By using nailfold videomicroscopy in conjunction with local exposure of 60 s to cold air, the acute haemodynamic responses in capillary blood cell velocity 60 min after a single oral dose of 20 mg sustained-released nifedipine and 20 mg ketanserin were evaluated for each substance in 12 patients with vasospastic disease. The results obtained showed that the cold-induced flow stop duration was significantly (P < 0.05) decreased and capillary blood cell velocity significantly (P < 0.05) increased after local cooling. Systolic and diastolic blood pressure, heart rate and skin temperature did not differ significantly before and after treatment with either nifedipine or ketanserin. It is concluded that nifedipine and ketanserin are useful agents in the treatment of digital vasospastic disease. Furthermore, in vivo videomicroscopy is one of the few non-invasive and clinically useful direct methods for evaluating the effect of a drug on the microcirculation of normal and ischaemic skin areas.
RaynaudAGMOn Local Asphyxia and Symmetrical Gangrene of the Extremities. Selected Monographs No. 121 (transl. Bawlow T). London: New Sydenham Society, 1888.
2.
AllenEVBrownGERaynaud's disease: a critical review of minimal requisites for diagnosis. Am J Med Sci1932; 183: 187–200.
KeenanEJPorterJMAlpha-2 adrenergic receptors in platelets from patients with Raynaud's syndrome. Surgery1983; 94: 204–209.
5.
KahalleMBOsbomILe RoyECElevated levels of circulatory platelet aggregates and beta-thromboglobulin in scleroderma. Ann Intern Med1982; 96: 610–613.
6.
GoyleKBDormandyJAAbnormal blood viscosity in Raynaud's phenomenon. Lancet1976; i: 1317–1318.
7.
McGrathMAPeckRPennyRBlood hyperviscosity with reduced skin blood flow in sclera derma. Ann Rheum Dis 1977; 36: 569–574.
8.
BluntRJGeorgeASHurlowRAHyperviscosity and thrombotic changes in idiopathic and secondary Raynaud's syndrome. Br J Haematol1980; 45: 657–661.
9.
DoddsAJO'ReilyMJGYatesCJPHaemorheological response to plasma exchange in Raynaud's syndrome. Br Med J1979; ii: 1186–1187.
10.
CunliffeWJMenonISBlood fibrinolytic activity in diseases of small blood vessels and the effect of low molecular weight dextran. Br J Dermatol1969; 81: 220–225.
11.
BrowseNLGrayLJarretPEBlood and vein-wall fibrinolytic activity in health and vascular disease. Br Med J1977; i: 478–481.
12.
HalpernAKuhnPHShaftelHERaynaud's phenomenon and serotonin. Angiology1960; 11: 151–167.
13.
CoffmanJDDrug options for vasospastic disease. Drug Therapy1984; 1: 145–159.
14.
Van NuetenJMVanhouttePMCalcium-entry blockers and vasospasm. In: Vasodilatation (VanhouttePMLeusenI eds). New York: Raven Press, 1981; pp 459–468.
15.
TrenkDMoslerAKirchWPharmacokinetics and pharmacodynamics of the 5-HT2-receptor antagonist ketanserin in man. J Cardiovasc Pharmacol1983; 5: 1034–1039.
16.
FagrellBMonitoring the effects of vasoactive drugs by capillaroscopy and capillary blood flow velocity measurement. Int Angiol1983; 2: 153–158.
17.
MahlerFSanerHBossCLocal cold exposure test for capillaroscopic examination of patients with Raynaud's syndrome. Microvasc Res1987; 33: 422–427.
18.
GasserPCapillary blood cell velocity in finger nailfold: characteristics and reproducibility of the local cold response. Microvasc Res1990; 40: 29–35.
BossCSchneuwlyPMahlerFEvaluation and clinical application of the flying spot method in nailfold capillary TV-microscopy. Int J Microcirc Clin Exp1987; 6: 15–23.
21.
CookeEDNicolaidesANRaynaud's syndrome. Br Med J1990; i: 553–555.
22.
OstergrenJFagrellBVideophotometric capillaroscopy for evaluating drug effects on skin microcirculation – double-blind study with nifedi pine. Clin Physiol1984; 4: 169–176.
23.
NilssonHJonassonTLeppertJThe effect of the calcium entry blocker nifedipine on cold-induced vasospasm. Acta Med Scand1987; 221: 53–60.
24.
CreagerMAPariserKMWionstonEMNifedipine-induced fingertip vasodilatation in patients with Raynaud's phenomenon. Am Heart J1984; 108: 370–376.
25.
GushRJTaylorLJJaysonMIVAcute effects of sublingual nifedipine in patients with Raynaud's phenomenon. J Cardiovasc Pharmacol1987; 9: 628–631.
26.
WiseRAMalametRWigleyFMAcute effects of nifedipine on digital blood flow in human subjects with Raynaud's phenomenon and in scleroderma: oral versus sublingual hemodynamic effects. J Rheumatol1987; 14: 278–283.
27.
WollersheimHThienTvan't LaarANifedipine in primary Raynaud's phenomenon and in scleroderma: oral versus sublingual hemodynamic effects. J Clin Pharmacol1987; 27: 907–913.
28.
BrouwerRMLWentingGJVisserWDoes serotonin receptor blockade have a therapeutic effect in Raynaud's phenomenon?Vasa [Suppl]1987; 18: 64–67.
29.
SeiboldJRTerreginoCASelective antagonism of S2-serotonergic receptors relieves but does not prevent cold induced vasoconstriction in primary Raynaud's phenomenon. J Rheumatol1986; 13: 337–340.
30.
LongstaffJGushRWilliamsEHEffect of ketanserin on peripheral blood flow, haemorheology, and platelet function in patients with Raynaud's phenomenon. J Cardiovasc Pharmacol1985; 7 (suppl 7): S99–S105.
31.
KirchWLinderHRHuttHJKetanserin versus nifedipine in secondary Raynaud's phenomenon. Vasa1987: 16: 77–80.
32.
CoffmanJDClementDLCreagerMAInternational study of ketanserin in Raynaud's phenomenon. Am J Med1989; 87: 264–268.
33.
GasserPFlammerJShort- and long-term effect of nifedipine on the visual field in patients with presumed vasospasm. J Int Med Res1990; 18: 334–339.
