Abstract
Objectives to investigate the effects of chronic ischaemia on
the subcutaneous and the skeletal muscle resistance vasculature. To
understand the redistribution of available blood in the ischaemic limb. Methods
human subcutaneous and skeletal muscle resistance arteries were
obtained from limbs amputated for critical limb ischaemia and studied
under isobaric conditions using pressure myography. Morphological
measurements of wall and lumen were analysed using light microscopy and
image analysis. Vasoconstrictor responses to potassium and adrenoceptor
agonists were used to measure functional status. Noradrenaline re-uptake
mechanisms and α1-selectivity were investigated. Results
both human skeletal muscle and subcutaneous resistance arteries undergo
a severe atrophy of the arterial wall in ischaemic conditions. However,
whereas subcutaneous resistance arteries become less able to
vasoconstrict to adrenoceptor stimulation, the response of skeletal
muscle resistance arteries becomes exaggerated and significantly
augmented. This is true in response to both the endogenous
vasoconstrictor noradraline and the α1-selective adrenoceptor agonist phenylephrine. Conclusions
hypersensitivity to circulating catecholamines in the skeletal muscle
vascular resistance bed may contribute to the progression of ischaemic
disease by differentially diverting available blood to the subcutaneous
tissue to the detriment of skeletal muscle perfusion.
Original language | English |
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Pages (from-to) | 387-395 |
Number of pages | 9 |
Journal | European Journal of Vascular and Endovascular Surgery |
Volume | 19 |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2000 |
Keywords
- aged
- amputation
- arteries
- biopsy
- critical illness
- diabetes mellitus, type 1
- diabetes mellitus, type 2
- diabetic angiopathies
- female
- humans
- ischemia
- leg
- male
- muscle, skeletal
- myography
- skin
- vascular resistance