Circulatory Disorders

Top class magnetic therapy

Background Peripheral Artery Disease

A circulatory disorder or in the technical term "peripheral arterial occlusive disease (PAD)" is one of the most neglected diseases in preventive diagnostics, since it initially develops completely painlessly and gradually. It is a common side effect of diabetes mellitus and in many cases also indicates tobacco consumption, high blood pressure, high blood lipid levels, but also sedentary lifestyle. According to a nationwide study (6,880 patients / 65 years and older), one in five should suffer from an incipient or even advanced circulatory disorder in the lower extremity without having noticed it [1] .


In a previous study, 11.7% of the elderly suffered from an attack on the large blood vessels and 16.0% had serious changes in the small blood vessels [2] . The most common cause is arteriosclerosis, which often begins with a narrowing or occlusion of the pelvic leg arteries. There are even estimates that the frequency of PAD is about five times higher than that described in the specialist literature [3] .


Only when the blood circulation is limited to such an extent that the muscles receive too little oxygen will there be violent, cramp-like pain in the calf, which can also occur in the foot, thigh or buttocks. One speaks here of the so-called "window disease", because affected people are forced to take a break after a relatively short walk. In order to conceal this, they often - if available - stop at shop windows. The PAVK is always a harbinger of a heart attack or stroke or reduces life expectancy by about 10 years.


Background of venous leg ulcers (leg ulcers)

Circulatory disorders do not only result from narrowing of the supplying arteries, but are also caused by drainage disorders of the venous system ("chronic venous insufficiency"). If, for example, varicose veins block the blood in the veins, water collects in the surrounding tissue, which over time leads to hardening of the connective tissue. The result is nutritional disorders of the tissue, so that even minor injuries ("scratching") can cause poorly healing wounds and ulcers (ulcus cruris). Venous insufficiency is often complicated by arterial micro- or macroangiopathies (“arterial inflow disorders”).

Microcirculation for the purpose of maintaining health

The actual blood circulation effects do not take place in the main stem vessels, but only in the periphery of the blood vessel system. This increase in capillary blood flow, also known as microcirculation, is the actual target area for measures to increase blood flow. The more the capillary blood flow increases, the more the peripheral resistance decreases, ie a high blood pressure begins to decrease.


Circulatory disorders are a pervasive problem in modern industrial society. Adequate blood flow, that is to say, adapted to the respective physiological conditions does not take place per se, but is controlled autonomously by the vegetative nervous system. It is immensely susceptible to stress, because the archaic escape-fight reflex regulated by the sympathetic (“activation”) and parasympathetic system (“relaxation”) harbors the risk of a restricted blood supply to entire tissue regions without the person affected noticing anything about it. It was not for nothing that the American Institute of Stress announced 30 years ago that the majority of all chronic diseases are directly or indirectly related to misdirected stress processing [4] .


Therapeutic strategies

Standard therapies for pAD include, for example, the drug or surgical removal of a thrombus or blood clot, vasodilation, stents or bypass surgery. In the case of leg ulcers, compression therapy is in the foreground, followed by challenging wound treatment. Necessary amputations (78,000 cases / year) cannot be ruled out for pAD, as well as for advanced leg ulcers (e.g. foot).


In order to minimize the increased risk of developing a circulatory disorder, it is obvious, for example, to do a sedentary job to provide a healthy balance through diet, exercise, or at least regular exercise. This also applies if there are first indications of arteriosclerotic changes, or in particular in the case of diagnosed diabetes, since this leads to damage to the blood vessels. Unfortunately, many sufferers are prevented from taking active care of their health due to lack of time, illness, bedriddenness, age reasons or simply because of lack of motivation. So it makes sense to use the special circulation-enhancing and other cellular stimulation effects of a PEMF [5] .


PEMF in the prophylaxis and therapy of circulatory disorders

It is still far too little known that the physical method of electromagnetic cell stimulation (PEMF) can produce effects that are relatively close to natural movement. On the one hand, there is evidence that cell activity reacts to certain electromagnetic impulses and that there are even “receiving antennas” (receptors) whose irritation leads to the formation of messenger substances [6] , [7],.


The first to be mentioned here are second messengers ("second messengers") such as cAMP or Ca ++ , which are responsible for almost cell actions. The cryptochromes [8] , [9] which occur naturally in mammals and which react to a PEMF synchronize the activity of the genes (tailored to the respective metabolic situation) and control the growth, cell division and the important apoptosis, which is controlled by mRNA Serve cell renewal.


On the other hand, PEMF act directly on the vascular system, which has been shown to increase capillary blood flow. This is due to PEMF-related nitrogen monoxide (NO) formation in the small blood vessels, which also has to do with the fact that NO naturally also regulates blood flow regulation [10] . For example, it can be observed that PEMF (NO) dilates the arterioles (i.e. the smallest arteries that are upstream of the microscopic capillaries) and that the resulting increased blood flow remains intact for at least 3 hours after use [11] , [12 ] .


In this context, it must be questioned whether an increase in blood flow due to a pulsating magnetic field is actually related to an increase in so-called vasomotion that has been expressed and observed in studies [13] .


Vasomotion means the temporal changes in blood flow and vascular resistance that result from oscillating contractions of the smooth vascular muscle cells of arterioles, but also in small arteries [14] , [15] : A distinction must be made here between two arteriolar sections [16] , In the distal arterioles (i.e. where they pass into capillaries), vasomotion takes place at a frequency of 10-25 cycles per minute.


The slow vasomotion in the proximal arterioles (i.e. where the arterioles begin) is only 1 - 3 / minute. The purpose of this oscillation is to increase both the resistance and the blood flow in the arterioles and thus the arterial pressure - of course, always assuming that the capillaries are also ready to allow this intermittent blood flow. The frequency independence is astonishing here, ie the only decisive factor seems to be the amplitude of the oscillation [17] .


Contrary to the prevailing opinion on the vasomotion frequencies of 10 - 25 cycles / min (distal) or 1 - 3 cycles / min (proximal), for example, a study that is related to a specific magnetic field manufacturer comes to the doubtful conclusion that it is known be that in the physiological range vasomotion frequencies of 1 - 5 vibrations per minute (on average 3 / min) can be found [18] . And that as a result, after 30 days of treatment, vasomotor activity increases by 7.58%. Unfortunately, in which section of the arterioles was examined is missing, as is the specification of which oscillation cycle was used as the starting value.

Another important aspect arises from the expansion of the arterioles diameter: This not only increases the flow rate of the blood, but also initiates angiogenesis, that is, the formation of new blood vessels (19) , if this is not a solitary event [19] , [20] . The increasing shear forces in the blood vessels are likely to be responsible for this [21] . In a cell culture study with cardiac muscle cells from rats, for example, it could be demonstrated that under a PEMF (15 Hz / 1.8 mT), among other things, a 1.5-fold increase in VEGF (Vascular Endothelial Growth Factor) develops - and a 2-fold increase of the FGF-2 (Fibroblast Growth Factor-2) [22] . In a further cell culture study, for example, PEMF use increased angiogenesis via FGF-2 [23] .


VEGF is a signaling molecule that plays an important role in angiogenesis by mediating endothelial formation (inner skin of the vessels). For example, VEGF-C and VEGF-D are involved in the synthesis of lymphatic vessels. VEGF can also cause its own vasodilation via nitrogen monoxide. Proof of this is that VEGF increases extremely in wound healing.


FGF (Fibroblast Growth Factor) is also an important growth hormone that is formed in cell and tissue injuries. It is therefore essential for wound healing.

PEMF study location

In animal experiments [24] , 108 rats, which had an artery microsurgically implanted in the sense of an "arterial circulatory model", received PEMF treatment (10 µT and 200 µT) immediately after the operation and 4, 8 and 12 weeks afterwards. Compared to control rats, there was significant vascularization in both groups.


In another animal study [25] the cremaster anesthetized rat muscle was treated either with PEMF or a placebo device for either 2 or 60 minutes. Compared to the control group, the arteriolar diameter of the muscle increased by 9% after 2 minutes and by 8.7% after one hour. According to the Hagen-Poiseuille law, this corresponds to an increase in the flow rate of approximately 40% [26] . Systemic arterial blood pressure and heart rate were unaffected in this study.


Similar PEMF effects were found in an investigation regarding a possible increase in microcirculation in anesthetized mice (50 Hz, 1 mT, 10 minutes / fluorescence microscopy), which showed a significant increase in capillary blood velocity compared to placebo [27] . Interestingly enough, a comparable result was achieved with a static magnetic field of 10 times the field strength.


In a study of possible blood circulation-promoting effects, a one-time magnetic field treatment (4 Hz, 5 µTm, magnetic field mat) was carried out in a placebo-controlled experiment with pAD patients (stages IIb - IV). As a result (measurement by laser Doppler fluxometry) there was an increase in blood circulation of over 50% and an increase in the transcutaneous oxygen partial pressure (tcpO 2 ) on the back of the foot of 17% after one hour of use. The higher the values, the greater the lower the initial values [28] . The laser Doppler used diagnostically here is used to measure the vasomotion and the flow of the muscular microcirculation.


In a study (prospective, double-blind, multicenter) for PEMF treatment of venous therapy-related leg ulcers (in addition to classic wound treatment / 3 hours a day), the following results were obtained: After 8 weeks, the wound area in the PEMF group increased by 47 7% from - while it even increased by 42.7% in the placebo group. In the same way, the depth of the wound and the intensity of pain were also significantly reduced compared to placebo [29] .


With regard to a PEMF effect on non-healing foot ulcers in diabetics, a double-blind, placebo-controlled study (12 Hz, 1.2 mT, 16 treatments of 60 minutes each) was carried out. After three weeks, the wound size had decreased by 18%. In the control group it was only 10%. PEMF also showed an increase in capillary blood velocity in the wound area by 28% and an increase in capillary diameter by 14% - which was not observed in the placebo group [30] .


The wound healing effect of PEMF has already been confirmed by an earlier animal study. In this way, tissue necrosis could be prevented in the skin of diabetic mice, with an increase (3-fold) in the growth factor FGF-2. The authors conclude that PEMF can prevent the development of non-healing ulcers, tissue necrosis and amputation in diabetes patients [31] .


To determine the vascular state (elasticity), the degree of oxygenation, vegetative influences or the microvascular blood flow, NIRP diagnostics (near infrared red remission pletysmography) is a particularly suitable method [32] . With QRS treatment (1 - 60 µT), for example, a clear vasodilation with an increase in microcirculation could be demonstrated [33] .



A PEMF application expands the arterioles and thus improves blood flow and microcirculation in the capillary area. It is doubtful that the underlying mechanism of action is related to an increase in vasomotion. Rather, activation of the nitrogen monoxide system seems to be responsible for this.


An increased increase in microcirculation also stimulates angiogenesis, ie the formation of new vessels, whereby the vascular growth factors VEGF and FGF-2 obviously play a decisive role. This is of considerable importance for the treatment of therapy-resistant ulcers and wounds (e.g. in diabetics / in chronic venous insufficiency), since it reduces the risk of tissue necrosis and the wound healing process is always dependent on a functioning microcirculation.


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[4] Rosch P.. Is cancer another ”disease of adaptation?” Some insights into the role of stress and civilization. Compr Ther 1993; 19 (5): 183-7

[5] PEMF = pulsing electromagnetic fields

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[7] Dertinger H, Weiberzahn KF. Treatment of Psoriasis with Interferential Current - New Perspectives of electromagnetic therapy. Act Dermatol 2002: 28: 165-169

[8] Maeda K et al. Magnetically sensitive light-induced reactions in cryptochrome are consistent with its proposed role as a magnetoreceptor. Proc Natl Acad Sci USA 2012; 109 (13): 4774-9

[9] Prato FS, Kavaliers M, Thomas AW. Light-dependent an -independent behavioral effects of extremely low frequency magnetic fields in a land snail are consistent with a parametric resonance mechanism. Bioelectomagnetics 1997; 18 (3): 284-91

[10] Chichon N et al. Benign effect of extremely low-frequency electromagnetic field on brain plasticity assessed by nitric oxide metabolism during poststroke rehabilitation. Oxid Med Cell Longev 2017: 2181942. doi: 10.1155 / 2017/2181942. Epub 2017 Sep 12

[11] Bragin DE et al. Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain. J Neurosurg 2015; 122 (5): 1239-47

[12] Smith TL, Wong-Gibbons D, Maultsby J. Microcirculatory effects of pulsed electromagnetic fields. J Orthop Res 2004; 22 (1): 80-4

[13] Klopp R. Institute for Microcirculation, Bernau near Berlin.

[14] De Ney JGR et al. Rhythmic contractile activity in resistence-sized arteries of spontaneously hypertensive rats. Halpern W (Ed): Resistence arteries. Pernatology Press. Pp. 336-34

[15] Gustafsson H. Vasomotion and underlying mechanisms in small arteries. An in vitro study of rat blood vessels. Act Physiol Scand 1993; 149: 6141-6144

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[17] Parthimos D et al. Comparison of chaotic and sinusoidal vasomotion in the regulation of microvascular flow. Cardiovasc Res 1996; 31: 388-399

[18] Klopp RC et al. Influence of a specifically biorhythmically defined physical stimulus on the deficient vasomotion in small-caliber subcutaneous arterioles in patients with diabetic polyneuropathy. J Complement Integr Med 2013; 10 (Suppl): 523-529

[19] Hutchins PM et al. Long term microvascular response to hydralazine in spontaneously hypertensive rats. Hypertension 1988; 12: 74-9

[20] Yuan XQ et al. The long-term effects of nimodipine on pial microvasculature and systemic circulation in conscious rat. At the J Physiol. 1990; 258 (5): 1395-1401

[21] Milkiewicz M et al. Association between shear stress, angiogenesis, and VEGF in skeletal muscles in vivo. Microcirculation 2001; 8: 229-41

[22] Li F et al. Pulsed magnetic field accelerate proliferation and migration of cardiac microvascular endothelial cells. Bioelectromagnetics 2015; 36 (1): 1-9. Epub 2014 Oct 22

[23] Tepper OM et al. Electromagnetic fields increase in vitro and in vivo angiogenesis through endothelial release of FGF-2. FASEB J 2004; 18 (11): 1231-3

[24] Roland D et al. Effects of pulsed magnetic energy on a microsurgically transferred vessel. Plast Reconstr. Surg 2000; 105: 1371-1374

[25] Smith Tl, Wong-Gibbons D, Maultsby J. Microcirculatory effects of pulsed electromagnetic fields. J Orthop Res 2004; 22 (1): 80-4

[26] Funk RHW et al. Potent stimulation of blood flow in fingers of volunteers after local short-term treatment with low-frequency magnetic fields from a novel device. Evidence Based Compl Alternat Med 2014; Epub 2014 May 21

[27] Xu S, Okano H, Ohkubo C. Acute effects of whole-body exposure to static magnetic fields and 50-Hz electromagnetic fields on muscle microcirculation I anesthetized mice. Bioelectrochem 2001; 53 (1): 127-35

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[29] Stiller MJ et al. A portable pulsed electromagnetic field (PEMF) device to enhance healing of recalcitrant venous ulcers: a double-blind, placebo-controlled clinical trial. Br J Dermatol 1992; 127 (2): 147-54

[30] Kwan RL et al. Pulsed electromagnetic field therapy promotes healing and microcirculation of chronic diabetic foot ulcers: a pilot study. Adv Skin Wound Care 2015; 28 (5): 212-9

[31] Callaghan MJ et al. Pulsed electromagnetic fields accelerate normal an diabetic wound healing by increasing endogenous FGF-2 release. Plastic Reconstr Surg 2008; 121 (1): 130.41

[32] Grohmann G. For macro and microcirculation on the forefoot under various compression pressures in healthy subjects. Phlebology 2000; 29: 114-23

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