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Antegrade pulsatile arterial-like flow in human limb veins at increased intravascular pressure
Karolinska Inst, Swedish Def Res Agcy.
Karolinska Inst, Swedish Def Res Agcy.
2009 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 29, no 3, 209-215 p.Article in journal (Refereed) Published
Abstract [en]

The purpose was to study the effects of moderately to markedly increased local intravascular pressures on the flow characteristics in human limb veins. The subject was either seated inside a pressure chamber with one arm slipped through a hole in the chamber door (n = 7) or positioned supine with a lower leg extended to the outside (n = 15). By increasing chamber pressure, transmural pressure in the vessels of the test limb was increased up to +150 mmHg for the arm and +240 mmHg for the leg. Venous flow profiles and arterial flow and vessel diameters were measured with ultrasonographic/Doppler techniques. The arm vessels were studied before and during blocking of the blood flow (BBF) through the hand. Antegrade, pulsatile, arterial-like flow were observed at high distending pressures in the brachial and radial veins in all subjects and in similar to 50% of the subjects also in the cephalic vein and posterior tibial veins. In five of seven subjects, blood flow in the brachial vein remained pulsatile even during BBF. That pulsatile flow was observed in all veins may suggest that moderately to markedly elevated intravascular pressures induce propagation of pulse waves from the arteries via the capillaries to the veins, and/or induce considerable arteriovenous shunting, by forcing open arteriovenous anastomoses.

Place, publisher, year, edition, pages
2009. Vol. 29, no 3, 209-215 p.
Keyword [en]
arteriovenous anastomoses, A-V shunts, transmural pressure, venous flow, venous pulsations
URN: urn:nbn:se:kth:diva-25960DOI: 10.1111/j.1475-097X.2009.00859.xISI: 000264545000009PubMedID: 19236434OAI: diva2:361121
QC 20101108Available from: 2010-11-08 Created: 2010-11-08 Last updated: 2010-11-09Bibliographically approved
In thesis
1. Distensibility in Arteries, Arterioles and Veins in Humans: Adaptation to Intermittent or Prolonged Change in Regional Intravascular Pressure
Open this publication in new window or tab >>Distensibility in Arteries, Arterioles and Veins in Humans: Adaptation to Intermittent or Prolonged Change in Regional Intravascular Pressure
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The present series of in vivo experiments in healthy subjects, were performed to investigate wall stiffness in peripheral vessels and how this modality adapts to iterative increments or sustained reductions in local intravascular pressures. Vascular stiffness was measured as changes in arterial and venous diameters, and in arterial flow, during graded increments in distending pressures in the vasculature of an arm or a lower leg. In addition, effects of intravascular pressure elevation on flow characteristics in veins, and on limb pain were elucidated. Arteries and veins were stiffer (i.e. pressure distension was less) in the lower leg than in the arm. The pressure-induced increase in arterial flow was substantially greater in the arm than in the lower leg, indicating a greater stiffness in the arterioles of the lower leg. Prolonged reduction of intravascular pressures in the lower body, induced by 5 wks of sustained horizontal bedrest (BR), decreased stiffness in the leg vasculature. BR increased pressure distension in the tibial artery threefold and in the tibial vein by 86 %. The pressure-induced increase in tibial artery flow was greater post bedrest, indicating reduced stiffness in the arterioles of the lower leg. Intermittent increases of intravascular pressures in one arm (pressure training; PT) during a 5-wk period decreased vascular stiffness. Pressure distension and pressure-induced flow in the brachial artery were reduced by about 50 % by PT. PT reduced pressure distension in arm veins by 30 to 50 %. High intravascular pressures changed venous flow to arterial-like pulsatile patterns, reflecting propagation of pulse waves from the arteries to the veins either via the capillary network or through arteriovenous anastomoses. High vascular pressures induced pain, which was aggravated by BR and attenuated by PT; the results suggest that the pain was predominantly caused by vascular overdistension. In conclusion, vascular wall stiffness constitutes a plastic modality that adapts to meet demands imposed by a change in the prevailing local intravascular pressure. That increased intravascular pressure leads to increased arteriolar wall stiffness supports the notion that local pressure load may serve as a “prime mover” in the development of vascular changes in hypertension.

Place, publisher, year, edition, pages
Stockholm: KTH, 2010. 51 p.
Trita-STH : report, ISSN 1653-3836 ; 2010:5
arterial stiffness, venous distensibility, venous flow characteristics, bedrest, pressure training
National Category
urn:nbn:se:kth:diva-25965 (URN)978-91-7415-778-9 (ISBN)
Public defence
2010-11-26, sal 3:221, Alfreds Nobels Alle 10, Flemingsberg, Huddinge, 09:00 (Swedish)
medicine doktorsexamen QC 20101109Available from: 2010-11-09 Created: 2010-11-08 Last updated: 2012-03-20Bibliographically approved

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