Prolonged low flow reduces reactive hyperemia and augments low flow mediated constriction in the brachial artery independent of the menstrual cycle.
Prolonged low flow reduces reactive hyperemia and augments low flow mediated constriction in the brachial artery independent of the menstrual cycle.
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DOI：
10.1371/journal.pone.0055385
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Birch KM
中科院分区：
文献类型：
--
作者：
Rakobowchuk M;Parsloe ER;Gibbins SE;Harris E;Birch KM
无创性前臂缺血再灌注损伤和低流量诱导的血管功能障碍模型提供了评价血管功能的方法。雌激素（一种内源性抗氧化剂）对缺血-再灌注损伤恢复的作用尚未评估，长时间低血流对血管功能的影响也未确定。8名健康女性（33±10岁）在月经周期的卵泡期、排卵期和黄体中期参加了实验室。休息30分钟后，通过超声测量前臂缺血5分钟和缺血3分钟后肱动脉直径的变化来评估肱动脉血管功能。随后，完成20分钟的前臂缺血期。此外，在恢复后15、30和45分钟完成血管功能评估。确定了血流介导的扩张、低血流介导的收缩和缺血区域近端的反应性充血。血流介导的扩张在恢复15分钟时减少，但在30和45分钟时恢复（PRE：7.1± 1.0%，POST：15：4.5± 0.6%，POST：30：5。5±0.7% POST 45 ∶5.9± 0.4%，p<0.01）。相反，低流量介导的收缩增加（PRE：−1.3± 0.4%，POST 15：−3.3± 0.6%，POST 30：−2.5±0.5%，POST 45：−1.5± 0.12%，p<0.01）。整个恢复期反应性充血减少（p<0.05）。数据不受月经期的影响。长时间的低流量改变了血管功能，可能与血管收缩增加和血管舒张减少有关。顺行剪切力的减少和更大的逆行剪切力可能调节肱动脉反应，但总剪切力的减少也起着重要作用。这些数据表明，缺血区域近端的血管功能发生了实质性变化，在再灌注后具有潜在的临床意义。
Non-invasive forearm ischemia-reperfusion injury and low flow induced vascular dysfunction models provide methods to evaluate vascular function. The role of oestrogen, an endogenous anti-oxidant on recovery from ischemia-reperfusion injury has not been evaluated nor has the impact of prolonged low flow on vascular function been established. Eight healthy women (33±10 yr) attended the lab during the follicular, ovulatory and mid-luteal phases of their menstrual cycles. After 30 minutes of rest, brachial artery vascular function was assessed by ultrasound measurements of diameter changes during 5 minutes of forearm ischemia and 3 minutes after. Subsequently, a 20-minute forearm ischemia period was completed. Further, vascular function assessments were completed 15, 30 and 45 minutes into recovery. Flow-mediated dilation, low-flow-mediated constriction, and reactive hyperaemia proximal to the area of ischemia were determined. Flow-mediated dilation was reduced at 15 minutes of recovery but recovered at 30 and 45 minutes (PRE: 7.1±1.0%, POST15∶4.5±0.6%, POST30∶5. 5±0.7% POST45∶5.9±0.4%, p<0.01). Conversely, low-flow mediated constriction increased (PRE: −1.3±0.4%, POST15: −3.3±0.6%, POST30: −2.5±0.5% POST45: −1.5±0.12%, p<0.01). Reactive hyperaemia was reduced throughout recovery (p<0.05). Data were unaffected by menstrual phase. Prolonged low flow altered vascular function and may relate as much to increased vasoconstriction as with decreased vasodilation. Reductions in anterograde shear and greater retrograde shear likely modulate the brachial artery response, but the reduced total shear also plays an important role. The data suggest substantial alterations in vascular function proximal to areas of ischemia with potential clinical implications following reperfusion.
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