engleski

Assessment of microvascular function in hypertension using Laser Doppler flowmetry (LDF)

Essential hypertension are characterized by endothelial dysfunction which represents an early marker of the development of atherosclerotic changes and future cardiovascular events, suggesting that impaired vascular reactivity is an initial step in development of cardiovascular complications caused by hypertension. Increased oxidative stress production and imapired nitric oxide bioavailability is probably one of the major mechanisms in the development of endothelial dysfunction, which can be found in individuals with cardiovascular risk factors. Because of the large activity of endothelial cells it is very difficult to investigate their function in clinical research, but many studies have evaluated the endothelium in hypertensive patients, using different techniques. The cutaneous circulation is an accessible and representative vascular bed for the assessment of mechanisms underlying vascular disease. Laser Doppler flowmetry (LDF) represents an excellent method for its assessment and has been widely used because the method is non-invasive, easy to operate and provides continuous measurement. Human hypertension is associated with modificated skin blood flowmotion, which may be a marker of impaired skin microvascular function. Microvascular function in hypertensive patients were observed by measuring vasodilation in the forearm skin using LDF model of reactive hyperemia and responses to various stimuli. The response to acetylcholine (endothelium- dependent vasodilation) was reduced which indicates impaired endothelial function, since the response to sodium nitroprusside (endothelium-independent vasodilation) has not been changed compared with normotensive control subjects. Data indicate that essential hypertension is associated with endothelial dysfunction in the skin microcirculation of the forearm suggesting that the study of cutaneous microvascular response could become an easy way for early detection of microvascular impairment in vascular diseases.

hypertension, microcirculation, laser Doppler flowmetry

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