V.V. FATTAKHOV, N.V. MAKSUMOVA

KSMA – Branch Campus of the FSBEI FPE RMACPE MOH Russia , 36 Butlerov Str., Kazan, Russian Federation, 420012

Fattakhov V.V. ― D. Med. Sc., Professor of Surgery Department, tel. +7-987-297-12-08, e-mail: vvfat@mail.ru

Maksumova N.V. ― Assistant Lecturer of the Department of Functional Diagnostics, tel. +7-917-257-80-03, e-mail: nv_maks@mail.ru

The issues of diagnostics, prevention and treatment of various disorders of blood microcirculation, including microvascular angina (MVA), sudden cardiac death (SCD), «silent» strokes (SS), microvascular lesions of the internal organs and chronic limb ischemia (CLI) are the topical problem of medical practice. Invasive and high-tech researches are unavailable during outpatient studies. The laser Doppler ultrasonography (LDU), the optical tissue oximetry (OTO), the evaluation of the vegetative status of the organism, the heart rate variability (HRV) and microcirculation variability allow indirectly to judge on possible options for microvascular pathologies of heart and other organs. It was found that under normal HRV, the normocirculatory or moderately hyperemic type of microcirculation occurs in the myocardium with sufficient and adequate tissue perfusion and active saturation of the heart tissue. The hyperemic type of microcirculation of blood and blood shunts leads to stagnant blood flow to the myocardium with venular stasis and relative hypoxia of the myocardium. Clinically, MVA, SS, and CLI can occur. In spastic or sclerotic type of blood microcirculation, the true myocardial ischemia takes place due to the actual decrease in tissue perfusion, and myocardial hypoxia. Such states could result in MVA, SCD, TIA, and gangrene of the extremities.

Key words: microcirculation, tissue saturation, violations of microcirculation, microvascular pathology, laser Doppler ultrasonography, optical tissue oximetry, heart rate variability.

REFERENCES

1. Voskanyan A.S., Efimenko N.A., Chernekhovskaya N.E., Fedorova T.A., Shishlo V.K Mikrotsirkulyatornoe ruslo serdtsa [Microcirculatory bed of the heart]. Mikrotsirkulyatsiya i sposoby ee korrektsii. Moscow, 2003. Pp. 28-32.
2. Lazernaya dopplerovskaya floumetriya mikrotsirkulyatsii krovi. Rukovod-stvo dlya vrachey, pod red. A.I. Krupatika, V.V. Sidorova [Laser Doppler flowmetry of blood microcirculation. Manual for doctors. Ed. by A.I. Krupatik, V.V. Sidorov]. Moscow: Meditsina. 254 p.
3. ESC ESC / EASD 2007 management materials Diabetes mellitus, prediabetes and cardiovascular diseases «(Guidelinesondiabetes, pre-diabetes, andcardiovasculardiseases). The original text of the document is published in the journal European Heart Journal. 2007; 28 (1): 88-136. Ratsional’naya farmakoterapiya, 2007. 12, no. 4 (in Russ.), available at: http://rpt.health-ua.com/article/132.html/
4. Tesfaye S., Malir R.A., Harris N. et al. Arterio-venous shunting and proliferating new vessels in acute painful neuropathy of rapid glycaemic control (insulin neuritis). Diabetologia,1996; 39: 329-335.
5. Zubkova S.T. Some aspects of diagnosis and treatment of diabetic angiopathies. Zdorov’e Ukrainy, 2003, no. 68, April (in Russ.), available at: http://health-ua.com/articles/141.html
6. Makarov L.M. Kholterovskoemonitorirovanie [Holterskoonmonitoring]. Moscow: Medpraktika, 2000. 216 p.
7. Mikhaylov V.M. Variabel’nost’ ritma serdtsa. Opyt prakticheskogo primeneniya metoda [The variability of the rhythm of the heart. Experience of practical application of the method]. Ivanovo, 2000. 200 p.
8. Yankin M.Yu., Podkhomutnikov V.M. Features of regulation of heart rhythm and hemodynamics of patients with myocardial infarction of different age groups. Sibirskiy meditsinskiy zhurnal, 2009, no. 2, pp. 21-27 (in Russ.).
9. Maksumova N.V. Evaluation of vegetative tone and adaptation level on the basis of complex analysis of heart rate variability indices. Prakticheskaya meditsina, 2015, no. 3(88), vol. 1, pp. 46-51 (in Russ.).
10. Ryabykina G.V., Sobolev A.V. Kholterovskoe i bifunktsional’noe monitorirovanie EKG i arterial’nogo davleniya. Izd. 2-e, ispravl. i dopoln. [Holter and bi-functional monitoring of ECG and arterial pressure. Ed. 2nd, corrected and supplemented]. Moscow: Izd-vo “Medpraktika-M”, 2016. 347 p.
11. Moss D., McGrady A., Davies T.C., Wickramasekera I. Handbook of Mind-Body Medicine for Primary Care. London: Sage Publications; 2003. 576 p.
12. Yabluchansky N., Kulik A., Martynenko A. The heart rate variability (HRV) Point: Counterpoint discussion raises a whole range of questions, and our attention has also been attracted by the topic. J. Appl. Physiol, 2007, no. 102, pp. 1715.
13. McKee M.G. Biofeedback: an overview in the context of heart-brain medicine. Cleve. Clin. J. Med, 2008, no. 75 (suppl 2), pp. 31-34.
14. Sutarto A.P., Abdul Wahab M.N., Mat Zin N. Heart Rate Variability (HRV) biofeedback: A new training ap-proach for operator’s performance enhancement. J. of Industrial Engineering and Management, 2010, no. 3 (1), pp. 176-198.
15. Damulin I.V. Vascular cognitive disorders associated with injury of small vessels. Vestnik nevrologii, psikhiatrii i neyrokhirurgii, 2014, no. 7, pp. 2-7(in Russ.).
16. Greenberg S.M. Smallvessels, bigproblems. New Engl. J. Med. 2006; 354(14):1451-1453.
17. 17. Gould D.B., Phalan F.C., van Mil S.E. et al. Role of COL4A1 in small-vessel disease and hemorrhagic stroke. New Engl.J.Med., 2006; 354(14):1489-1496.
18. Werring D.J., Coward L.J., Losseff N.A. et al. Cerebral microbleeds are common in ischemic stroke but rare in TIA. Neurology, 2005; 65; 1914-1918.
19. Guermazi A., Miaux Y., Rovira-Canellas A. et al. Neuroradiological findings in vascular dementia. Neuroradiol, 2007; 49: 1-22.
20. Fattakhov V.V. Optimization of macro- and microcirculation in chronic diseases of the veins. The International Scientific Association “Science & Genesis”. The International MultidisciplinarySongress “Knowledge Is Power, Power Is Knowledge”. 27 July, 2015. Vienna (Austria), 2015. Pp. 20-27.
21. Fattakhov V.V., Maksumova N.V. Mikrovaskulyarnye izmeneniya pri zabolevaniyakh nizhnikh konechnostey. Pervyy s»ezd khirurgov Privolzhskogo federal’nogo okruga (s mezhdunarodnym uchastiem) [Microvascular changes in diseases of the lower extremities. First Congress of Surgeons of the Volga Federal District (with international participation)]. Nizhniy Novgorod, 2016. Pp. 15-16.
22. Makolkin V.I., Podzolkov V.I., Bran’ko V.V. et al. Mikrotsirkulyatsiya v kardiologii [Microcirculation in cardiology]. Moscow, 2004. 136 p.