patients with obliterating atherosclerosis of lower extremities arteries and diabetes mellitus type 2. Regional blood circulation and microcirculation. 2019;18(2):28-34. (In Russ.) https://doi.org/10.24884/1682-6655-2019-18-2-28-34
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