Investigation of cardiac pulsations in the cutaneous circulation in patients with essential hypertension Esansiyel hipertansiyonlu hastalarda deri kan akımındaki kardiyak pulsasyonların i̇ncelenmesi

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Esen F., Çaǧlar S., Ata N., Esen H.

Turkiye Klinikleri Journal of Medical Sciences, vol.33, no.2, pp.344-352, 2013 (Peer-Reviewed Journal) identifier


Objective: To investigate the leading hemodynamic risk factor, pulsatile nature of blood flow, in the cutaneous circulation in patients with essential hypertension (EHT). Material and Methods: Thirty three patients with EHT and 59 normotensive healthy young (n=25) and middle aged (n=34) subjects, participated voluntarily in this study. Skin blood flow was measured with a laser Doppler flowmeter (LDF) from volar region of the forearm when the subject is at rest in supine position under basal conditions, and during local thermal hyperemia (42°C). Fast Fourier transformation of LDF signal was used to calculate the power spectral density (PSD) of control mechanisms of central (pulsatile) and local skin blood flow. The integral of PSD curve was normalized to 1 and the integrals of local (0.005-0.145 Hz) and central (0.145-16 Hz) regions were compared among three groups. Results: The integral of central (IM) and local (IL) components were not significantly different (p=0.335 and IL ~ IM=0.5) in healthy young subjects for baseline LDF signal. This equilibrium was not maintained, IM ~ 0.8 and IL ~ 0.2, during vasodilatation in response to thermal hyperemia. However, central power (IM ~ 0.8) was dominant in EHT patients and in middle aged subjects even for the baseline LDF signal (p<0.001). There was significant response with thermal hyperemia in middle aged healthy subjects but not in EHT patients. Conclusion: The increase in the pulsatility of baseline LDF signal (central/local imbalance in baseline PSD function) and its variability with a vasodilator stimulus can be used as an index for determining the micro/macro-vascular health. © 2013 by Türkiye Klinikleri.