The effect of intravenous infusion of prostaglandin E1 on cutaneous microcirculation in black foot disease.
In order to evaluate the effect of an intravenous infusion of prostaglandin E1 (PGE1), 80 micrograms/day for two weeks, on microcirculatory vasculature in seven patients (M:F = 3:4, age 60-78) with black foot disease (a peripheral vascular disease of undefined etiology), we applied laser Doppler velocimetry to measure the maximal cutaneous microcirculatory flow (LDF) at a proximal site near gangrenous ulcers of the foot. Maximal flow was induced by local warming to 42 degrees C with a modified laser Doppler heating probe. Three phasic measurements were recorded, i.e., during pretreatment, treatment and follow-up with the separation interval being two weeks. The net maximal LDF (LDF at 42 degrees C minus LDF at room temperature) increased from 8.8 +/- 4.0 to 11.9 +/- 4.0 volt, p < 0.05. Cutaneous vascular conductance (CVC) was calculated as LDF/mean BP. Mean BP showed no significant change before or after treatment. Net CVC was changed from 7.5 +/- 3.1 to 11.9 +/- 4.0 volt/100 mmHg, p < 0.05. The LDF dropped significantly during the two-week period between treatment and follow-up in five subjects (10.8 +/- 3.4 vs 4.6 +/- 1.8, p < 0.05), while the follow-up LDF was close to the control data (4.6 +/- 1.8 vs 6.3 +/- 2.2, p = NS). Hence, we conclude that PGE1 may beneficially enhance microcirculatory blood flow in black foot disease through direct vasodilatory effects.
Kwan
C M
CM
Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan, R.O.C.
Chang
W C
WC
Chen
J H
JH
Wang
M Y
MY
D000368:Aged; D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D005534:Foot Diseases / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D016523:Foot Ulcer / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D005734:Gangrene; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D012867:Skin / Q000098:blood supply
D000527:Alprostadil