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Objectives <p>To quantify bilateral cutaneous microvascular responses to unilateral forearm cold-water immersion (CWI) and describe concurrent autonomic cardiac responses.</p> Methods <p>Thirty healthy adults completed a within-subject bilateral experiment with randomized unilateral 5&#xa0;°C forearm immersion. Bilateral fingertip perfusion was recorded by laser Doppler flowmetry (LDF), and heart rate variability was recorded continuously. primary endpoint was the within-participant ipsilateral–contralateral difference in relative perfusion decrease from baseline to nadir during cold exposure. Secondary endpoints were LDF kinetic and recovery outcomes, and heart rate (HR) and heart rate variability (HRV) outcomes were treated as secondary autonomic outcomes. HRV–contralateral perfusion associations were exploratory.</p> Results <p>Resting perfusion was similar between limbs (mean difference, -0.07 perfusion units; 95% CI, -0.22 to 0.08; <i>p</i> = 0.370). For the primary endpoint, the immersed limb showed a greater relative perfusion decrease than the contralateral limb (60.2 ± 2.8% vs. 10.3 ± 1.2%; mean difference, 50.0% points; 95% CI, 48.7 to 51.2; dz = 15.28; adjusted <i>p</i> &lt; 0.001). Secondary LDF endpoints showed earlier vasoconstriction, delayed post-removal peak perfusion, higher peak perfusion, and longer recovery in the immersed limb. Heart rate increased by 9.21&#xa0;bpm, whereas RMSSD and SDNN decreased by 9.28 and 7.44 ms, respectively (all adjusted <i>p</i> &lt; 0.001). Exploratory HRV–contralateral perfusion correlations were not significant.</p> Conclusions <p>Unilateral 5&#xa0;°C forearm immersion elicited a dominant local vasoconstrictive–hyperemic response, smaller contralateral changes, and concurrent autonomic cardiac activation.</p>

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Ipsilateral and contralateral microvascular kinetics during unilateral forearm cold-water immersion: a within-subject laser Doppler flowmetry and heart rate variability study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Magdalena Hagner-Derengowska,
  • Anna Michalska,
  • Viorel Petru Ardelean,
  • Vlad Adrian Geantă,
  • Robert Trybulski

摘要

Objectives

To quantify bilateral cutaneous microvascular responses to unilateral forearm cold-water immersion (CWI) and describe concurrent autonomic cardiac responses.

Methods

Thirty healthy adults completed a within-subject bilateral experiment with randomized unilateral 5 °C forearm immersion. Bilateral fingertip perfusion was recorded by laser Doppler flowmetry (LDF), and heart rate variability was recorded continuously. primary endpoint was the within-participant ipsilateral–contralateral difference in relative perfusion decrease from baseline to nadir during cold exposure. Secondary endpoints were LDF kinetic and recovery outcomes, and heart rate (HR) and heart rate variability (HRV) outcomes were treated as secondary autonomic outcomes. HRV–contralateral perfusion associations were exploratory.

Results

Resting perfusion was similar between limbs (mean difference, -0.07 perfusion units; 95% CI, -0.22 to 0.08; p = 0.370). For the primary endpoint, the immersed limb showed a greater relative perfusion decrease than the contralateral limb (60.2 ± 2.8% vs. 10.3 ± 1.2%; mean difference, 50.0% points; 95% CI, 48.7 to 51.2; dz = 15.28; adjusted p < 0.001). Secondary LDF endpoints showed earlier vasoconstriction, delayed post-removal peak perfusion, higher peak perfusion, and longer recovery in the immersed limb. Heart rate increased by 9.21 bpm, whereas RMSSD and SDNN decreased by 9.28 and 7.44 ms, respectively (all adjusted p < 0.001). Exploratory HRV–contralateral perfusion correlations were not significant.

Conclusions

Unilateral 5 °C forearm immersion elicited a dominant local vasoconstrictive–hyperemic response, smaller contralateral changes, and concurrent autonomic cardiac activation.