Noninvasive Assessment of Endothelial Function in the Skin Microcirculation
Noninvasive Assessment of Endothelial Function in the Skin Microcirculation
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DOI：
10.1038/ajh.2010.10
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发表时间：
2010-05-01
影响因子：
3.2
通讯作者：
Levy, Bernard I.
中科院分区：
文献类型：
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作者：
Debbabi, Haythem;Bonnin, Philippe;Levy, Bernard I.
背景血管的结构和功能沿血管树变化。内皮功能障碍是心血管(CV)风险增加的标志，可以通过几种方法进行评估，其中一些方法是侵入性的，应用受到限制。本研究的目的是确定皮肤微循环对乙酰胆碱的激光多普勒反应是否反映了用肱动脉血流介导的扩张(FMD)来评估导管动脉的反应。方法用激光多普勒血流仪(LDF)无创测量局部应用乙酰胆碱(Ach-SkBF)后皮肤微循环的内皮依赖性血管扩张，是一种不依赖于操作者的方法。对55例非优势上肢患者进行ACh-SkBF和FMD测量，以评估心血管危险因素。(min-max)490+/-414%，(10-1667%)，FMD为3.77+/-3.01%(0.91-10.91)。Ach-SkBF与FMD呈良好的线性关系：ACh-SkBF=122.7，FMD+25.8(r=0.92P&t；0.0001)。结论大动脉和皮肤微血管对血流增加和乙酰胆碱的内皮扩张反应相似。因此，使用LDF和乙酰胆碱离子导入相结合的方法测量皮肤微循环中的血流变化，是一种在大范围正常和改变的内皮反应中评估内皮功能的具有技术挑战性和可靠的无创方法。
BACKGROUNDThe structure and function of blood vessels varies along the vascular tree. Endothelial dysfunction is a hallmark of increased cardiovascular (CV) risk that can be assessed by several methods, some of which are invasive and of restricted application. The aim of this study was to determine whether the laser Doppler response of skin microcirculation to acetylcholine, reflects that of conduit artery assessed by brachial artery flow-mediated dilation (FMD).METHODSNoninvasive measurement of endothelium-dependent vasodilation in the skin microcirculation by laser Doppler flowmetry (LDF) in response to a local transdermal iontophoretic application of acetylcholine (Ach-SkBF) is an operator-independent method. Ach-SkBF and FMD were measured in the nondominant upper limb of 55 unselected consecutive patients admitted in our department for evaluation of CV risk factors.RESULTSAch-SkBF was (mean +/- s.d. (min-max)) 490 +/- 414%, (10-1667%) and FMD was 3.77 +/- 3.01% (0.91-10.91). A strong linear relationship was found between Ach-SkBF and FMD:Ach-SkBF = 122.7 FMD + 25.8 (r = 0.92, P < 0.0001).CONCLUSIONSEndothelial dilatory response to increased blood flow and to acetylcholine are similar in large arteries and in the skin microvasculature. Thus, measurement of blood flow changes in the skin microcirculation using LDF coupled with acetylcholine iontophoresis represents a technically challenging and reliable noninvasive method for the assessment of endothelial function within a large range of normal and altered endothelium responses.