Comparison of continuous wave Doppler ultrasound of the radial artery and laser Doppler flowmetry of the fingertips with sympathetic stimulation


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Abstract

Abstract.Laser Doppler is widely used to evaluate sympathetic vasoconstrictor function. Continuous wave (cw)-Doppler of the radial artery may be an alternative but less expensive approach to quantify sympathetically induced resistance changes in the peripheral vascular system. In order to compare the power of both methods, this study was performed with simultaneous assessment of cw Doppler and laser Doppler flowmetry in volunteers. Twenty-five healthy subjects (median age years, range 20-27) rested in a relaxed supine position and were asked to perform a deep inspiratory gasp and a commanded cough (DIG + C). Radial artery blood flow was assessed with a standard cw Doppler device, arteriolar blood flow was assessed simultaneously employing a single point laser Doppler perfusion monitor at the fingertips. We quantified the latency between stimulus and onset of vasoconstriction, the latency to the maximum vasoconstriction and the duration of response. The decrease in flow velocities (cw Doppler) after stimulus was compared with the decrease in capillary flow (laser Doppler). While the flow profile as measured with laser Doppler remained monophasic after stimulation, cw Doppler showed biphasic flow (or absent diastolic flow) in all subjects after DIG + C. The latencies between stimulus and onset of reaction were significantly shorter when measured with laser Doppler (1.8 s vs. 2 s, p = 0.049), the latencies till the maximum extent of the reaction was reached did not differ significantly (3.2 vs. 3.3 s). The duration of the response was significantly shorter when measured by laser Doppler (12.0 vs. 14.5 s (p < 0.0001). While skin blood flow in the laser Doppler measurement decreased after stimulation from 654 flux units (FU) to 319 FU (-59%), mean flow velocities in the radial artery declined from 1.07 kHz to 0.14 kHz (-87%). This relative change was significantly different (p < 0.0001). The correlation between the decline of flux units as measured by laser Doppler and cw Doppler changes was r = 0.616 (p = 0.004). Both methods are feasible to monitor flow changes due to sympathetic stimulation. Latencies and relative quantitative changes were closely correlated.Thus, cw Doppler is a valid alternative approach to laser Doppler flowmetry in healthy volunteers.

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