Vascular Resistance Testing

[RichGotsPots]

I've been posting a lot about endothelium defficiencies and many people have posted about Nitric Oxide and other related issues, but how many of use have actually had their Vascular resistance tested?

i got this info from WikiP http://en.wikipedia.org/wiki/Vascular_resistance- which is usually the place I start to research then from there I seek more research related studies:

I'll post some of the interesting points from WikiP so you can get my point and don't have to read some the too technical info on WikiP:

Vascular resistance is a term used to define the resistance to flow that must be overcome to push blood through the circulatory system. The resistance offered by the peripheral circulation is known as the systemic vascular resistance (SVR), while the resistance offered by the vasculature of the lungs is known as the pulmonary vascular resistance (PVR). The systemic vascular resistance may also be referred to as the total peripheral resistance. Vasoconstriction (i.e., decrease in blood vessel diameter) increases SVR, whereas vasodilation (increase in diameter) decreases SVR.

Regulation of vascular resistance

There are many factors that alter the vascular resistance. Many of the platelet-derived substances, including serotonin, are vasodilatory when the endothelium is intact and are vasoconstrictive when the endothelium is damaged.

Cholinergic stimulation causes release of endothelium-derived relaxing factor (EDRF) (later it was discovered that EDRF was nitric oxide) from intact endothelium, causing vasodilation. If the endothelium is damaged, cholinergic stimulation causes vasoconstriction.

To Summarize: There are two type of measurements SVR and PVR. A doctor measures these to check for many different Vascular problems. For example PVR measurements can help doctors find out if there if the patient has Pulmonary Hypertension (which I'll talk about in another post) and SVR helps doctors discover general casrdiovascular issues, in the heart or all over the body.

The most precise method that doctors use is cauterization, but over the last 15 years there have been many non-invasive methods that help predict vascular issues.

Of course there are a few different treatments I've read about but this post is simply to find out, how many of use have been tested for either SVR or PVR.

Thank you

[janiedelite]

I've had this done to check my peripheral vascular resistance. They put a tiny blood pressure cuff on each of my toes and compared those measurements to arm cuff BP readings. This was done because my toes were purple for most of the winter of 2008-9. Believe it or not, my peripheral vascular resistance was normal. However, I was lying down. It was after I had a skin biopsy that we saw that it was the capillaries and arterioles that were malfunctioning, causing purple toes.

[HopeSprings]

It was after I had a skin biopsy that we saw that it was the capillaries and arterioles that were malfunctioning, causing purple toes.

Janie - did the biopsy show small fiber neuropathy or something else? What does this refer to?

[juliegee]

Yes, I've had this same testing done before too- several times. I guess mine was normalish too- despite the purplish/black extremities Where did they take the skin biopsy from, Janie? I know you have small fiber neuropathy. Is that how they SURMISED it was the capillaries and arterioles? Did that change your treatment?

I ask as I KNOW I have small fiber neuropathy, but have never been tested. I'm trying to figure out if it is worth it.

Thanks-

Julie

[janiedelite]

I was seeing a dermatologist for the itchy, discolored, painful purple toes. I also had little lumps that would come and go on my toes. He biopsied one of those lumps and it came back as pernio (chilblains). The specific wording of the biopsy said "perivascular lymphohistiocytic infiltrates". Mayo later used that same biopsy a year later to check for small fiber neuropathy. I wish they would have taken a new biopsy for the SFN testing as my burning feet had worsened quite a bit in that year. The biopsy was negative for SFN, but my sensory testing was so abnormal that the Mayo neurologist deemed I have SFN regardless.

What has helped the most in controlling the pernio and purple toes is managing my pooling and blood volume with compression, salt and fluids. Also, stress makes the pernio flare up, even during the summer months. My docs have surmised that I have this peripheral circulatory issues because of the high levels of norepinephrine I produce while upright. Also, I wear wool socks during cold months which helps somewhat.

[juliegee]

That's very helpful, Janie. It doesn't make me feel the need for a skin biopsy as my treatment probably wouldn't change. I, too, get the all over bumps on my hands and feet. I was told they were chillblains. I also wear wool sock- all year long. They are way better than slippers!

Thanks for the great info. I TOLD you we have the same version of this madness

[janiedelite]

Yes, Julie, we are SO similar!!! I'm glad to know that I'm not the only POTS patient that makes their docs tilt their heads, scratch their chins, and say "Huh?"

[HopeSprings]

Chillblains - I get those too! A few popped up a couple of years ago on my toes... itchy and painful. They seemed to be triggered by the cold weather for me because after the winter they went away and only came back the following winter. It does seem that keeping my feet warm in socks lessens or prevents them.

[ramakentesh]

Most patients would probably have this tested. Most patients either exhibit reduced peripheral resistance and increased blood flow in the peripheral vasculature or they experience increased postural peripheral resistance to compensate for increased stomach blood flow in normal flow POTS and overall increased peripheral resistance in low flow POTS and NET deficiency.

Any patient with postural hypertension has increased peripheral resistance.

[ramakentesh]

As for endothelium deficiencies that isnt really a term that works.

The endothelium is just basically the innermost layer of a blood vessel. It is however sensitive to a vast array of different molecules and peptides including inflammatory cytokines, peptides like substance P or Calcitonin gene related peptide, histamine and a whole range of other factors. Nitric oxide also occurs in the nervous system as nNOS and in the immune system as iNOS. Reactive Oxygen Species are of interest in endothelial function and in POTS.

[RichGotsPots]

Well they point to endothelium is damaged as having messed up vaso responses. Meaning if you can test organs and find out if those local endothelium cell are damaged it might provide a clue to why regular med don't work the way they are meant to..

[ramakentesh]

They might in that one reference or study. But there are probably about half a million published research studies on the endothelium and nitric oxide activity. Many conflicting, many not directly relevant to POTS.

And I can see by your response that you havent actually appreciated what I just posted.

[ramakentesh]

As I said above altered endothelial vasoconstrictive and vasodilatory responses can be effected by literally dozens of factors that dont directly relate to actual damage of the endothelial wall.

[RichGotsPots]

I know you have said it and you said there is "probably about half a million published research studies on the endothelium and nitric oxide activity," but can you post a study that backs up what you are saying? My post has stated it from a source, if you disagree perhaps if you posted a study that contradicted my post that would be good support..

And again my question was how many of use have gotten their Endothellium and Vascular resistance tested?