(Hypertension. 1995;25:918-923.)
© 1995 American Heart Association, Inc.
Articles |
Measuring Forearm Blood Flow and Interpreting the Responses to Drugs and Mediators
From the Department of Medicine and Therapeutics, University of Aberdeen (Scotland) (N.B.); the Clinical Pharmacology Unit, Department of Pharmacology and Clinical Pharmacology, St George's Hospital Medical School, London (A.C., J.C., B.R., P.V.); and the Department of Medicine, Western General Hospital, University of Edinburgh (Scotland) (D.W.), UK.
Correspondence to Patrick Vallance, Clinical Pharmacology Unit, Department of Pharmacology and Clinical Pharmacology, St George's Hospital Medical School, London SW17 0RE, UK.
Abstract Venous occlusion plethysmography has been widely used to study forearm blood flow. The principle of the technique is straightforward: the rate of swelling of the forearm during occlusion of venous return is used to assess the rate of arterial inflow. Provided that perfusion pressure (arterial blood pressure) remains constant, changes in flow reflect changes in smooth muscle tone in small arteries and arterioles. Local infusion into the brachial artery allows assessment of the direct effect of drugs on vascular tone and has been used to probe the roles of endogenous mediators. The technique is at its most powerful when dose-response relationships to different drugs or mediators within a single study are being compared but can also be used for comparison of responses to drugs between healthy control subjects and patient populations. However, when responses between groups are being compared, it is important to take into account the starting conditions of baseline blood flow and pressure. This article describes venous occlusion plethysmography, discusses the presentation and analysis of data (dose of drug or concentration? forearm blood flow or resistance?), and highlights certain potential problems and limitations of the technique as a means of studying disease states.
Key Words: blood flow • plethysmography • vascular resistance
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A. D. Hingorani, J. Cross, R. K. Kharbanda, M. J. Mullen, K. Bhagat, M. Taylor, A. E. Donald, M. Palacios, G. E. Griffin, J. E. Deanfield, et al. Acute Systemic Inflammation Impairs Endothelium-Dependent Dilatation in Humans Circulation, August 29, 2000; 102(9): 994 - 999. [Abstract] [Full Text] [PDF]
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S. Fichtlscherer, G. Rosenberger, D. H. Walter, S. Breuer, S. Dimmeler, and A. M. Zeiher Elevated C-Reactive Protein Levels and Impaired Endothelial Vasoreactivity in Patients With Coronary Artery Disease Circulation, August 29, 2000; 102(9): 1000 - 1006. [Abstract] [Full Text] [PDF]
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 M. Preik, M. Kelm, P. Rosen, D. Tschope, and B. E. Strauer Additive Effect of Coexistent Type 2 Diabetes and Arterial Hypertension on Endothelial Dysfunction in Resistance Arteries of Human Forearm Vasculature Angiology, July 1, 2000; 51(7): 545 - 554. [Abstract] [PDF]
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M. P Love, C. J Ferro, W. G Haynes, C. Plumpton, A. P Davenport, D. J Webb, and J. J.V McMurray Endothelin receptor antagonism in patients with chronic heart failure Cardiovasc Res, July 1, 2000; 47(1): 166 - 172. [Abstract] [Full Text] [PDF]
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 M. Bayerle-Eder, M. Wolzt, E. Polska, H. Langenberger, J. Pleiner, D. Teherani, G. Rainer, K. Polak, H.-G. Eichler, and L. Schmetterer Hypercapnia-induced cerebral and ocular vasodilation is not altered by glibenclamide in humans Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2000; 278(6): R1667 - R1673. [Abstract] [Full Text] [PDF]
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M. L. H. Honing, P. Smits, P. J. Morrison, and T. J. Rabelink Bradykinin-Induced Vasodilation of Human Forearm Resistance Vessels Is Primarily Mediated by Endothelium-Dependent Hyperpolarization Hypertension, June 1, 2000; 35(6): 1314 - 1318. [Abstract] [Full Text] [PDF]
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S. Ueda, S. Masumori-Maemoto, K. Ashino, T. Nagahara, E. Gotoh, S. Umemura, and M. Ishii Angiotensin-(1-7) Attenuates Vasoconstriction Evoked by Angiotensin II but Not by Noradrenaline in Man Hypertension, April 1, 2000; 35(4): 998 - 1001. [Abstract] [Full Text] [PDF]
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R. Butler, A. D. Morris, J. J. F. Belch, A. Hill, and A. D. Struthers Allopurinol Normalizes Endothelial Dysfunction in Type 2 Diabetics With Mild Hypertension Hypertension, March 1, 2000; 35(3): 746 - 751. [Abstract] [Full Text] [PDF]
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C. A. J. Farquharson and A. D. Struthers Spironolactone Increases Nitric Oxide Bioactivity, Improves Endothelial Vasodilator Dysfunction, and Suppresses Vascular Angiotensin I/Angiotensin II Conversion in Patients With Chronic Heart Failure Circulation, February 15, 2000; 101(6): 594 - 597. [Abstract] [Full Text] [PDF]
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S. Vigili de Kreutzenberg, C. Crepaldi, S. Marchetto, L. Calò, A. Tiengo, S. Del Prato, and A. Avogaro Plasma Free Fatty Acids and Endothelium-Dependent Vasodilation: Effect of Chain-Length and Cyclooxygenase Inhibition J. Clin. Endocrinol. Metab., February 1, 2000; 85(2): 793 - 798. [Abstract] [Full Text]
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K. van der Zander, A. J.H.M Houben, A. A Kroon, and P. W de Leeuw Effects of brain natriuretic peptide on forearm vasculature: comparison with atrial natriuretic peptide Cardiovasc Res, December 1, 1999; 44(3): 595 - 600. [Abstract] [Full Text] [PDF]
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G. Vervoort, J. F. Wetzels, J. A. Lutterman, L. G. van Doorn, J. H. Berden, and P. Smits Elevated Skeletal Muscle Blood Flow in Noncomplicated Type 1 Diabetes Mellitus : Role of Nitric Oxide and Sympathetic Tone Hypertension, November 1, 1999; 34(5): 1080 - 1085. [Abstract] [Full Text] [PDF]
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A. P. Davie and J. J. V. McMurray Effect of Angiotensin-(1-7) and Bradykinin in Patients With Heart Failure Treated With an ACE Inhibitor Hypertension, September 1, 1999; 34(3): 457 - 460. [Abstract] [Full Text] [PDF]
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M. C. Verhaar, R. M. F. Wever, J. J. P. Kastelein, D. van Loon, S. Milstien, H. A. Koomans, and T. J. Rabelink Effects of Oral Folic Acid Supplementation on Endothelial Function in Familial Hypercholesterolemia : A Randomized Placebo-Controlled Trial Circulation, July 27, 1999; 100(4): 335 - 338. [Abstract] [Full Text] [PDF]
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A. P. Davie, H. J. Dargie, and J. J. V. McMurray Role of Bradykinin in the Vasodilator Effects of Losartan and Enalapril in Patients With Heart Failure Circulation, July 20, 1999; 100(3): 268 - 273. [Abstract] [Full Text] [PDF]
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E. Henry, D. E. Newby, D. J. Webb, and C. O’Brien Peripheral Endothelial Dysfunction in Normal Pressure Glaucoma Invest. Ophthalmol. Vis. Sci., July 1, 1999; 40(8): 1710 - 1714. [Abstract] [Full Text] [PDF]
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M. C. Verhaar, M. L.H. Honing, T. van Dam, M. Zwart, H. A. Koomans, J. J.P. Kastelein, and T. J. Rabelink Nifedipine improves endothelial function in hypercholesterolemia, independently of an effect on blood pressure or plasma lipids Cardiovasc Res, June 1, 1999; 42(3): 752 - 760. [Abstract] [Full Text] [PDF]
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D. E. Newby, R. A. Wright, C. Labinjoh, C. A. Ludlam, K. A. A. Fox, N. A. Boon, and D. J. Webb Endothelial Dysfunction, Impaired Endogenous Fibrinolysis, and Cigarette Smoking : A Mechanism for Arterial Thrombosis and Myocardial Infarction Circulation, March 23, 1999; 99(11): 1411 - 1415. [Abstract] [Full Text] [PDF]
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M. Kelm, H. Preik-Steinhoff, M. Preik, and B. E. Strauer Serum nitrite sensitively reflects endothelial NO formation in human forearm vasculature: evidence for biochemical assessment of the endothelial L-arginine-NO pathway Cardiovasc Res, March 1, 1999; 41(3): 765 - 772. [Abstract] [Full Text] [PDF]
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S. J. Cleland, J. R. Petrie, S. Ueda, H. L. Elliott, and J. M. C. Connell Insulin-Mediated Vasodilation and Glucose Uptake Are Functionally Linked in Humans Hypertension, January 1, 1999; 33(1): 554 - 558. [Abstract] [Full Text] [PDF]
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C. M. Stein, H. B. He, and A. J. J. Wood Basal and Stimulated Sympathetic Responses After Epinephrine : No Evidence of Augmented Responses Hypertension, December 1, 1998; 32(6): 1016 - 1021. [Abstract] [Full Text] [PDF]
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P. Pickkers, A. D. Hughes, F. G. M. Russel, T. Thien, and P. Smits Thiazide-Induced Vasodilation in Humans Is Mediated by Potassium Channel Activation Hypertension, December 1, 1998; 32(6): 1071 - 1076. [Abstract] [Full Text] [PDF]
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D E Newby, N E R Goodfield, A D Flapan, N A Boon, K A A Fox, and D J Webb Regulation of peripheral vascular tone in patients with heart failure: contribution of angiotensin II Heart, August 1, 1998; 80(2): 134 - 140. [Abstract] [Full Text]
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S. John, M. Schlaich, M. Langenfeld, H. Weihprecht, G. Schmitz, G. Weidinger, and R. E. Schmieder Increased Bioavailability of Nitric Oxide After Lipid-Lowering Therapy in Hypercholesterolemic Patients : A Randomized, Placebo-Controlled, Double-blind Study Circulation, July 21, 1998; 98(3): 211 - 216. [Abstract] [Full Text] [PDF]
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S. Ueda, J. R. Petrie, S. J. Cleland, H. L. Elliott, and J. M. C. Connell The Vasodilating Effect of Insulin Is Dependent on Local Glucose Uptake: A Double Blind, Placebo-Controlled Study J. Clin. Endocrinol. Metab., June 1, 1998; 83(6): 2126 - 2131. [Abstract] [Full Text]
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J. P Noon, B. R Walker, M. F Hand, and D. J Webb Impairment of forearm vasodilatation to acetylcholine in hypercholesterolemia is reversed by aspirin Cardiovasc Res, May 1, 1998; 38(2): 480 - 484. [Abstract] [Full Text] [PDF]
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D. E Newby, R. A Wright, P. Dawson, C. A Ludlam, N. A Boon, K. A.A Fox, and D. J Webb The L-arginine/nitric oxide pathway contributes to the acute release of tissue plasminogen activator in vivo in man Cardiovasc Res, May 1, 1998; 38(2): 485 - 492. [Abstract] [Full Text] [PDF]
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D. E. Newby, R. Jalan, S. Masumori, P. C. Hayes, N. A. Boon, and D. J. Webb Peripheral vascular tone in patients with cirrhosis: role of the renin-angiotensin and sympathetic nervous systems Cardiovasc Res, April 1, 1998; 38(1): 221 - 228. [Abstract] [Full Text] [PDF]
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