Postural changes in femoral artery blood flow in normal subjects, patients with peripheral vascular occlusive disease and patients undergoing lumbar sympathectomy, measured by duplex ultrasound flowmetry

Morgan, Ruth; Psaila, J.V.; Stone, James; Carolan, G.; Woodcock, J. P.

doi:10.1016/s0950-821x(05)80289-0

Cited by 15 publications

(15 citation statements)

References 29 publications

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“…First, there is mounting evidence that IMC improves perfusion and tissue oxygenation during periods of active treatment. [22][23][24] This is believed to be due to differential pressure drops in the arteries and veins during the rapid release of the compression that increases arterio-venous pressure gradients, thus increasing blood flow. Such periodic increases in blood flow during periods of IMC treatment could help restore endothelial function which, in turn, could improve the ability of the endothelium to release vasodilatory factors (eg, nitric oxide and prostacyclin) in response to increased shear stresses during exercise.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

Haro

Aciń

Flórez

et al. 2010

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

Haro

Aciń

Flórez

et al. 2010

Journal of Vascular Surgery

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“…First, a reduced postural vasoconstriction by CCBs may contribute relatively more to the development of dependent oedema in diabetic patients 23,55 or arteriopaths 56 with an already impaired postural autoregulation. In this kind of subject, CCB-mediated ankle swelling may develop more frequently and at lower dosages than in subjects with an intact veno-arteriolar response, a possibility to be explored in the future.…”

Section: Discussionmentioning

confidence: 99%

Calcium channel blockers, postural vasoconstriction and dependent oedema in essential hypertension

2001

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Treatment with calcium channel blocker (CCB)s, dihydropyridines and others, is frequently complicated by dependent oedema in the absence of sodium retention or cardiac failure, a bothersome side effect of unclear aetiology. The present paper reviews our own and other work dealing with the antagonism exerted by such drugs on postural vasoconstriction, a mechanism triggered by limb venous congestion during orthostasis and controlled through a local sympathetic axo-axonic reflex and increased myogenic tone in response to changes in transmural pressure. By stabilising capillary pressure, postural vasoconstriction counteracts fluid

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“…HE CLINICAL observation that patients with critical limb ischemia tend to find relief in the sitting position and the need to identify conditions that might affect the already impaired tissue perfusion have stimulated research into the effect of postural alteration on lower limb arterial flow. Arteriovenous oxygen difference, 1 venous occlusion plethysmography, 2,3 xenon clearance, [4][5][6][7][8][9][10][11] and duplex ultrasonographic flowmetry 12 are among the methods that have been used by different investigators.…”

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confidence: 99%

Effect of Posture on Popliteal Artery Hemodynamics

Delis

Nicolaides²,

Stansby³

2000

Arch Surg

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Hypothesis: Marked peripheral vasodilation and rubor characterize critically ischemic limbs on dependency. We believe that intermittent claudication is also associated with peripheral hemodynamic changes on postural alteration, which differ distinctly from normal. Evaluation of such differences and understanding of the underlying physiological derangements may be essential in the development of treatments for intermittent claudication. We comparatively assess the effect of posture on lower limb arterial hemodynamics in normal subjects and in patients with intermittent claudication (or Fontaine II) due to peripheral vascular disease, determined in the popliteal artery. Design: A cohort study. Setting: A university-associated tertiary care hospital. Patients: Thirty-seven legs of 29 normal subjects (group A) and 50 legs of 36 patients with intermittent claudication (ankle-brachial index range, 0.39-0.76; median, 0.57) (group B). Interventions: Popliteal artery volume flow (vFl), mean velocity, and luminal diameter were measured on (1) recumbency, (2) sitting, and (3) return to recumbency in groups A and B using color duplex imaging. Main Outcome Measures: The pulsatility index, peak systolic velocity, and end diastolic velocity (EDV) were measured on (1) recumbency, (2) sitting, and (3) return to recumbency. Results: Popliteal artery vFl in normal subjects decreased from 110 ± 43 mL/min on recumbency to 57 ± 27 mL/min on sitting (PϽ.001) and returned to 111 ± 46 mL/ min on resumption of recumbency (PϽ.001). Similarly, in patients with intermittent claudication, vFl decreased from 113 ± 52 mL/min on recumbency to 76 ± 41 mL/min on sitting (PϽ.001) and increased on resumption of recumbency to 114 ± 53 mL/min (PϽ.001). There was no difference (P = .97) in the vFl between the study groups on recumbency, but sitting vFl in normal subjects was significantly lower than in patients with intermittent claudication (P = .04). The mean velocity, peak systolic velocity, and EDV displayed a similar pattern of change as vFl. The pulsatility index in both groups increased significantly on sitting (PϽ.001) and decreased on return to recumbency (PϽ.001). All data are given as mean ± SD. Conclusions: Lower limb arterial vFl, mean velocity, peak systolic velocity, and EDV decrease significantly (PϽ.001) when posture is altered from recumbency to sitting, in normal subjects and in patients with intermittent claudication. A decrease in the EDV and an increase in the pulsatility index on sitting indicate enhancement of arterial resistance to flow secondary to peripheral vasoconstriction. Quantitative differences between the groups in vFl (PϽ.04), EDV (PϽ.01), and pulsatility index (PϽ.001) on dependency indicate that the orthostatic vasoactive response in patients with intermittent claudication is significantly subdued, reflecting a marked derangement in venoarteriolar response.

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Postural changes in femoral artery blood flow in normal subjects, patients with peripheral vascular occlusive disease and patients undergoing lumbar sympathectomy, measured by duplex ultrasound flowmetry

Cited by 15 publications

References 29 publications

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

A prospective randomized controlled study with intermittent mechanical compression of the calf in patients with claudication

Calcium channel blockers, postural vasoconstriction and dependent oedema in essential hypertension

Effect of Posture on Popliteal Artery Hemodynamics

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