Impact of tetraplegia vs. paraplegia on venoarteriolar, myogenic and maximal cutaneous vasodilation responses of the microvasculature: Implications for cardiovascular disease.
Impact of tetraplegia vs. paraplegia on venoarteriolar, myogenic and maximal cutaneous vasodilation responses of the microvasculature: Implications for cardiovascular disease.
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四肢瘫痪与截瘫对微脉管系统的静脉小动脉、肌源性和最大皮肤血管舒张反应的影响：对心血管疾病的影响。
DOI：
10.1080/10790268.2020.1761173
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
KelloggJr,Dean
中科院分区：
文献类型：
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作者：
Trbovich,Michelle;Wu,Yubo;Koek,Wouter;Zhao,Joan;KelloggJr,Dean
目的：心血管疾病(CVD)是脊髓损伤患者死亡的主要原因。虽然脊髓损伤后大血管重塑和功能的研究很多，但对微血管结构和功能的改变研究相对较少，但重要的是预测心血管疾病的风险。具体地说，脊髓损伤后静脉小动脉(VAR)、肌源性(MYO)和最大血管扩张反应的完整性在很大程度上是未知的，特别是在四肢瘫痪(TP)患者中，CVD的风险最高。这是第一次检测正常人(AB)与TP和截瘫(PP).Design:Observational.Setting:Laboratory.Participants:Eight AB、6名TP和8名PP患者微血管的VAR(袖套膨胀)、MYO(肢体依赖性)和最大血管扩张反应的差异。干预：一侧前臂和小腿局部应用2.5%利多卡因/2.5%普利洛卡因，另一侧肢体作为对照。在肢体依赖、袖带充气和局部皮肤加热(TLOC)时对治疗和对照部位应用激光多普勒血流计，最高温度达42°C。结果：皮肤血管阻力(SkVR)随袖带充气和肢体依赖而变化，局部加热时皮肤最大血管传导度(CVC)变化。结果：在袖带充气和肢体依赖过程中，不同组或肢体(上肢与下肢)之间的SKVR变化无显著差异。结论：SCI后肩袖充盈(VAR)和肢体依赖(VAR)及肢体依赖(VAR和MYO)时SKVR的增加无明显变化，但LE后的最大血管舒张率高于AB组(P = 0.007.0 5)。
Objective:Cardiovascular disease (CVD) is a leading cause of mortality in persons with SCI. Whilemacrovascular remodeling and function after SCI is well documented, changes in themicrovascular structure and function are comparably understudied, but importantly predict CVD risk. Specifically, the integrity of venoarteriolar (VAR), myogenic (MYO) and maximal vasodilation responses are largely unknown after SCI, especially in persons with tetraplegia (TP) at highest risk of CVD. This is the first to examine the differences in VAR (cuff inflation), MYO (limb dependency) and maximal vasodilation responses of the microvasculature between able bodied (AB) versus those with TP and paraplegia (PP).Design:Observational.Setting:Laboratory.Participants:Eight AB, 6 TP, and 8 PP persons.Interventions:One forearm and calf were treated topically with lidocaine 2.5%/prilocaine 2.5% while contralateral limb served as a control. Laser doppler flowmeters were applied over treated and control sites during limb dependency, cuff inflation and local skin heating (Tloc) up to 42°C.Outcome measures:Skin vascular resistance (SkVR) change with cuff inflation and limb dependency and maximal cutaneous vascular conductance (CVC) during local heating.Results:Change in SkVR was not significantly different between groups or extremity (upper vs. lower) during cuff inflation or limb dependency. However, CVC at Tloc 42°C was significantly different in the lower extremity (LE) of TP and PP (P = 0.007, 0.35) compared to AB.Conclusion:Increases in SkVR during cuff inflation (VAR) and limb dependency (VAR and MYO) are unaltered after SCI, however maximal vasodilation in the LE post-SCI is higher than AB persons.