title: Postocclusive reactive hyperemia in hand-arm vibration syndrome.
abstract: OBJECTIVE
  To assess laser Doppler-recorded postocclusive reactive hyperemic responses in vibration-induced Raynaud's phenomenon and compare it with primary and secondary to sclerodermy Raynaud's phenomenon.
  
  
  METHODS
  Thirty patients with vibration-induced Raynaud's phenomenon and 30 healthy controls and patients with primary and secondary to sclerodermy Raynaud's phenomenon were investigated. Fingerpulp skin blood flow was monitored by laser Doppler flowmetry during postocclusive reactive hyperemia test.
  
  
  RESULTS
  Lower initial perfusion values were established in all the patients with Raynaud's phenomenon compared to the healthy controls (p < 0.0001). The postocclusive reactive hyperemic peak was lower in all the Raynaud's phenomenon groups compared to the controls (p < 0.0001). The postocclusive and basal perfusions were lower in the secondary Raynaud's phenomenon groups compared to the control and the primary Raynaud's phenomenon groups (p < 0.0001). The velocities to postocclusive hyperemic peak were lower in all the Raynaud's phenomenon patients (p < 0.0001), so were in the vibration-induced (p < 0.002) and the sclerodermy Raynaud's phenomenon (p < 0.004) groups in relation to the primary Raynaud's phenomenon group. The perfusion values and the velocities were significantly influenced by the initial superficial skin temperatures and perfusions, while the velocities were dependent also on gender, and the hyperemic peak on age.
  
  
  CONCLUSIONS
  Postocclusive reactive hyperemia is abnormal in all Raynaud's phenomenon patients. Laser Doppler-recorded reactive hyperemia test contributes to diagnosing Raynaud's phenomenon and has proved to be valuable for group analysis. The applied method is not sensitive enough to discriminate adequately the type of Raynaud's phenomenon among individual cases.
authors.affiliation: Medical University of Sofia, Sofia, Bulgaria (University Hospital St. Ivan Rilsky, Clinic of Occupational Diseases). zlatka_stoyneva@yahoo.com.
authors.forename: Zlatka
authors.initials: Z
authors.lastname: Stoyneva
mesh_terms: D000328:Adult; D005260:Female; D005385:Fingers / Q000098:blood supply; D053421:Hand-Arm Vibration Syndrome / Q000503:physiopathology*; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000503:physiopathology; D011928:Raynaud Disease / Q000503:physiopathology*; D012595:Scleroderma, Systemic / Q000503:physiopathology; D012881:Skin Temperature
keywords: Raynaud’s phenomenon; hand-arm vibration syndrome; laser Doppler flowmetry; microcirculation; reactive hyperemia test; sclerodermy