Abstract
Background. Detailed study of the functional state of microcirculation in combination of arterial hypertension and tobacco smoking, as the most common and prognostically important risk factors for atherogenesis, will not only clarify pathogenetic effect of tobacco smoke on the terminal vascular bed, but also outline directions of active counteraction to it.Purpose. To study the effect of TS on the functional state of SM using laser Doppler flowmetry in patients with AH.Methods. 185 patients with stage 1,2 AH involved in the study were divided into 2 equivalent groups according to main clinical and laboratory data: group 1 – non-smokers (n = 134, mean age was 57.0 [50.0; 60.0]), group 2 – patients who smoke 1–1.5 packs of cigarettes per day (n = 51, mean age was 54.0 [48.0; 58.0]). Patients were prescribed short-acting antihypertensives drugs, which were used whenever required 5 days before the study. SM was investigated by laser Doppler flowmetry using occlusion test and amplitude-frequency spectrum analysis of hemoperfusion fluctuations.Results. Obtained data showed negative acute effect of ingredients of tobacco smoke on almost all structural elements of microhemocirculation. Revealed deviations are characterized by constriction of precapillary segment of microvascular bed with increase in myogenic tone and equal 3.1 units [2.6; 4.1] versus 2.3 units [1.7; 3.4] in the alternative group (p = 0.007), decrease in capillary blood flow from 4.5 units [3.5; 5.8] compared with the group of non-smokers – 5.2 units [4.0; 7.3] (p = 0.041), statistically significant intensification of arteriolar-venular blood flow with formation of venous congestion, limitation of dilated reserve of microcirculation.Conclusion. Tobacco smoking leads to significant microcirculation disorders that are projected onto changes in terminal vascular bed, inherent with AH, which significantly reduces the functional state of microcirculation, limits its reserve potential and promotes the development of tissue ischemia.
Highlights
Detailed study of the functional state of microcirculation in combination of arterial hypertension and tobacco smoking, as the most common and prognostically important risk factors for atherogenesis, will clarify pathogenetic effect of tobacco smoke on the terminal vascular bed, and outline directions of active counteraction to it
Характеристика больных, включенных в исследование Peculiarity of patients included in the study
Патофизиологические механизмы воздействия табакокурения на сердечно-сосудистую систему (обзор литературы) // Саратовский научно-медицинский журнал. – 2007. – Т. 17. – No 6. – С. 50–52
Summary
Амплитудно-частотный спектр колебаний гемоперфузии изучали с использованием вейвлет-анализа с помощью прилагаемого к аппарату программного обеспечения: оценивали амплитуду эндотелиальных (Аэ), нейрогенных (Ан), миогенных (Ам) ритмов, дающих представление об активных (тонусформирую щих) механизмах контроля перфузии, а также амплитуду кардиальных (Ас) и дыхательных (Ад) ритмов, отражающую участие пассивных факторов микрогемоциркуляции. Клиническая характеристика больных, включенных в исследование, представлена в табл. 2), показатель, отражающий уровень общей тканевой гемоперфузии (ПМ) у курящих и некурящих больных АГ, не имел статистически значимого различия У больных 2-й группы отмечено существенное снижение амплитуды колебаний кровотока в миокардиальном частотном диапазоне (Ам), составившее 0,12 [0,08; 0,17] перф. Статистически значимое увеличение амплитуды колебаний кровотока в нейрогенном частотном диапазоне (Ан) у исследуемых 2-й группы до 0,20 [0,12; 0,25] перф. Характеристика больных, включенных в исследование Peculiarity of patients included in the study
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