Pulsatility index (PI) is defined as the difference between the peak systolic flow and minimum diastolic flow velocity, divided by the mean velocity recorded throughout the cardiac cycle. It is a non-invasive method of assessing vascular resistance with the use of Doppler ultrasonography. It was first introduced in 1974 by Gosling and King and is also known as the Gosling Index. PI as a method of examining macrocirculation has a variety of clinical applications. For instance, in diabetic patients, it has been measured on the common carotid, middle cerebral or renal arteries to help predict complications such as cerebrovascular disease or nephropathy. In hypertensive patients, it has been used to assess complications and assess the chronicity of the disease. To our knowledge, despite the diverse use of this ultrasonographic parameter, there is a deficiency in reports that would comprehensively summarize its clinical applications. Based on our extensive review of the literature and the gathered information, we conclude that pulsatility index (PI) is an easy to obtain parameter with a broad range of both, research and clinical applications. It has been widely used in the assessment of macrocirculation in highly prevalent chronic medical conditions, such as hypertension, both type 1 and type 2 diabetes and thyroid disorders.
Microcirculation accounts for about 99% of blood vessels in adults and mediates between the arterial and venous parts of the cardiovascular system, both structurally and functionally. Skin microcirculation consists of two vascular plexuses: superficial and deep. Microcirculation includes vessels with a diameter of less than 150 μm, i.e. arteries, small veins, lymphatic vessels and arteriovenous anastomoses, which build the microcirculation unit. Skin microcirculation may be affected both in systemic pathologies and specific skin disorders. Several non-invasive techniques are available to assess the skin microcirculation. The clinical value is recognised for capillaroscopy and videocapillaroscopy, laser Doppler flowmetry thermography and transcutaneous oxygen measurement. The list of methods that may be used in clinical research also includes: photoplethysmography, orthogonal spectral polarization, near infrared spectroscopy and tissue reflectance spectrophotometry and optical coherence tomography.
The direct comparisons of BP readings allowed to conclude that diastolic blood pressure tended to be slightly overestimated when assessed with SpaceLabs 90207 in patients with both, AFib and SR, which was not a case for systolic BP. When the results were confronted with available validation protocols requirements, all referral criteria were met except for one. Taken together, our results suggest acceptable BP readings dispersion of SpaceLabs 90207 in BP monitoring of patients with both AFib and SR.
Introduction: Skin microcirculation is recognized as an appropriate model to use when investigating the relationship between cardiovascular risk factors and microvascular function. It is currently a matter of debate whether studies on skin microcirculation in young type 1 diabetic patients without existing microangiopathy may be helpful in identifying subjects with impaired endothelial function. Aim of the study:To evaluate the potential changes in skin microcirculation of patients up age of 18 years using capillaroscopy, post reactive hyperaemia (PORH) and venous occlusion (VO) tests, and to establish the relationship between those changes and disease duration and metabolic control in patients with type 1 diabetes. Material and methods: Study group consisted of 112 pediatric patients aged 8.4-18.0 years, with a median age of 14.95 years. The median diabetes duration and age at onset were 5 years and 9.6 years, respectively. The median HbA 1c in the studied group was 7.6% at the time when the microcirculation was being examined. Capillaroscopy studies were focused on type 1 diabetic patients and employed non-selective stimuli such as the PORH and VO tests. The relative area covered by capillaries (coverage) was measured before the testing and again after the PORH and VO tests. Results: The analysis revealed that none of the skin microcirculation indices correlated significantly with patient age, diabetes duration or metabolic control. Conclusions: In young patients with uncomplicated type 1 diabetes mellitus skin microcirculation function is not dependent on age, disease duration or metabolic control.
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