[Assessment of the microcirculation system by laser Doppler flowmetry]

Laser Doppler flowmetry (LDF) is extensively used to study microcirculatory disorders, a main problem facing modern medicine. A wealth of data have been obtained on microcirculation in diabetes mellitus, HD, venous insufficiency and other diseases. This review focuses on basic principles of the method for the assessment of microcirculatory disorders by LDF using the domestically produced equipment. The main elements of the microcirculation system, capillary hemodynamics, and mechanisms of its regulation are described. The main elements and terms of LDF are considered, such as microcirculation index, flux, and variation coefficient along with elements of analysis of the amplitude-frequency fluctuation spectrum and different types of tissue blood flow. Active factors of microcirculation control modulate the blood flow from the vascular wall; their action is mediated through its muscular component. Passive factors cause variations of blood flow outside the microcirculation system; they are the pulsed wave originating from arteries and the sucking action of the venous respiratory pump. Under normal conditions, the vasomotor rhythm driven by the pacemaker in the precapillary segment of the microcirculation bed predominates. The compensatory role of other regulatory mechanisms increases with decreasing contribution of vasomotion to the active modulation of microcirculation hemodynamics. A change in the low to high frequency rhythm ratio reflects the microcirculation index (MI). In case of well-balanced active vasomotor and passive compensatory modulations of tissue blood flow observed in normoemic type of microcirculation, MI amounts to 2.2 ± 0.05. Enhancement of high-frequency and pulsed fluctuation spectra results in a decrease of MI to 1.73 ± 0.04 (hyperemic type) and 1.86 ± 0.053 (hypoemic type).