title: Abnormal amplitude and kinetics of digital postocclusive reactive hyperemia in systemic sclerosis.
abstract: OBJECTIVE
  Postocclusive reactive hyperemia is mediated by two major mediators: sensory nerves and endothelium-derived hyperpolarizing factors. We hypothesized that the skin microvascular response to 5 min ischemia would differ depending upon the hand location in patients with systemic sclerosis (SSc), primary Raynaud's phenomenon (PRP) and healthy controls.
  
  
  METHODS
  Fifteen patients with SSc, 15 sex- and age-matched patients with PRP and healthy controls were enrolled. Their right hands were subjected to 5 min ischemia followed by a postocclusive hyperemia test, with local microcirculation monitoring by laser speckle contrast imaging on the dorsal face of the hand.
  
  
  RESULTS
  Postocclusive reactive hyperemia was abnormal in terms of peak and area under the curve (AUC) on all fingers except the thumb in patients with SSc and PRP compared with controls. In contrast, the kinetics of the response was longer only in SSc patients, with mean (SD) time to peak on the index, middle and ring finger were respectively 72 (58), 73 (51) and 67 (47) s for SSc; 40 (20), 40 (20) and 36 (19) s for PRP; and 34 (30), 34 (30) and 29 (24) s for controls (P=0.009 for interaction).
  
  
  CONCLUSIONS
  We observed decreased distal digital microvascular perfusion following 5 min of ischemia in patients presenting with PRP or SSc, while the kinetics was prolonged only in SSc. A dynamic assessment of digital skin blood flow using laser speckle contrast imaging following 5 min ischemia could be used as a tool to assess microvascular abnormalities in patients with Raynaud's phenomenon secondary to SSc.
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France.
authors.forename: F
authors.initials: F
authors.lastname: Gaillard-Bigot
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France.
authors.forename: M
authors.initials: M
authors.lastname: Roustit
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France; Vascular Medicine Department, Grenoble University Hospital, 38043, France.
authors.forename: S
authors.initials: S
authors.lastname: Blaise
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France.
authors.forename: M
authors.initials: M
authors.lastname: Gabin
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France.
authors.forename: C
authors.initials: C
authors.lastname: Cracowski
authors.affiliation: Vascular Medicine Department, Grenoble University Hospital, 38043, France.
authors.forename: C
authors.initials: C
authors.lastname: Seinturier
authors.affiliation: Vascular Medicine Department, Grenoble University Hospital, 38043, France.
authors.forename: B
authors.initials: B
authors.lastname: Imbert
authors.affiliation: Vascular Medicine Department, Grenoble University Hospital, 38043, France.
authors.forename: P
authors.initials: P
authors.lastname: Carpentier
authors.affiliation: Univ. Grenoble Alpes, HP2, 38000, France; Clinical Pharmacology Unit, Inserm CIC003, Grenoble University Hospital, 38043, France. Electronic address: Jean-Luc.Cracowski@ujf-grenoble.fr.
authors.forename: J L
authors.initials: JL
authors.lastname: Cracowski
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001794:Blood Pressure; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005385:Fingers / Q000098:blood supply; D006225:Hand / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D007511:Ischemia; D007700:Kinetics; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D011928:Raynaud Disease / Q000503:physiopathology*; D012039:Regional Blood Flow / Q000502:physiology; D012107:Research Design; D012595:Scleroderma, Systemic / Q000473:pathology* / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply; D013997:Time Factors
keywords: Endothelium; Laser speckle contrast imaging; Microcirculation; Microcirculation imaging; Post-occlusive reactive hyperemia; Primary Raynaud's Phenomenon; Raynaud's phenomenon; Skin; Systemic sclerosis; Vasodilatation