The influence of smoking on the functional state of microcirculation according to laser doppler flowmetry and clinical anamnestic data of patients with arterial hypertension

2021 ◽  
Vol 24 (4) ◽  
pp. 24-31
Author(s):  
N. N. Streltsova ◽  
A. P. Vasiliev

Background. Detailed study of the functional state of microcirculation in combination of arterial hypertension and tobacco smoking, as the most common and prognostically important risk factors for atherogenesis, will not only clarify pathogenetic effect of tobacco smoke on the terminal vascular bed, but also outline directions of active counteraction to it.Purpose. To study the effect of TS on the functional state of SM using laser Doppler flowmetry in patients with AH.Methods. 185 patients with stage 1,2 AH involved in the study were divided into 2 equivalent groups according to main clinical and laboratory data: group 1 – non-smokers (n = 134, mean age was 57.0 [50.0; 60.0]), group 2 – patients who smoke 1–1.5 packs of cigarettes per day (n = 51, mean age was 54.0 [48.0; 58.0]). Patients were prescribed short-acting antihypertensives drugs, which were used whenever required 5 days before the study. SM was investigated by laser Doppler flowmetry using occlusion test and amplitude-frequency spectrum analysis of hemoperfusion fluctuations.Results. Obtained data showed negative acute effect of ingredients of tobacco smoke on almost all structural elements of microhemocirculation. Revealed deviations are characterized by constriction of precapillary segment of microvascular bed with increase in myogenic tone and equal 3.1 units [2.6; 4.1] versus 2.3 units [1.7; 3.4] in the alternative group (p = 0.007), decrease in capillary blood flow from 4.5 units [3.5; 5.8] compared with the group of non-smokers – 5.2 units [4.0; 7.3] (p = 0.041), statistically significant intensification of arteriolar-venular blood flow with formation of venous congestion, limitation of dilated reserve of microcirculation.Conclusion. Tobacco smoking leads to significant microcirculation disorders that are projected onto changes in terminal vascular bed, inherent with AH, which significantly reduces the functional state of microcirculation, limits its reserve potential and promotes the development of tissue ischemia.

2019 ◽  
Vol 24 (2) ◽  
pp. 108-119 ◽  
Author(s):  
B. N. Davydov ◽  
D. A. Domenyuk ◽  
S. V. Dmitrienko

Relevance. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders. Identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.Materials and methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low efciency and redistribution of blood flow in favor of the nutritive link.Conclusions. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early – compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late – decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.


1991 ◽  
Vol 261 (6) ◽  
pp. F998-F1006 ◽  
Author(s):  
M. S. Nobes ◽  
P. J. Harris ◽  
H. Yamada ◽  
F. A. Mendelsohn

The effects of angiotensin II (ANG II) or angiotensin III (ANG III) on renal cortical blood flow (CBF) or papillary blood flow (PBF) were investigated in Inactin-anesthetized young rats with the use of laser-Doppler flowmetry. Infusion of equimolar pressor doses of ANG II (300 ng.kg-1.min-1 iv) or ANG III (267 ng.kg-1.min-1) decreased CBF by 31 +/- 2.6% (P less than 0.001) and 20.3 +/- 3.2% (P less than 0.01), respectively but increased PBF by 19 +/- 6.1% (P less than 0.05) and 14.6 +/- 4.4% (P less than 0.05). The ANG II-induced increase in PBF was not prevented by aortic clamping to maintain constant renal perfusion pressure or pretreatment with the prostaglandin synthase inhibitor, indomethacin. The nonpeptide ANG II receptor antagonist, DuP 753 completely abolished the systemic and intrarenal effects of ANG II. After pretreatment with a kallikrein inhibitor, aprotinin, ANG II infusion increased mean arterial pressure but did not affect PBF, suggesting that kinins, but not prostaglandins, modulate the action of systemic ANG II on PBF. We conclude that circulating ANG II induces vasoconstriction in the cortex and also promotes the intrarenal production of kinins, which act to enhance papillary blood flow.


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