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DOI: 10.1055/s-2001-19076
© Georg Thieme Verlag Stuttgart · New York
Störung von Ruhedurchblutung, endothelabhängiger reaktiver Hyperämie und spontaner Vasomotorik bei Diabetikern - Nachweis mittels Venenverschlussplethysmographie
Disturbed basal perfusion, endothelium-dependent reactive hyperaemia and spontaneous vasomotor activity in diabetics - demonstration with strain gauge plethysmographyPublication History
2. 3. 2001
19. 9. 2001
Publication Date:
18 December 2001 (online)
Kurzfassung
Ziel: Nachweis der gestörten Ruhedurchblutung, der gestörten, endothelfunktionsabhängigen reaktiven Hyperämie und der spontanen Vasomotorik bei Diabetikern. Gegenstand und Gestaltung: Untersucht wurden 16 Diabetiker und eine Kontrollgruppe von 21 Personen. Die Ruhedurchblutung der Unterarme, die reaktive Hyperämie nach dreiminütigem suprasystolischen Stau und die spontanen Undulationen der Messwerte in der Phase der reaktiven Hyperämie wurden analysiert. Ergebnisse: Die Ruhedurchblutung und die reaktive Hyperämie sind bei den Diabetikern im Vergleich zum Kontrollkollektiv signifikant reduziert. Zudem zeigen sich in der Phase der reaktiven Hyperämie keine signifikanten Undulationen der Messwerte bei den Diabetikern im Vergleich zur Kontrollgruppe. Schlussfolgerung: Der Diabetes geht nicht nur mit einer reduzierten Ruhedurchblutung, sondern auch mit einer gestörten Endothelfunktion und einer gestörten spontanen Vasomotorik der Unterarme einher. Dies lässt sich venenverschlussplethysmographisch nachweisen.
Disturbed basal perfusion, endothelium-dependent reactive hyperaemia and spontaneous vasomotor activity in diabetics - demonstration with strain gauge plethysmography
Objective: To demonstrate disturbed basal perfusion, endothelium-dependend reactive hyperaemia and spontaneous vasomomotor activity in diabetics. Method: In 16 diabetics and 21 control-persons basal perfusion of the lower arm was measured as well as reactive hyperaemia after a 3 minute suprasystolic block. The spontaneous undulations of the perfusion-curves which represent spontaneous vasomotor activity were analysed additionally. Results: Basal perfusion as well as reactive hyperaemia is reduced compared to the values obtained in the control-persons. There were no significant spontaneous undulations in the phase of reactive hyperaemia demonstrable in the diabetics in contrast to the control-persons. Conclusion: Diabetes goes along with not only reduced basal perfusion of the lower arm but also with an endothelial dysfunction and with an altered spontaneous vasomotor activity. This can be demonstrated with strain gauge plethysmography.
Schlüsselwörter
Endotheliale Dysfunktion - reaktive Hyperämie - spontane Vasomotorik - Diabetes mellitus - Venenverschlussplethysmographie
Key words
Endothelial dysfunction - reactive hyperaemia - spontaneous vasomotor activity - diabetes - strain gauge venous plethysmography
Literatur
- 1 Altenkirch H U, Fransson L, Koch G. Assessment of arterial and venous circulation in upper and lower extremities by venous occlusion strain gauge plethysmography. Normal values and reproducibility. Vasa. 1989; 18, 2 140-145
- 2 Muhry R, Przywara S, Moser M, Hildebrandt G, Kenner T. Die Wirkung von Kohlensäurebädern auf die Hautdurchblutung zu verschiedenen Tageszeiten. Phys Rehab Kur Med. 1999; 9 79-84
- 3 Clarkson P, Celermajer D S, Donald A E, Sampson M, Sorensen K E, Adams M, Yue D K, Betteridge D J, Deanfield J E. Impaired vascular reactivity in insulin-dependent diabetes mellitus is related to disease duration and low density lipoprotein cholesterol levels. JACC. 1996; 28, 3 573-579
- 4 Tooke J E, Ostergren J, Lins P E, Fagrell B. Skin mircrovascular blood flow control in long duration diabetics with and without complications. Diabetes research. 1987; 5, 4 189-192
- 5 Inoue T, Matsunaga R, Sakai Y, Yaguchi I, Takayanagi K, Morooka S. Insulin resistance affects endothelium-dependent acetylcholine-induced coronary artery response. Eur Heart J. 2000; 21 895-900
- 6 Leyva F, Rauchhaus M, Anker S D, Proudler A J, Godsland I F, Stiefel P K, Coats A JS, Poole-Wilson P A, Stevenson J C. Non-invasive assessment of vascular function. Paradoxical vascular response to intravenous glucose in coronary heart disease. Eur Heart J. 2000; 21 39-44
- 7 Cevese A, Cerutti G. Interference of sympathetic innervation with reactive hyperemia in dog's skeletal muscle. Bollettino - societa italiane biologia sperimentale. 1981; 57, 13 1395-1401
- 8 Escourrou P. Vasomotricite et geometrie vasculaire. Archives des maladies du coeur et des vaisseaux. 1991; 84 Spec no 1 53-57
- 9 Rizzoni D, Castellano M, Porteri E, Bettoni G, Muiesan P, Muiesan M L, Giulini S M, Cinelli A, Salvetti M, Agabiti Rosei E. Arterial spontaneous rhythmic contractile activity in humans and rats: spectral analysis and regulatory mechanisms. Journal of hypertension. 1995; 13, 9 1043-1052
- 10 Stauss H M, Anderson E A, Haynes W G, Kregel K C. Frequency response characteristics of sympathetically mediated vasomotor waves in humans. American journal of physiology. 1998; 274, 4 Pt 2 H 1277-1283
- 11 Aono T, Sato T, Nishinage M, Kawamoto A, Ozawa T. Power spectral analysis of spontaneous blood pressure and heart rate variability in elderly hypertensives. Hypertension research. 1996; 19, 1 9-16
- 12 Kuo T B, Yang C C, Chan S H. Selective activation of vasomotor component of SAP spectrum by nucleus reticularis ventrolateralis in rats. American journal of physiology. 1997; 272, 1 Pt 2 H 485-492
- 13 Khaishman E B. A histochemical study of vegetative innervation of blood-vessels of serosa. Archives d'anatomie microscopique et de morphologie experimentale. 1975; 64, 4 337-358
- 14 Seller H, Langhorst P, Polster J, Koepchen H P. Zeitliche Eigenschaften der Vasomotorik. Pflügers Archiv. 1967; 296 110-132
- 15 Schmidt-Schoenbein H, Ziege S, Grebe R, Blazek V, Speilmann R, Linzenich F. Synergetic interpretation of patterned vasomotor activity in microvascular perfusion: discrete effects of myogenic and neurogenic vasoconstriction as well as arterial and venous pressure fluctuations. International journal of microcirculation: clinical and experimental. 1997; 17, 6 346-359
- 16 Hagen C, Brenke A, Brenke R. Untersuchungen zur Hautdurchblutung und deren Beeinflussbarkeit durch Wärme bei Sklerodermiepatienten und Gesunden. Phys Rehab Kur Med. 1999; 9 219-223
- 17 Seyfert H, Wendt T. 14-tägiges allgemeines Kreislauftraining verbessert die endotheliale Funktion der Armblutgefäße. Würzburg; 9. rehabilitationswissenschaftliches Kolloquium 13. - 15. März 2000
- 18 Silber D, McLuaghlin D, Sinoway L. Leg exercise conditioning increases peak forearm blood flow. Journal of applied physiology. 1991; 71, 4 1568-1573
- 19 Higashi Y, Sasaki S, Kurisu S, Yoshimizu A, Sasaki N, Matsuura H, Kajiyma G, Oshima T. Regular Aerobic Exercise Augments Endothelium-Dependent Vascular Relaxation in Normotensive as Well as Hypertensive Subjects. Circulation. 1999; 100 1194-1202
- 20 Richard V, Thuillez C. Improvement of endothelial function with the fixed low-dose perindopril-indapamide combination. Eur Heart J. 1999; Suppl L L38-L43
- 21 Rizzoni D, Proteri E, Castellano M, Bettoni G, Muiesan M L, Salvetti M, Cinelli A, Agabiti-Rosei E. Effects of antihypertensive therapy with angiotensin converting enzyme inhibitors or calcium antagonists on spontaneous cyclic vasomotor activity in small resistance arteries of spontaneously hypertensive rats. Journal of hypertension. 1995; 13, 12 Pt 2 1827-1832
- 22 O'Driscoll G, Green D, Taylor R. Simvastatin, an HMG-coenzyme A reductase inhibitor, improves endothelial function within 1 month. Circulation. 1997; 95, 5 1126-1131
- 23 Lefer A M, Scalia R, Lefer D J. Vascular effects of HMG CoA-reductase inhibitors (statins) unrelated to cholesterol lowering: new concepts for cardiovascular disease. Cardiovascular Research. 2001; 49 281-287
- 24 Klepzig H, Kober G, Matter C, Luus H, Schneider H, Boedeker K H, Klowski W, Amann F W, Gruber D, Harris S, Burger W. Sulfonylureas and ischaemic preconditioning. A double-blind, placebo-controlled evaluation of glimepiride and glibenclamide. Eur Heart J. 1999; 20 439-446
- 25 Laakso M, Edelman S V, Brechtel G, Baron A D. Decreased effect of insulin to stimulate skeletal muscle blood flow in obese man. J Clin Invest. 1990; 85 1844-1852
- 26 Quaschning R, Ruschitzka F T, Maier W, Lüscher T F. Die Rolle des Endothels bei der Entstehung und Behandlung von Gefäßerkrankungen. Internist. 2000; 41 355-362
- 27 Heitzer T, Ylä-Herttuala S, Luoma J, Kurz S, Münzel T, Just H, Olschewski M, Drexler H. Cigarette Smoking Potentiates Endothelial Dysfunction of Forearm Resistance Vessels in Patients With Hypercholesterolemia. Circulation. 1996; 93 1346-1353
- 28 Panza J A, Casino P R, Kilcoyne C M, Quyyumi A A. Role of Endothelium-Derived Nitric Oxide in the Abnormal Endothelium-Dependent Vascular Relaxation of Patients With Essential Hypertension. Circulation. 1993; 87 1468-1474
- 29 Sica D A. Endothelial cell function: new considerations. Eur Heart J. 2000; Suppl B B 13-B 21
Dr. Hartmut Seyfert
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