Izvestiya of Saratov University.

Physics

ISSN 1817-3020 (Print)
ISSN 2542-193X (Online)

For citation:

Mashkov K. V., Skripal A. V., Sagaidachnyi A. A., Bakhmetyev A. S. Assessment of microcirculatory tone based on changes in resistive indices of major arteries measured by Doppler ultrasound during an occlusion test. Izvestiya of Saratov University. Physics , 2026, vol. 26, iss. 2, pp. 136-148. DOI: 10.18500/1817-3020-2026-26-2-136-148, EDN: JCJQIQ

This is an open access article distributed under the terms of Creative Commons Attribution 4.0 International License (CC-BY 4.0).
Published online: 
30.06.2026
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Language: 
Russian
Heading: 
Biophysics and medical physics
Article type: 
Article
UDC: 
616-072.7:612.13:612.135
DOI: 
10.18500/1817-3020-2026-26-2-136-148
EDN: 
JCJQIQ

Assessment of microcirculatory tone based on changes in resistive indices of major arteries measured by Doppler ultrasound during an occlusion test

Autors: 
Mashkov Konstantin V., Saratov State University
Skripal Anatoly Vladimirovich, Saratov State University
Sagaidachnyi Andrey Aleksandrovich, Saratov State University
Bakhmetyev Artem Sergeevich, Saratov State Medical University named after V. I. Razumovsky
Abstract: 

Background and Objectives: This study investigates the quantitative assessment of microcirculatory vascular tone using ultrasound Dopplerography after an occlusion test. The objective was to establish the relationship between changes in resistance indices of major arteries, volumetric blood flow, and the functional state of the microcirculatory bed. Materials and Methods: The study included 8 healthy volunteers (4 males and 4 females) with a mean age of 20 ± 2 years. Spectral Doppler waveforms were recorded in the brachial artery distal to the cuff occlusion site. The occlusion test was performed for 3 min, followed by continuous Doppler recording from the moment of cuff release until restoration of baseline hemodynamic parameters. The resistance index was calculated based on the retrograde component of blood flow, taking into account the direction of velocity depending on peripheral resistance conditions. Volumetric blood flow Q was calculated automatically using the time-averaged linear flow velocity measured by pulsed-wave Doppler and the brachial artery diameter obtained in B-mode. Given the limited sample size (n = 8), paired comparisons were conducted using the nonparametric Wilcoxon signed-rank test. Results: Immediately after cuff release, a pronounced hyperemic response has been observed, characterized by the elevated systolic blood flow velocity and a positive retrograde component that persisted for several seconds. Within approximately 20 s, the Doppler waveform evolved into a triphasic pattern, indicating a gradual increase in peripheral vascular resistance. This transition is accompanied by a decrease in systolic velocity and a change in the direction of the retrograde component. After 60 s, a fully developed triphasic flow pattern has been observed, reflecting restoration of vascular tone. The inverse relationship between the resistance index and volumetric blood flow has been identified. Based on this relationship, a new parameter reflecting microcirculatory tone has been introduced, demonstrating sensitivity to dynamic changes during post-occlusive recovery. Conclusion: The proposed approach allows for continuous assessment of peripheral vascular tone using ultrasound Dopplerography. The use of the retrograde flow component enables one to overcome the methodological limitations of conventional indices and improve the reliability of measurements under different flow patterns.

Key words: 
resistive index
Doppler ultrasound
occlusion test
microcirculation
vascular tone
post-occlusive reactive hyperemia
volumetric blood flow
retrograde blood flow
Acknowledgments: 
This study was supported by the Russian Science Foundation (project No. 25-25-01101, https://rscf.ru/project/25-25-01101/).
Reference: 
  1. Litvitskiy P. F. Impairments of regional blood flow and microcirculation. Regional Circulation and Microcirculation, 2020, vol. 19, no. 1, pp. 82–92 (in Russian). https://doi.org/10.24884/1682-6655-2020-19-1-82-92
  2. Korolev A. I., Fedorovich A. A., Gorshkov A. Yu., Drapkina O. M. Skin microcirculation in essential arterial hypertension. Regional Circulation and Microcirculation, 2020, vol. 19, no. 2, pp. 4–10 (in Russian). https://doi.org/10.24884/1682-6655-2020-19-2-4-10
  3. Jackson W. F. Myogenic tone in peripheral resistance arteries and arterioles: The pressure is on! Frontiers in Physiology, 2021, vol. 12, art. 699517. https://doi.org/10.3389/fphys.2021.699517
  4. Fedorovich A. A., Gorieva Sh. B., Rogoza A. N., Chikhladze N. M. Functional state of arteriolar and venular skin microvessels in patients with hypertension. Regional Circulation and Microcirculation, 2014, vol. 13, no. 3, pp. 45–60 (in Russian). https://doi.org/10.24884/1682-6655-2014-13-3-45-60
  5. Mućka S., Miodońska M., Jakubiak G. K., Starzak M., Cieślar G., Stanek A. Endothelial function assessment by flow-mediated dilation method: A valuable tool in the evaluation of the cardiovascular system. International Journal of Environmental Research and Public Health, 2022, vol. 19, iss. 18, art. 11242. https://doi.org/10.3390/ijerph191811242
  6. Levy B. I., Schiffrin E. L., Mourad J. J., Agostini D., Vicaut E., Safar M. E., Struijker-Boudier H. A. Impaired tissue perfusion: A pathology common to hypertension, obesity, and diabetes mellitus. Circulation, 2008, vol. 118, no. 9, pp. 968–976. https://doi.org/10.1161/CIRCULATIONAHA.107.763730
  7. Giudici A., Wilkinson I. B., Khir A. W. Review of the techniques used for investigating the role elastin and collagen play in arterial wall mechanics. IEEE Reviews in Biomedical Engineering, 2021, vol. 14, pp. 256–269. https://doi.org/10.1109/RBME.2020.3005448
  8. Reesink K. D., Spronck B. Constitutive interpretation of arterial stiffness in clinical studies: A methodological review. American Journal of Physiology – Heart and Circulatory Physiology, 2019, vol. 316, no. 3, pp. H693–H709. https://doi.org/10.1152/ajpheart.00388.2018
  9. Boutouyrie P., Chowienczyk P., Humphrey J. D., Mitchell G. F. Arterial stiffness and cardiovascular risk in hypertension. Circulation Research, 2021, vol. 128, no. 7, pp. 864–886. https://doi.org/10.1161/CIRCRESAHA.121.318061
  10. Regnault V., Lacolley P., Laurent S. Arterial Stiffness: From Basic Primers to Integrative Physiology. Annual Review of Physiology, 2024, vol. 86, pp. 99–121. https://doi.org/10.1146/annurev-physiol-042022-031925
  11. Spronck B. Stiff vessels approached in a flexible way: Advancing quantification and interpretation of arterial stiffness. Artery Research, 2018. vol. 21, pp. 63–68. https://doi.org/10.1016/j.artres.2017.11.006
  12. Rogatkin D. A., Ivlieva A. L., Shtiflyuk M. E. Cumulative assessment of tone and reactivity of the microvascular bed based on in vivo optical flowmetry data. Justification of the approach. Meditsinskaja fizika, 2024, no. 3, pp. 65–82. (in Russian). https://doi.org/10.52775/1810-200X-2024-103-3-65-82
  13. Sagaidachnyi А. А. Occlusion test: Methods of analysis, reaction mechanisms, application prospects. Regional Circulation and Microcirculation, 2018, vol. 17, no. 3, pp. 5–22 (in Russian). https://doi.org/10.24884/1682-6655-2018-17-3-5-22
  14. Rosenberry R., Nelson M. D. Reactive hyperemia: A review of methods, mechanisms, and considerations. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology, 2020, vol. 318, no. 3, pp. R605–R618. https://doi.org/10.1152/ajpregu.00339.2019
  15. Philpott A., Anderson T. J. Reactive hyperemia and cardiovascular risk. Arteriosclerosis, Thrombosis, and Vascular Biology, 2007, vol. 27, no. 10, pp. 2065–2067. https://doi.org/10.1161/ATVBAHA.107.149740
  16. Coccarelli A., Nelson M. D. Modeling reactive hyperemia to better understand and assess microvascular function: A review of techniques. Annals of Biomedical Engineering, 2023, vol. 51, no. 3, pp. 479–492. https://doi.org/10.1007/s10439-022-03134-5
  17. Laurent S., Agabiti-Rosei C., Bruno R. M., Rizzoni D. Microcirculation and macrocirculation in hypertension: A dangerous cross-link? Hypertension, 2022, vol. 79, no. 3, pp. 479–490. https://doi.org/10.1161/HYPERTENSIONAHA.121.17962
  18. Fedorovich A. A., Korolev A. I., Ososkov V. S., Samatova K. S., Drapkina O. M. New trends in the development of noninvasive assessment of human skin microcirculation: A descriptive review. Cardiovascular Therapy and Prevention, 2025, vol. 24, no. 6, art. 4412 (in Russian). https://doi.org/10.15829/1728-8800-2025-4412
  19. Korolev A. I., Ososkov V. S., Fedorovich A. A., Chashhin M. G., Dadaeva V. A., Strelkova A. V., Omel’janenko K. V., Mihajlova M. A., Gorshkov A. Yu., Drapkina O. M. Structural and functional state of the skin microcirculation in men with various phenotypes of arterial hypertension with low and moderate cardiovascular risk. Cardiovascular Therapy and Prevention, 2024, vol. 23, no. 10, art. 4133 (in Russian). https://doi.org/10.15829/1728-8800-2024-4133
  20. Wielicka M., Neubauer-Geryk J., Kozera G., Bieniaszewski L. Clinical application of pulsatility index. Medical Research Journal, 2020, vol. 5, no. 3, pp. 201–210. https://doi.org/10.5603/MRJ.a2020.0016
  21. Dong Y., Wang W. P., Ignee A., Zuo D., Qiu Y. J., Zhang Q., Lu X. Y., Chen S., Dietrich C. F. The diagnostic value of Doppler Resistive Index in the differential diagnosis of focal liver lesions. Journal of Ultrasonography, 2023, vol. 23, iss. 93, pp. e45–e52. https://doi.org/10.15557/JoU.2023.0010
  22. Wen W., Zhang Y., Jia G., Chi Y. Exploring coronary microvascular dysfunction from functional impairment and structural damage. Frontiers in Cardiovascular Medicine, 2026, vol. 12, art. 1600947. https://doi.org/10.3389/fcvm.2025.1600947
  23. Damianaki A., Hendriks-Balk M., Brito W., Polychronopoulou E., Theiler K., Maillard M., Maurer J., Eugster P., Pruijm M., Wuerzner G. Contrast-enhanced ultrasonography reveals a lower cortical perfusion and a decreased renal flow reserve in hypertensive patients. Nephrology Dialysis Transplantation, 2024, vol. 39, no. 2, pp. 242–250. https://doi.org/10.1093/ndt/gfad158
  24. Pijls N. H., Keulards D. C. J., Kakuta T, Amano T., Ando H., Tanaka N., Mahendiran T., Takumi T., Matsuo H., Keeble T. R., Damman P., Fearon W. F., Mizukami T., Tonino P. A. L., Alfonso F., De Bruyne B, Akasaka T. Absolute coronary blood flow measurement and the principle of microvascular resistance reserve. Cardiovascular Intervention and Therapeutics, 2026, vol. 41, pp. 305–320. https://doi.org/10.1007/s12928-025-01211-9
  25. Li Z., Liu H., Li M., Liu S., Pan X., Zhao H., Xue Ch., Xu D. Effects of resistance exercise intensity on cerebral blood flow and cerebrovascular reactivity in healthy young males: A pilot study. Physiological Reports, 2025, vol. 13, iss. 9, art. e70361. https://doi.org/10.14814/phy2.70361
  26. Skripal An. V., Fomin A. V., Bakhmetyev A. S., Brilenok N. B., Sagaidachnyi A. A., Dobdin S. Y., Tikhonova A. S. Diagnostics of arterial vessels of athletes using Doppler ultrasound measurement. Izvestiya of Saratov University. Physics, 2022, vol. 22, iss. 2, pp. 141–148 (in Russian). https://doi.org/10.18500/1817-3020-2022-22-2-141-148
  27. Savicheva A. A., Berns S. A., Isajkina O. Ju., Gorshkov A. Ju., Veremeev A. V., Drapkina O. M. Laboratory and instrumental assessment of endothelial function associated with vascular stiffness: Current status and future perspectives. Cardiovascular Therapy and Prevention, 2025, vol. 24, no. 6, pp. 106–113 (in Russian). https://doi.org/10.15829/1728-8800-2025-4426
  28. Nohria A., Gerhard-Herman M., Creager M. A., Hurley S., Mitra D., Ganz P. Role of nitric oxide in the regulation of digital pulse volume amplitude in humans. Journal of Applied Physiology, 2006, vol. 101, iss. 2, pp. 545–548. https://doi.org/10.1152/japplphysiol.01285.2005
  29. Thijssen D .H. J., Black M. A., Pyke K. E., Padilla J., Atkinson G., Harris R. A., Parker B., Widlansky M. E., Tschakovsky M. E., Green D. J. Assessment of flow-mediated dilation in humans: A methodological and physiological guideline. American Journal of Physiology – Heart and Circulatory Physiology, 2011, vol. 300, iss. 1, pp. H2–H12. https://doi.org/10.1152/ajpheart.00471.2010
  30. Pradhan R. K. Effect of myogenic tone on agonist-mediated vasoconstriction in isolated arteries: A computational study. Computer Methods and Programs in Biomedicine, 2025, vol. 258, art. 108495. https://doi.org/10.1016/j.cmpb.2024.108495
  31. Davis M. J., Earley S., Li Y. S., Chien S. Vascular Mechanotransduction. Physiological Reviews, 2023, vol. 103, no. 2, pp. 1247–1421. https://doi.org/10.1152/physrev.00053.2021
  32. Cui Y., Gollasch M., Kassmann M. Arterial myogenic response and aging. Ageing Research Reviews, 2023, vol. 84, art. 101813. https://doi.org/10.1016/j.arr.2022.101813
Received: 
31.03.2026
Accepted: 
27.04.2026
Published: 
30.06.2026
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