Sympathetic Vasomotor Response of the Radial Artery in Patients With Diabetic Foot Syndrome
- Bernhard M. Eicke, MD1,
- Julian Bauer, MD1,
- Susanne Mink, MD12,
- Valerio Kuhl, MD1,
- Alexander Hlawatsch, MD3,
- Ernst Küstner, MD4 and
- Anja Victor, BS5
- 1Department of Neurology, Johannes Gutenberg-University, Mainz, Germany
- 2Department of Neurology, Klinikum Ludwigsburg, Ludwigsburg, Germany
- 3Department of Radiology, Johannes Gutenberg-University, Mainz, Germany
- 4Department of Endocrinology, Johannes Gutenberg-University, Mainz, Germany
- 5Department of Biomedical Statistics, Johannes Gutenberg-University, Mainz, Germany
- Address correspondence and reprint requests to B. Martin Eicke, MD, Department of Neurology, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, D-55101 Mainz, Germany. E-mail: eicke{at}neurologie.klinik.uni-mainz.de
Abstract
OBJECTIVE—Neurophysiological assessment of the peripheral autonomic system is characterized by various limitations. An alternative approach to laser Doppler and venous plethymography is the assessment of the sympathetic vasomotor response of the radial artery obtained by continuous wave Doppler sonography. Nomogram data have been established and demonstrate the temporary disappearance of diastolic flow after coughing or deep inspiration.
RESEARCH DESIGN AND METHODS—We assessed the sympathetic vasomotor response in 25 patients (mean age 64 years, range 43–76) with diabetic foot syndrome. The Doppler data were correlated with nerve conduction studies of the median and peroneal nerve, the extent of radiologically diagnosed media sclerosis, and compared with nomogram values (n = 41).
RESULTS—Although similar mean flow velocities were found under baseline conditions, the flow pattern was characterized by higher pulsatility in the diabetic group (resistance index [RI] 1.1 vs. 0.7). No significant difference in RI was observed after coughing. The latency of onset of the response was prolonged (2.1 vs. 1.5 s), while the duration of the response did not differ (18 vs. 15 s). Only the nerve conduction velocity of the peroneal nerve correlated inversely with the RI. The extent of radiologically proven calcification tended to correlate with the pulsatility of the baseline signal and the response latencies.
CONCLUSIONS—The data obtained by this study suggest the concurrent existence of reduced vessel elasticity due to media sclerosis and dysfunction of the autonomic vasomotor system.
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted May 22, 2003.
- Received July 12, 2002.
- DIABETES CARE
