Local Regulation of Blood Flow in Subcutaneous Tissue in Generalized Scleroderma

Henriksen, O.; Kristensen, Jørgen Kvist; Wadskov, S

doi:10.1111/1523-1747.ep12494588

Cited by 16 publications

(6 citation statements)

References 22 publications

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“…These results seem to be in accordance with previous data on baroreflex impairment and orthostatism intolerance in SSc patients. Normal vasoconstrictive response to an increase in venous transmural pressure is almost abolished in tissues with sclerodermic changes, probably due to sympathetic neuropathy 40 . Besides, advanced and fibrotic forms of SSc are associated with a blunted orthostatic stress response 9 .…”

Section: Discussionmentioning

confidence: 99%

Heart rate variability helps classify phenotype in systemic sclerosis

Delliaux,

Sow,

Echcherki

et al. 2024

Sci Rep

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We aimed to develop a systemic sclerosis (SSc) subtypes classifier tool to be used at the patient’s bedside. We compared the heart rate variability (HRV) at rest (5-min) and in response to orthostatism (5-min) of patients (n = 58) having diffuse (n = 16, dcSSc) and limited (n = 38, lcSSc) cutaneous forms. The HRV was evaluated from the beat-to-beat RR intervals in time-, frequency-, and nonlinear-domains. The dcSSc group differed from the lcSSc group mainly by a higher heart rate (HR) and a lower HRV, in decubitus and orthostatism conditions. Stand-up maneuver lowered HR standard deviation (sd_HR), the major axis length of the fitted ellipse of Poincaré plot of RR intervals (SD2), and the correlation dimension (CorDim) in the dcSSc group while increased these HRV indexes in the lcSSc group (p = 0.004, p = 0.002, and p = 0.004, respectively). We identified the 5 most informative and discriminant HRV variables. We then compared 341 classifying models (1 to 5 variables combinations × 11 classifier algorithms) according to mean squared error, logloss, sensitivity, specificity, precision, accuracy, area under curve of the ROC-curves and F1-score. F1-score ranged from 0.823 for the best 1-variable model to a maximum of 0.947 for the 4-variables best model. Most specific and precise models included sd_HR, SD2, and CorDim. In conclusion, we provided high performance classifying models able to distinguish diffuse from limited cutaneous SSc subtypes easy to perform at the bedside from ECG recording. Models were based on 1 to 5 HRV indexes used as nonlinear markers of autonomic integrated influences on cardiac activity.

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Section: Discussionmentioning

confidence: 99%

Heart rate variability helps classify phenotype in systemic sclerosis

Delliaux,

Sow,

Echcherki

et al. 2024

Sci Rep

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“…in patients with acute myocardial infarction (8) or in normals subjected to lower body negative pressure (9). The loss of vasoconstrictor response to venous distension in patients with generalized scleroderma may be due to changes in reactivity of the smooth muscle cells in the arterioles (5).…”

Section: Discussionmentioning

confidence: 99%

“…Autoregulation and the local veno-arteriolar reflex in subcutaneous tissue were investigated as previously described (5). Blood flow in subcutaneous tissue was measured by thc local rnxenon washout technique (4).…”

Section: Methodsmentioning

confidence: 99%

“…Local regulation of blood flow has been intensively explored by Henriksen (4). ln patients with generalized scleroderma Henriksen et al (5) found that in subcutaneous tissue intrinsic vascular reactions responsible for the autoregulatory response was present, whereas the normal "vasoconstrictor response" to an increase in venous trans murat pressure was almost abolished.…”

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confidence: 99%

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The regulation of subcutaneous blood flow in patient with Dercum´s disease

Skagen,

Petersen,

Kastrup

et al. 1986

Acta Derm Venereol

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Dercum´s disease or adiposis dolorosa is a poorly understood disorder with painful fatty deposits in the skin localized to the lower extremities. The etiology is unknown. In such a patient the mechanisms of local regulation of blood flow in subcutaneous tissue was investigated by the local 133Xenon washout technique. The patient was reinvestigated one week after treatment with intravenous lidocaine. The local vasoconstrictor response to increase in venous transmural pressure was not present in this patient, but reappeared after lidocaine treatment. Autoregulation of blood flow in subcutaneous tissue was present before as well as after lidocaine treatment. It seems likely that a pain elicited increase in sympathetic activity in the vasoconstrictor fibres abolished the normal vasoconstrictor response to increase in venous transmural pressure. The mechanism of pain relief after intravenous lidocaine infusion is uncertain, but central as well as peripheral mechanisms may be considered.

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“…The sympathetic nervous system and the motor and sensory components of the peripheral nervous system are all involved in the disease process. Henriksen, Kristensen and Wadskov (1977) increase in venous transmural pressure and attributed this to a sympathetic neuropathy. Christopher and Robinson (1972) found a decrease in conduction velocity in both sensory and motor peripheral nerves.…”

Section: Discussionmentioning

confidence: 99%

Progressive Systemic Sclerosis

Neill

1980

British Journal of Anaesthesia

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The anaesthetic history of a patient with progressive systemic sclerosis is reported. On each occasion large amounts of systemic analgesics were required to control pain after operation. Regional nerve block produced prolonged periods of sensory anaesthesia. Both of these features are attributed to the effect of the disease process on the peripheral vasculature. It is suggested that advantage should be taken of the prolongation of sensory anaesthesia to help control postoperative pain in such patients.

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Local Regulation of Blood Flow in Subcutaneous Tissue in Generalized Scleroderma

Cited by 16 publications

References 22 publications

Heart rate variability helps classify phenotype in systemic sclerosis

Heart rate variability helps classify phenotype in systemic sclerosis

The regulation of subcutaneous blood flow in patient with Dercum´s disease

Progressive Systemic Sclerosis

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