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Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
Online ISSN 1827-1839
Zlatka B. STOYNEVA 1, 2, Svetlan M. DERMENDJIEV 2, Daniela G. MEDJIDIEVA 1, Vlayko E. VODENICHAROV 3
1 Center for Occupational Diseases, Medical University of Sofia, Bulgaria; 2 Section of Occupational Diseases, Medical University of Plovdiv, Bulgaria; 3 Department of Hygiene, Medical Ecology and Nutrition, Medical University of Sofia, Bulgaria
BACKGROUND: The objective of the study was to assess skin autonomic microvascular reactivity to sympathetic stimulations and its association with primary and secondary Raynaud’s phenomenon (RP).
METHODS: Laser-Doppler recorded finger pulp skin blood flow was monitored during orthostatic and deep breathing tests of 4 subjects groups, each of them by 20: 1st - healthy controls; 2nd – vibration- induced secondary RP (vRP); 3rd - primary RP (pRP); and 4th - systemic sclerosis-related secondary RP (sclRP). Within groups comparisons by Wilcoxon matched pairs rank test and between groups by Bonferroni’s multiple test for unpaired data were done using SPSS. RESULTS: Reliably lower initial perfusion values were established in all the RP patients. The local sympathetic axon-reflex mediated responses to orthostasis were reduced in all RP groups with increased perfusions in upright posture instead of decreased. The vasoconstrictor responses to deep breathing tended to increase instead of decreasing in vRP and pRP groups, while in sclRP group the perfusions decreased. Strong correlations between the initial finger pulp perfusions and the orthostatic and deep breathing perfusion responses were found in the control, pRP and vRP groups (p<0.0001) and a modest correlation between the initial perfusions and the deep breathing perfusion responses in the sclRP group.
CONCLUSIONS: Abnormal cutaneous microvascular reactivity to central and local axon-reflex sympathetic stimulations was established in RP patients reflecting autoregulatory dysfunctions which might contribute to the manifestations of the ischemic microcirculatory paroxysms. Laser Doppler flowmetry with functional orthostatic and deep breathing tests contribute to the diagnosis of RP.