Digital Blood Flow in Cooled and Contralateral Finger in Patients with Raynaud's Phenomenon. Comparative Measurements Between Photoelectrical Plethysmography and Laser Doppler Flowmetry

Abstract

The effects of cooling of a hand on lateral and contralateral digital skin blood flow were investigated in 18 patients with primary or secondary Raynaud's phenomenon. The aim of the study was to compare photoelectrical plethsmog raphy (PhEP) and laser Doppler flowmetry (LDF). PhEP and LDF were used simultaneously for skin blood flow measurements of the third finger of both hands. One hand was cooled in water from 33 ° to 3 ° C in steps of 3 ° C, each step lasting four minutes. It was followed by a recovery period of ten minutes in room air of 24 ° C. During stepwise cooling from 33 ° to 9 ° C the relative PhEP and LDF values, measured on the cooled hand, decreased to 6.2% ± 3.2% and 10% ± 12% respectively. The correlation coefficients between LDF and PhEP varied between 0.79 and 0.99. In the contralateral hand the relative PhEP and LDF values decreased to 38% ± 30.% and 64% ± 7.9% respec tively. The correlation coefficients between LDF and PhEP values were lower on the contralateral hand and ranged from 0.26 to 0.95. By calculating the LDF/PhEP ratios during cooling and recovery, more specific changes in red blood cell velocities during cooling were studied. Increasing LDF/PhEP ratios suggest increasing red blood cell velocities during cooling at 9 ° C and a difference in the measuring methods. For testing the severity of Raynaud's phenomenon and the effect of treatment the results of both methods show consistent and quite comparable results when measured on the cooled hand. The effect of indirect cooling on the contralateral hand is, however, less consistent.