R.KH. ZULKARNEEV, T.R. BIKTASHEV, A.S. RAKHIMKULOV, YU.F. SAFINA, SH.R. ZULKARNEEV

Bashkir State Medical University of the Ministry of Health of the Russian Federation, Ufa

 Contact details:

Zulkarneev R.Kh. — MD, Professor of the Department of Internal Diseases

Address: 3 Lesnoyproezd St., Ufa, Russian Federation, 450071, tel.: +7 (347) 246-53-97, e-mail: zurustem@mail.ru

 The purpose — to develop a modification of the functional test for assessing vascular reactivity using post-occlusive reactive hyperemia (PORH). The test should be suitable for diagnosing endothelial dysfunction (ED) in clinical practice.

Material and methods. A modification of the test is proposed: 1) a local thermometry by commonly used non-contact infrared thermometer is proposed to assess local blood flow, 2) standardization of cooling the examined finger tissues during complete vascular occlusion is also proposed by immersing it in an aqueous medium cooled to a given temperature.

Results. A preliminary criterion for the ED diagnosis was established. If the local temperature of the examined hand finger is < 32.0⁰C at the time point 90 sec after the end of arterial occlusion then it is as sign of ED (sensitivity — 75%, specificity — 96%).

Key words: post-occlusive reactive hyperemia, endothelial dysfunction, metabolic syndrome, community-acquired pneumonia.

REFERENCES

1. Bonetti P.O., Lerman L.O., Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arteriosclerosis, thrombosis, and vascularbiology, 2003, vol. 23, pp. 168–175.
2. Babushkina I.V., Sergeeva A.S., Pivovarov Yu.N. et al. Structural and functional features of the vascular endothelium. Kardiologiya, 2015, vol. 55, no. 2, pp. 82–86 (in Russ.).
3. Anderson T.J., Gerhard M.D., Meredith I.T. et al. Systemic nature of endothelial dysfunction in atherosclerosis. The American journal of cardiology, 1995, vol. 75, pp. 71B–74B.
4. Cöhnheim J. Untersuchungenueber die Embolische Processe. Hirschwald, Berlin, 1872.
5. Celermajer D.S., Sorensen K.E., Bull C. et al. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol, 1994, vol. 24 (6), pp. 1468–1474.
6. Joannides R., Haefeli W.E., Linder L. et al. Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation, 1995, vol. 91, pp. 1314–1349.
7. Parker B.A., Tschakovsky M.E., Augeri A.L. et al. Heterogenous vasodilator pathways underlie flowmediated dilation in men and women. American journal of physiology, 2011, vol. 301, pp. 1118–1126.
8. Anderson T.J., Uehata A., Gerhard M.D. et al. Close relation of endothelial function in the human coronary and peripheral circulation. Journal of the American College of Cardiology, 1995, vol. 26, pp. 1235–1241.
9. Ivanov A.N., Grechikhin A.A., Norkin I.A. et al. Methods for diagnosing endothelial dysfunction. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya, 2014, vol. 13, no. 4, pp. 4–11 (in Russ.).
10. Shabrov A.V., Apresyan A.G., Dobkes A.L. et al. Modern methods for assessing endothelial dysfunction and the possibility of their application in practical medicine. Ratsional’naya farmakoterapiya v kardiologii, 2016, vol. 12, no. 6, pp. 733–742 (in Russ.).
11. Samolyuk M.O., Grigor’eva N.Yu. Evaluation of endothelial dysfunction and the possibility of its correction at the present stage in patients with cardiovascular diseases. Kardiologiya, 2019, vol. 59, no. 3S, pp. 4–9 (in Russ.).
12. Sagaydachnyy A.A. Occlusion test: analysis methods, reaction mechanisms, application prospects. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya, 2018, vol. 17, no. 3, pp. 5–22 (in Russ.).
13. Corretti M.C., Anderson T.J., Benjamin E.J. et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. Journal of the American College of Cardiology, 2002, vol. 39, pp. 257–265.
14. Gul K.M., Ahmadi N., Wang Z. et al. Digital thermal monitoring of vascular function: a novel tool to improve cardiovascular risk assessment. Vasc Med, 2009, vol. 14 (2), pp. 143–148.
15. Sagaydachnyy A.A., Fomin A.V. Analysis of the time derivative of the temperature response of the fingers to shoulder occlusion and its relationship with hemodynamic parameters. Regionarnoe krovoobrashchenie i mikrotsirkulyatsiya, 2017, vol. 16, no. 3, pp. 31–40 (in Russ.).
16. Usanov D.A., Skripal’ A.V., Protopopov A.A. et al. Evaluation of the functional state of blood vessels by analyzing the temperature response to an occlusive test. Saratovskiy nauchno-meditsinskiy zhurnal, 2009, vol. 5, no. 4, pp. 554–558 (in Russ.).
17. Shitzer A., Stroschein L.A., Gonzalez R.R .et al. Lumped-parameter tissue temperature-blood perfusion model of acold-stressed fingertip. Journ. of Appl. Physiol, 1996, vol. 80, pp.1829–1834.
18. Akhtar M.W., Kleis D.J., Metcalfe R.W.etal. Sensitivity of Digital Thermal Monitoring Parameters to Reactive Hyperemia. Journal of Biomechanical Engineering, 2010, vol. 132, pp. 051005-1–051005-14.
19. Cersosimo E., De Fronzo R.A. Insulin resistance and endothelial dysfunction: the road map to cardiovascular disease. Diabetes Metab Res Rev, 2006, vol. 22 (6), pp. 423–436.
20. Kurshakov A.A., Anchikova L.I., Sayfutdinov R.G. et al. Endothelial dysfunction at an early stage of the metabolic syndrome. Prakticheskaya meditsina, 2010, vol. 43, no. 4, pp. 125–128.
21. Bedilo N.V., Vorob’eva N.A. Endothelial dysfunction in patients with community-acquired pneumonia. Aktual’nye voprosy transfuziologii i klinicheskoy meditsiny, 2015, iss. 1, pp. 161–164 (in Russ.).
22. Corrales-Medina V.F., Musher D.M., Shachkina S. et al. Acute pneumonia and the cardiovascular system. Lancet, 2013, vol. 381, pp. 496–505.
23. Chazova I.E., Nedogoda S.V., Zhernakova Yu.V. et al. Rekomendatsii po vedeniyu bol’nykh c metabolicheskim sindromom [Recommendations for the management of patients with metabolic syndrome]. Klinicheskie rekomendatsii. Moscow: Ministerstvo zdravookhraneniya Rossiyskoy Federatsii, 2013. 43 p.