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Tikhonova IV, Tankanag AV, Guseva IE, Grinevich AA. Analysis of interactions between cardiovascular oscillations for discrimination of early vascular disorders in arterial hypertension and type 2 diabetes. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mkrtumyan AM, Zvenigorodskaya LA, Shinkin MV. The study of microcirculation and tissue metabolism as early diagnostic criteria for the risk of diabetic foot development. TERAPEVT ARKH 2022; 94:957-962. [DOI: 10.26442/00403660.2022.08.201789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022]
Abstract
Aim. To assess the state of the microvasculature, tissue metabolism and its reserve capabilities for the purpose of early intervention for the prevention of diabetic foot syndrome.
Materials and methods. Thirty patients were examined. The patients were divided into three groups depending on the hypoglycemic therapy (metformin, empagliflozin, dapagliflozin). The comparison group consisted of 12 volunteers who did not have carbohydrate metabolism disorders.
Results. It was found: the HbA1c indicator significantly decreased in all three groups; significant dynamics in the state of the microvasculature was not observed in any of the three groups; in all groups, there was an improvement in tissue metabolism, however, in this case, no significant dynamics were observed in any of the 3 groups, which indicates the need for provocative tests.
Conclusion. For this purpose, the authors recommend the method of combined use of laser Doppler flowmetry and laser fluorescence spectroscopy. This technique allows diagnosing the state of the microvasculature and tissue metabolism and its reserve capabilities, using thermal and cold tests.
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Moon KC, Chung HY, Han SK, Jeong SH, Dhong ES. Possibility of Injecting Adipose-Derived Stromal Vascular Fraction Cells to Accelerate Microcirculation in Ischemic Diabetic Feet: A Pilot Study. Int J Stem Cells 2019; 12:107-113. [PMID: 30836733 PMCID: PMC6457712 DOI: 10.15283/ijsc18101] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/04/2019] [Accepted: 01/14/2019] [Indexed: 12/25/2022] Open
Abstract
Background and Objectives Beneficial effects of human adipose-derived stromal vascular fraction (SVF) cell injection on microcirculation have been recently reported in in vitro and in vivo studies. However, no clinical studies have reported its effect in diabetic patients who commonly experience compromised tissue perfusion, regardless of the status of intravascular blood flow. The present piloting study was designed to clinically examine the possibility of SVF cell injection to accelerate microcirculation, particularly in ischemic diabetic feet. Methods Ten diabetic feet were included to receive subcutaneous injection of SVF cells around wounds. Transcutaneous partial oxygen pressure (TcPO2) and cutaneous microvascular blood flow were measured before and every four weeks after cell injection until the 12th week visit. Results TcPO2 values increased from 31.3±7.4 before injection to 46.4±8.2 mmHg at 12 weeks after SVF injection (1.5-fold, p<0.05). Cutaneous microvascular blood flow levels increased from 34.0±21.1 before injection to 76.1±32.5 perfusion unit at 12 weeks after SVF injection (2.2-fold, p<0.05). There were no adverse events related to SVF cell injection. Conclusions Results of this study demonstrate that adipose-derived SVF cell injection have the possibility to provide beneficial effects on microcirculation in ischemic diabetic feet.
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Affiliation(s)
- Kyung-Chul Moon
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Ha-Yoon Chung
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Seung-Kyu Han
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Seong-Ho Jeong
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
| | - Eun-Sang Dhong
- Department of Plastic Surgery, Korea University Guro Hospital, Seoul, Korea
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Smirnova E, Shulkina S, Loran E, Podtaev S, Antonova N. Relationship between skin blood flow regulation mechanisms and vascular endothelial growth factor in patients with metabolic syndrome. Clin Hemorheol Microcirc 2018; 70:129-142. [DOI: 10.3233/ch-170247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E. Smirnova
- Perm State Medical University, Perm, Russia
- Institute of Continuous Media Mechanics, Russian Academy of Sciences Ural Branch, Korolyova str, Perm, Russia
| | - S. Shulkina
- Perm State Medical University, Perm, Russia
- Institute of Continuous Media Mechanics, Russian Academy of Sciences Ural Branch, Korolyova str, Perm, Russia
| | - E. Loran
- Perm State Medical University, Perm, Russia
- Institute of Continuous Media Mechanics, Russian Academy of Sciences Ural Branch, Korolyova str, Perm, Russia
| | - S. Podtaev
- Institute of Continuous Media Mechanics, Russian Academy of Sciences Ural Branch, Korolyova str, Perm, Russia
| | - N. Antonova
- Institute of Mechanics, Bulgarian Academy of Sciences, Sofia, Bulgaria
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Hsiu H, Chen CT, Hung SH, Chen GZ, Huang YL. Differences in time-domain and spectral indexes of skin-surface laser-Doppler signals between controls and breast-cancer subjects. Clin Hemorheol Microcirc 2018; 69:371-381. [DOI: 10.3233/ch-170295] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hsin Hsiu
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Chao-Tsung Chen
- Department of Traditional Chinese Medicine, Taipei City Hospital RenAi Branch, Taipei, Taiwan
| | - Shuo-Hui Hung
- Department of Surgery, Taipei City Hospital RenAi Branch, Taipei, Taiwan
| | - Guan-Zhang Chen
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Yu-Ling Huang
- Department of Traditional Chinese Medicine, Taipei City Hospital RenAi Branch, Taipei, Taiwan
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Liu M, Zhang X, Li B, Wang B, Wu Q, Shang F, Li A, Li H, Xiu R. Laser Doppler: A Tool for Measuring Pancreatic Islet Microvascular Vasomotion In Vivo. J Vis Exp 2018. [PMID: 29578495 DOI: 10.3791/56028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
As a functional status of microcirculation, microvascular vasomotion is important for the delivery of oxygen and nutrients and the removal of carbon dioxide and waste products. The impairment of microvascular vasomotion might be a crucial step in the development of microcirculation-related diseases. In addition, the highly vascularized pancreatic islet is adapted to support endocrine function. In this respect, it seems possible to infer that the functional status of pancreatic islet microvascular vasomotion might affect pancreatic islet function. Analyzing the pathological changes of the functional status of pancreatic islet microvascular vasomotion may be a feasible strategy to determine contributions that pancreatic islet microcirculation makes to related diseases, such as diabetes mellitus, pancreatitis, etc. Therefore, this protocol describes using a laser Doppler blood flow monitor to determine the functional status of pancreatic islet microvascular vasomotion, and to establish parameters (including average blood perfusion, amplitude, frequency, and relative velocity of pancreatic islet microvascular vasomotion) for evaluation of the microcirculatory functional status. In a streptozotocin-induced diabetic mouse model, we observed an impaired functional status of pancreatic islet microvascular vasomotion. In conclusion, this approach for assessing pancreatic islet microvascular vasomotion in vivo may reveal mechanisms relating to pancreatic islet diseases.
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Affiliation(s)
- Mingming Liu
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Xiaoyan Zhang
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Bingwei Li
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Bing Wang
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Qingbin Wu
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Fei Shang
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Ailing Li
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College;
| | - Hongwei Li
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Ruijuan Xiu
- Institute of Microcirculation, Chinese Academy of Medical Sciences & Peking Union Medical College
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Klonizakis M, Bianchi SM, Gernigon M, Abraham P, Nawaz S. Real-life adaptations in walking patterns in patients with established peripheral arterial disease assessed using a global positioning system in the community: a cohort study. Clin Physiol Funct Imaging 2018; 38:889-894. [PMID: 29368413 DOI: 10.1111/cpf.12501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 12/12/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Lower extremity peripheral arterial disease (PAD) is a chronic condition most commonly presenting with intermittent claudication (IC). Intermittent claudication limits walking ability and may negatively affect health-related quality of life. Treadmill assessment of maximal walking distance (MWD) is the gold standard to assess PAD symptom severity. Despite being a well-established and reproducible tool, it may be inappropriate (due to frailty or fear) for some patients and only describes maximal abilities for a single walk test. Global positioning systems (GPS) have been proposed as reliable and reproducible tool to measure total, mean and maximal walking distances in patients with PAD, in the community setting. Using GPS, our study attempted to explore what happens to the walking ability of patients with IC following no intervention under 'real-life' conditions. DESIGN AND METHODS Using the GlobalSat DG100 GPS, forty-three patients (69 ± 9 years; nine female; no invasive interventions or rehabilitation) undertook two 60-min walking assessments, 6 months apart. Assessments took place in community spaces that had even terrain, no tall trees or buildings and were free from motorized vehicles. Global positioning systems-measured maximum walking distance was the main study outcome measure. RESULTS Over the 6-month period, patients demonstrated significantly shorter GPS-measured, mean (552 m versus 334 m; P = 0·02) and maximum (714 m versus 545 m; P = 0·04) walking distances, stopping also more frequently (nine versus five times; P = 0·03). CONCLUSIONS Given the reported symptom progression, we advocate early intervention (e.g. exercise interventions) combined with frequent patient monitoring in attempts to maintain or improve walking ability.
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Affiliation(s)
- Markos Klonizakis
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK
| | - Stephen M Bianchi
- Academic Directorate of Respiratory Medicine, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Marie Gernigon
- EuroMov, Univ. Montpellier, Montpellier, France.,CIAMS, Univ. Paris Sud, Université Paris-Saclay, Orsay Cedex, France
| | - Pierre Abraham
- Département de physiologie et explorations fonctionnelles, CHU d'Angers, Angers, France
| | - Shah Nawaz
- Sheffield Vascular Institute, Sheffield, UK
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Liao F, Jan YK. Nonlinear dynamics of skin blood flow response to mechanical and thermal stresses in the plantar foot of diabetics with peripheral neuropathy. Clin Hemorheol Microcirc 2018; 66:197-210. [PMID: 28482622 DOI: 10.3233/ch-160239] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. OBJECTIVE The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy. METHODS 18 type 2 diabetics with peripheral neuropathy and 8 healthy controls were recruited. SBF at the first metatarsal head in response to a loading pressure of 300 mmHg and a local heating was measured using laser Doppler flowmetry. A sample entropy approach was used to quantify the degree of regularity of SBF. RESULTS Our results showed that the regularity degree of SBF in the diabetic foot underwent only small changes during post-occlusive reactive hyperemia and thermally induced biphasic response compared to non-diabetics. SBF of the diabetic foot has higher degree of irregularity during reactive hyperemia because of attenuated myogenic activity, and demonstrated higher regularity during the biphasic response largely due to significantly enhanced cardiac activities. CONCLUSIONS This study suggests that the regularity degree of SBF at the first metatarsal head could be used to assess impaired microvascular reactivity and thus may be used to assess the risk for DFU in diabetics with peripheralneuropathy.
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Affiliation(s)
- Fuyuan Liao
- Department of Biomedical Engineering, Xi'an Technological University, Xi'an, China
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, Rehabilitation Engineering Lab, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Computational Science and Engineering Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Mrowietz C, Franke R, Pindur G, Wolf U, Jung F. Reference range and variability of Laser-Doppler-Fluxmetry. Clin Hemorheol Microcirc 2017; 67:347-353. [DOI: 10.3233/ch-179215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- C. Mrowietz
- Institute for Clinical Hemostaseology and Transfusion Medicine, University of Saarland, Homburg/Saar, Germany
| | - R.P. Franke
- Central Institute for Biomedical Engineering, University of Ulm, Germany
| | - G. Pindur
- Institute for Clinical Hemostaseology and Transfusion Medicine, University of Saarland, Homburg/Saar, Germany
| | - U. Wolf
- University of Applied Science Fulda, Germany
| | - F. Jung
- Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany
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Lenasi H, Klonizakis M. Assessing the evidence: Exploring the effects of exercise on diabetic microcirculation. Clin Hemorheol Microcirc 2017; 64:663-678. [PMID: 27767975 DOI: 10.3233/ch-168022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diabetes mellitus (DM) is associated with cardiovascular complications. Impairment of glycemic control induces noxious glycations, an increase in oxydative stress and dearangement of various metabolic pathways. DM leads to dysfunction of micro- and macrovessels, connected to metabolic, endothelial and autonomic nervous system. Thus, assessing vascular reactivity might be one of the clinical tools to evaluate the impact of harmful effects of DM and potential benefit of treatment; skin and skeletal muscle microcirculation have usually been tested. Physical exercise improves vascular dysfunction through various mechanisms, and is regarded as an additional effective treatment strategy of DM as it positively impacts glycemic control, improves insulin sensitivity and glucose uptake in the target tissues, thus affecting glucose and lipid metabolism, and increases the endothelium dependent vasodilation. Yet, not all patients respond in the same way so titrating the exercise type individualy would be desirable. Resistance training has, apart from aerobic one, been shown to positively correlate to glycemic control, and improve vascular reactivity. It has been prescribed in various forms or in combination with aerobic training. This review would assess the impact of different modes of exercise, the mechanisms involved, and its potential positive and negative effects on treating patients with Type I and Type II DM, focusing on the recent literature.
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Affiliation(s)
- Helena Lenasi
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Slovenia
| | - Markos Klonizakis
- Centre for Sport and Exercise Science, Sheffield Hallam University, UK
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Stoyneva Z, Velcheva I, Antonova N, Titianova E. Microvascular reactivity to thermal stimulation in patients with diabetes mellitus and polyneuropathy. Clin Hemorheol Microcirc 2017; 65:67-75. [DOI: 10.3233/ch-15107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Z. Stoyneva
- Department of Neurology, University Hospital St. Ivan Rilsky – Sofia, Medical Universities of Sofia and Plovdiv, Bulgaria
| | - I. Velcheva
- Department of Neurology, University Hospital of Neurology and Psychiatry, Medical University, Sofia, Bulgaria
| | - N. Antonova
- Department of Biomechanics, Institute of Mechanics, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - E. Titianova
- Clinic of Functional Diagnostics of the Nervous System, Military Medical Academy, Sofia, Bulgaria
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