Sympathetic Vasomotor Response of the Radial Artery in Patients With Diabetic Foot Syndrome
| Autor: | Valerio Kuhl, Susanne Mink, Ernst Küstner, Bernhard Martin Eicke, Anja Victor, Julian Bauer, Alexander Hlawatsch |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty Sympathetic nervous system Sympathetic Nervous System Systole Endocrinology Diabetes and Metabolism Neural Conduction Diastole Nerve conduction velocity Reference Values Internal medicine medicine.artery Reaction Time Internal Medicine medicine Humans Plethysmograph Ultrasonography Doppler Color Radial artery Aged Advanced and Specialized Nursing business.industry Middle Aged Laser Doppler velocimetry medicine.disease Diabetic foot Diabetic Foot Surgery medicine.anatomical_structure Cough Radial Artery Cardiology business Blood Flow Velocity |
| Zdroj: | Diabetes Care. 26:2616-2621 |
| ISSN: | 1935-5548 0149-5992 |
| Popis: | OBJECTIVE—Neurophysiological assessment of the peripheral autonomic system is characterized by various limitations. An alternative approach to laser Doppler and venous plethymography is the assessment of the sympathetic vasomotor response of the radial artery obtained by continuous wave Doppler sonography. Nomogram data have been established and demonstrate the temporary disappearance of diastolic flow after coughing or deep inspiration. RESEARCH DESIGN AND METHODS—We assessed the sympathetic vasomotor response in 25 patients (mean age 64 years, range 43–76) with diabetic foot syndrome. The Doppler data were correlated with nerve conduction studies of the median and peroneal nerve, the extent of radiologically diagnosed media sclerosis, and compared with nomogram values (n = 41). RESULTS—Although similar mean flow velocities were found under baseline conditions, the flow pattern was characterized by higher pulsatility in the diabetic group (resistance index [RI] 1.1 vs. 0.7). No significant difference in RI was observed after coughing. The latency of onset of the response was prolonged (2.1 vs. 1.5 s), while the duration of the response did not differ (18 vs. 15 s). Only the nerve conduction velocity of the peroneal nerve correlated inversely with the RI. The extent of radiologically proven calcification tended to correlate with the pulsatility of the baseline signal and the response latencies. CONCLUSIONS—The data obtained by this study suggest the concurrent existence of reduced vessel elasticity due to media sclerosis and dysfunction of the autonomic vasomotor system. |
| Databáze: | OpenAIRE |
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