Effects of atherosclerosis on the cutaneous regional and microcirculatory response to ischemia
R. W. Schwartz, H. Qing-Fu, N. M. Logan, D. R. Richardson and G. L. Hyde
Department of Surgery, University of Kentucky Chandler Medical Center, Lexington.
The cutaneous vascular response to gravity load is abnormal in
atherosclerosis. In this study we compared the macrocirculatory and
microcirculatory response to ischemia in atherosclerotic smokers,
nonatherosclerotic smokers, and healthy nonsmokers. Using
videodensitometry, the capillary blood velocity of hallux nail fold
capillaries was measured at rest and following 1 minute of ankle cuff
occlusion. Blood-flow velocity of the dorsal metatarsal artery was measured
by ultrasound Doppler. Resting dorsal metatarsal artery velocity and
capillary blood velocity of atherosclerotic subjects were lower than those
of nonatherosclerotic smokers and nonsmokers. The dorsal metatarsal artery
velocity and capillary blood velocity increased in each group following
occlusion. Peak postocclusion dorsal metatarsal artery velocity was lower
in the atherosclerotic subjects, but peak capillary blood velocity was not
significantly different among groups. Atherosclerosis does not alter the
mechanisms of reactive hyperemia in either the macrocirculation or the
microcirculation. The magnitude of hyperemia is diminished at the
macrocirculatory level.
