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Orthostatic response of cephalic blood flow using a mini laser Doppler blood flowmeter and hemodynamics of a new active standing test

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Abstract

Purpose

Cephalic hemodynamic assessment is important in initial orthostatic hypotension. We sought to investigate cephalic blood flow (CBF) in the earlobe using a mini laser Doppler flowmeter (LDF) during orthostatic challenge. In addition, we clarified hemodynamic differences during a new active standing protocol using a footstool standing test (FST) with bending of the legs on the footstool in the sitting position to reduce the load of the squatting posture in the conventional squat standing test (SST).

Methods

Ten healthy men (21 ± 0.5 years) performed the SST after a 1 min squat and the FST after a 1 min load consisting of bending the legs on a footstool in the sitting position. Earlobe CBF, beat-to-beat arterial blood pressure (ABP), mean arterial blood pressure (MAP), and heart rate (HR) were recorded during each test.

Results

Earlobe CBF showed a transient fall synchronized with the ABP during each test. No significant differences in the recovery times (RTs) of CBF and MAP were observed during the SST (CBF 12.9 ± 0.6 s vs. MAP 12.1 ± 0.5 s, P = 0.313) and FST (CBF 10.6 ± 0.4 s vs. MAP 10.1 ± 0.8 s, P = 0.552). Although the CBF and ABP decreases were not different in each test, the HR increase was significantly lower with the FST (24 ± 2 bpm) than with the SST (31 ± 3 bpm, P < 0.005).

Conclusions

Earlobe CBF reflects the compensatory ABP regulatory response during standing and is potentially useful for estimating the orthostatic ABP response indirectly. Furthermore, the FST is a low-load protocol that can be an effective protocol for a standing test of cardiac function.

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Abbreviations

ABP:

Arterial blood pressure

BF:

Blood flow

CBF:

Cephalic blood flow

CO:

Cardiac output

DT:

Decrease time

FST:

Footstool standing test

HR:

Heart rate

HUT:

Head-up tilt

IOH:

Initial orthostatic hypotension

IT:

Increase time

LDF:

Laser Doppler flowmeter

MAP:

Mean arterial blood pressure

RT:

Recovery time

SST:

Squat standing test

SFR:

Sympathetic flow response

SV:

Stroke volume

TPR:

Total peripheral resistance

References

  • Aaslid R, Markwalder TM, Nornes H (1982) Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg 57:769–774

    Article  CAS  PubMed  Google Scholar 

  • Barantke M, Krauss T, Ortak J, Lieb W, Reppel M, Burgdorf C, Pramstaller P, Schunkert H, Bonnemeier H (2008) Effects of gender and aging on differential autonomic responses to orthostatic maneuvers. J Cardiovasc Electrophysiol 19:1296–1303

    Article  PubMed  Google Scholar 

  • Bonner R, Nossal R (1981) Model for laser Doppler measurements of blood flow in tissue. Appl Opt 20:2097–2107

    Article  CAS  PubMed  Google Scholar 

  • Borst C, van Brederode J, Wieling W, van Montfrans G, Dunning AJ (1984) Mechanisms of initial blood pressure response to postural change. Clin Sci (Lond) 67:321–327

    Article  CAS  Google Scholar 

  • Borst C, Wieling W, van Brederode J, Hond A, de Rijk L, Dunning A (1982) Mechanisms of initial heart rate response to postural change. Am J Physiol 243:H676–H681

    CAS  PubMed  Google Scholar 

  • Convertino V, Tripp LD, Ludwig DA, Duff J, Chelette TL (1998) Female exposure to high G: chronic adaptations of cardiovascular functions. Aviat Space Environ Med 69:875–882

    CAS  PubMed  Google Scholar 

  • de Mul FFM, van Spijker J, van der Plas D, Greve J, Aarnoudse J, Smits T (1984) Mini laser-Doppler (blood) flow monitor with diode. Appl Opt 23:2970–2973

    Article  PubMed  Google Scholar 

  • Hilz M (2002) Assessment and evaluation of hereditary sensory and autonomic neuropathies with autonomic and neurophysiological examinations. Clin Auton Res 12:133–143

    Article  Google Scholar 

  • Imholz BP, Settels JJ, van der Meiracker AH, Wesseling KH, Wieling W (1990) Non-invasive continuous finger blood pressure measurement during orthostatic stress compared to intra-arterial pressure. Cardiovasc Res 24:214–221

    Article  CAS  PubMed  Google Scholar 

  • Lipsitz L (1989) Orthostatic hypotension in the elderly. N Engl J Med 321:952–957

    Article  CAS  PubMed  Google Scholar 

  • Low P, Neumann C, Dyck P, Fealey R, Tuck R (1983) Evaluation of skin vasomotor reflexes by using laser Doppler velocimetry. Mayo Clin Proc 58:583–592

    CAS  PubMed  Google Scholar 

  • Obeid AN, Barnett NJ, Dougherty G, Ward G (1990) A critical review of laser Doppler flowmetry. J Med Eng Technol 14:178–181

    Article  CAS  PubMed  Google Scholar 

  • Oimomi M, Nishimoto S, Matsumoto S, Hatanaka H, Ishikawa K, Baba S (1985) Evaluation of periflux blood flow measurement in diabetic patients with autonomic neuropathy. Diabetes Res Clin Pract 1:81–85

    Article  CAS  PubMed  Google Scholar 

  • Peuker ET, Filler TJ (2002) The nerve supply of the human auricle. Clin Anat 15:35–37

    Article  PubMed  Google Scholar 

  • Philips JC, Scheen AJ (2011) Squatting test: a posture to study and counteract cardiovascular abnormalities associated with autonomic dysfunction. Auton Neurosci 162:3–9

    Article  PubMed  Google Scholar 

  • Rickards CA, Newman DG (2003) A comparative assessment of two techniques for investigating initial cardiovascular reflexes under acute orthostatic stress. Eur J Appl Physiol 90:449–457

    Article  PubMed  Google Scholar 

  • Rossberg F, Penaz J (1988) Initial cardiovascular response on change of posture from squatting to standing. Eur J Appl Physiol Occup Physiol 57:93–97

    Article  CAS  PubMed  Google Scholar 

  • Rowell L (1993) Human cardiovascular control. Oxford University Press, New York, pp 443–444

    Google Scholar 

  • Scheen AJ, Philips JC (2012) Squatting test a dynamic postural manoeuvre to study baroreflex sensitivity. Clin Aut Res 22:35–41

    Article  Google Scholar 

  • Serov AN, Nieland J, Oosterbaan S, de Mul FFM, van Kranenburg H, Bekman HHPT, Steenbergen W (2006) Integrated optoelectronic probe including a vertical cavity surface emitting laser for laser Doppler perfusion monitoring. IEEE Trans Biomed Eng 53:2067–2074

    Article  PubMed  Google Scholar 

  • Shi X, Huang G, Smith S, Zhang R, Formes K (2003) Aging and arterial blood pressure variability during orthostatic challenge. Gerontology 49:279–286

    Article  PubMed  Google Scholar 

  • Sprangers R, Wesseling K, Imholz A, Imholz B, Wieling W (1991) Initial blood pressure fall on stand up and exercise explained by changes in total peripheral resistance. J Appl Physiol 70:523–530

    Article  CAS  PubMed  Google Scholar 

  • Tanaka H, Sjöberg BJ, Thulesius O (1996) Cardiac output and blood pressure during active and passive standing. Clin Physiol 16:157–170

    Article  CAS  PubMed  Google Scholar 

  • Thomas KN, Cotter JD, Galvin SD, Williams MJA, Willie CK, Ainslie PN (2009) Initial orthostatic hypotension is unrelated to orthostatic tolerance in healthy young subjects. J Appl Physiol 107:506–517

    Article  PubMed  Google Scholar 

  • Thrasher TN (2005) Baroreflex control of sodium excretion and arterial pressure baroreceptors, baroreceptor unloading, and the long-term control of blood pressure. Am J Physiol Regul Integr Comp Physiol 288:R819–R827

    Article  CAS  PubMed  Google Scholar 

  • Toska K, Eriksen M, Walløe L (1994) Short-term cardiovascular responses to a step decrease in peripheral conductance in humans. Am J Physiol 266:H199–H211

    CAS  PubMed  Google Scholar 

  • Tschakovsky ME, Matusiak K, Vipond C, McVicar L (2011) Lower limb-localized vascular phenomena explain initial orthostatic hypotension upon standing from squat. Am J Physiol Heart Circ Physiol 301:H2102–H2112

    Article  CAS  PubMed  Google Scholar 

  • Vaddadi G, Lambert E, Corcoran SJ, Esler MD (2007) Postural syncope: mechanisms and management. Med J Aust 187:299–304

    PubMed  Google Scholar 

  • Van der Velde N, van den Meiracker AH, Stricker BHC, van der Cammen TJM (2007) Measuring orthostatic hypotension with the Finometer device: is a blood pressure drop of one heartbeat clinically relevant? Blood Press Monit 12:167–171

    Article  PubMed  Google Scholar 

  • Wieling W, Harms M, ten Harkel A, van Lieshout J, Sprangers R (1996) Circulatory response evoked by a 3 s bout of dynamic leg exercise in humans. J Physiol 494:601–611

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Wieling W, Krediet CTP, van Dijk N, Linzer M, Tschakovsky ME (2007) Initial orthostatic hypotension: review of a forgotten condition. Clin Sci (Lond) 112:157–165

    Article  Google Scholar 

  • Yamaguchi H, Tanaka H, Adachi K, Mino M (1996) Beat-to-beat blood pressure and heart rate responses to active standing in Japanese children. Acta Paediatr 85:577–583

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to sincerely thank the subjects for their interest and cooperation.

Conflict of interest

Financial support of collaboration for this study was provided by the Pioneer Corporation. M. Goma and Y. Kimura are employed by Pioneer Corporation.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Cyuo-shi, Yamanashi, 409-3898, Japan

    Masaki Goma

  2. Research and Development Division, Pioneer Corporation, 1-1 Shin-Ogura, Saiwai-ku, Kawasaki-shi, Kanagawa, 212-0031, Japan

    Masaki Goma & Yoshinori Kimura

  3. Department of Laboratory Medicine, School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima-shi, Fukushima, 960-1295, Japan

    Hiroki Shimura

  4. Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Cyuo-shi, Yamanashi, 409-3898, Japan

    Masahiro Kaneshige & Tetsuro Kobayashi

  5. Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Tetsuro Kobayashi

  6. Department of Biomedical Engineering, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama, 350-8585, Japan

    Masashi Kikuchi & Nobuyuki Terada

Authors
  1. Masaki Goma
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  2. Yoshinori Kimura
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  3. Hiroki Shimura
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  4. Masahiro Kaneshige
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Correspondence to Masaki Goma.

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Communicated by Massimo Pagani.

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Goma, M., Kimura, Y., Shimura, H. et al. Orthostatic response of cephalic blood flow using a mini laser Doppler blood flowmeter and hemodynamics of a new active standing test. Eur J Appl Physiol 115, 2167–2176 (2015). https://doi.org/10.1007/s00421-015-3197-6

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  • DOI: https://doi.org/10.1007/s00421-015-3197-6

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