[Circadian variations of cutaneous blood flow in normal subjects and in patients with peripheral arteriopathies. Effect of PGE1 and alpha-cyclodextrin].
BACKGROUND
In this study the circadian skin flux pattern was evaluated in 10 normal reference subjects and in 35 patients (mean age 68 +/- 11) subdivided in groups (10 with intermittent claudication (200-400 m of walking distance), 10 diabetics with claudication, 7 patients with rest pain and 8 with localised gangrene).


METHODS
A laser Doppler flowmeter was used to monitor skin flux for 24 hours. In patients with intermittent claudication the circadian pattern was comparable to normal subjects. In diabetics the daily curve showed several irregular peaks mostly dissociated from activity or rest.


RESULTS
In patients with critical ischaemia severe alterations of the circadian pattern were observed (the daily curve was flattened and dissociated from activity or rest) particularly in gangrene. PGE1 alpha-ciclodestrina treatment (60 micrograms/day) partially restored the circadian pattern and increased the average values of the 24-hour curve. In rest pain and gangrene the infusion of PGE1 alpha-ciclodestrina in the late evening increased the average night flux (which tended to fall to very low levels causing pain) and prevented or abolished night rest pain.
Laurora
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G
Angiology and Vasc. Surgery, Clinical Trials Unit, Pierangeli Clinic, Pescara.
Belcaro
G
G
D000527:Alprostadil / Q000494:pharmacology / Q000627:therapeutic use*; D001775:Blood Circulation; D002940:Circadian Rhythm; D003505:Cyclodextrins / Q000494:pharmacology / Q000627:therapeutic use*; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy* / Q000503:physiopathology; D017078:Laser-Doppler Flowmetry; D016491:Peripheral Vascular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D012867:Skin / Q000098:blood supply*; D014665:Vasodilator Agents / Q000627:therapeutic use
D003505:Cyclodextrins; D014665:Vasodilator Agents; D000527:Alprostadil