[Vascular endothelium as a target for therapeutic action]

Proceeding from semi-centennial successful experience of clinical application of Actovegin in various-aetiology diseases of the vascular bed of the lower limbs, the present study was aimed at assessing interconnection between metabolic and microhaemodynamic processes in the human skin. Activation of metabolic processes was achieved by means of intravenous infusions of Actovegin and the microcirculatory processes were investigated using non-invasive methods in a total of 28 apparently healthy volunteers. The functional state of the arteriolar and venular portions of the microcirculatory bed of the skin was evaluated by means of laser Doppler flowmetry with wavelet analysis of oscillations of blood flow in the skin of the right forearm, while the parameters of the capillary blood flow were assessed by means of computer-assisted capillaroscopy in the nail bed of the 4th finger of the right hand. The known metabolic effects of Actovegin were accompanied and followed by a reliable increase in the amplitude of vasomotions within the range of the endothelial, neurogenic, and myogenic rhythms, suggesting a decrease in tonicity of the precapillary arterioles and, consequently, increased velocity of the capillary blood flow and decreased dimensions of the pericapillary zone, thus indicating improved metabolic processes in the skin. The obtained findings demonstrate close relationship between the processes of metabolism and microhaemodynamics, making it possible to suppose that amplitude activity within the range of the endothelial rhythm (0,0095-0,021 Hz) on laser Doppler flowmetry reflects not only the vasomotor but also metabolic function of the microvascular endothelium.