Endothelial dysfunction and the state of the microcirculatory bed in patients with obliterating atherosclerosis of the arteries of the lower extremities of the femoral-popliteal-tibial segment

Introduction. Endothelial dysfunction is a predictor of the development and progression of atherosclerosis, in particular, obliterating atherosclerosis of the arteries of the lower extremities.The purpose of the study. To study the relationship between endothelial dysfunction and the state of the microcirculatory bed in patients with obliterating atherosclerosis of the arteries of the lower extremities with lesions of the femoral-popliteal-tibial segment.Materials and methods of research. The content of markers of endothelial dysfunction, endothelium-dependent vasodilation of the brachial artery and microcirculatory bed was assessed in 135 patients with obliterating atherosclerosis of the arteries of the lower extremities of the femoral-popliteal-tibial segment with stage III-IV according to the Fontaine-Pokrovsky classification. The patients were divided into two groups, one group with stage III ischemia, the other with stage IV limb ischemia.Results and discussion. The results of the study showed that there is a statistically significant increase in the level of markers of endothelial dysfunction, a decrease in endothelium-dependent vasodilation of the brachial artery. Higher values of these parameters were found in patients with stage IV ischemia. In patients with grade III limb ischemia, according to computer capillaroscopy, the number of linear working capillaries was 5,5±2,4 pcs. per 1 mm2, and the number of working capillaries by area was 16,7±5,3 pcs. per 1 mm2, with grade IV ischemia, the number of linear working capillaries was 3,3±1,3 pcs. per 1 mm2, and the number of working capillaries by the area is 5,7± 2,8 pieces per 1 mm2.Conclusion. In case of obliterating atherosclerosis of the arteries of the lower extremities of the femoral-popliteal-tibial segment with stage III-IV, according to the Fontaine-Pokrovsky classification, the phenomenon of endothelial dysfunction and changes in the microcirculatory bed, more pronounced in the IV degree of ischemia, is noted.