PERIODIC HEMODYNAMICS (FLOW MOTION) IN PERIPHERAL ARTERIAL OCCLUSIVE DISEASE

Purpose: The occurrence of periodic blood flow variations (flow motion ) in health and disease is controversially discussed. This is partly d ue to not reporting the incidence and to performing the analysis solel y visually. We have therefore studied flow motion with computerized me thods. Methods: We used a computerized Prony spectral line estimator p rogram to analyze the frequencies of resting skin blood flow variation s, as determined by laser Doppler flowmetry on the thumb and great toe , in 50 male control subjects (group a), in 50 patients with mild peri pheral arterial occlusive disease (PAOD stages I and II; group b), and in 25 patients with severe PAOD (stages III and IV; group c). Results : The median ankle/arm pressure ratio was 1.10 in the control group, 0 .72 in the mild PAOD group, and 0.66 in the severe PAOD group. Slow wa ve flow motion was detected in 19% of all thumbs from groups a and b ( systolic arm pressures > 100 mm Hg) and in 12% of the toes in the cont rol group. Patients with mild PAOD exhibited slow wave flow motion in 46% of the toes. Patients with severe PAOD showed slow waves in 77% of the toes. The median flow motion frequencies were about 1.6 cycles/mi n for groups a and b, when present. The median frequency in group c wa s significantly higher at 4.0 cycles/min, though still in the range of slow waves. The median peak-to-trough amplitude was between 17% and 2 0% of mean flow for all groups. Conclusions: We conclude that evaluati on of flow motion requires computerized frequency analysis and that sl ow wave flow motion is a perfusion pattern characteristic of PAOD rath er than of normal perfusion states. This finding has potential implica tions for diagnostic and therapeutic approaches in arterial occlusive disease.