VASOMOTION IN VENOUS DISEASE

Abnormalities of the capillary microcirculation may be important in the pathogenesis of venous ulceration. In this study the characteristics of capillary vasomotion in venous disease have been studied using laser Doppler flowmetry. The amplitude and frequency of vasomotion in the skin microcirculation as measured by laser Doppler flowmetry was determined in 101 subjects. These comprised 43 subjects with venous disease and lipodermatosclerosis (LDS), 14 subjects with uncomplicated varicose veins (VV), and 44 normal controls. In 43 of these 101 limbs, vasomotion was also measured after heating the skin to 43-degrees-C. The resting laser Doppler flux was significantly higher in the LDS group compared to the other two groups (LDS median = 76, VV median = 47 (P < 0.04), controls median = 49 (P < 0.003)). The amplitude of vasomotive waves was significantly higher in the LDS group compared to controls (LDS median = 20, VV median = 8.3 (P < 0.007), controls median = 14 (P < 0.007)), as was the frequency of vasomotion (LDS median = 3.3 waves/min, VV median = 2.5 (P = ns), controls median = 2.7 (P < 0.007)). On heating the skin to 43-degrees-C the frequency of the vasomotion increased significantly in the control (P < 0.004) and VV (P < 0.04) groups but not in the LDS group. The amplitude of the vaso-motion also increased significantly in the control (P < 0.01) and VV (P < 0.002) groups but not in the LDS group. Following heating, the frequency of vasomotive waves was significantly lower in the LDS group than in controls (P = 0.05).