A Dynamic Objective Evaluation of Peripheral Arterial Disease by Near-Infrared Spectroscopy

Manfredini, Fabio; Malagoni, Anna Maria; Felisatti, Michele; Mandini, Simona; Mascoli, Francesco; Manfredini, Roberto; Basaglia, Nino; Zamboni, Paolo

doi:10.1016/j.ejvs.2009.06.011

Cited by 57 publications

(81 citation statements)

References 25 publications

(11 reference statements)

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“…NIRS has been utilised during exercise in patients with PAD to examine tissue deoxygenation; the authors describe parameters generated from the area under the curve (AUC) of the Hb signals during the early stages of an incremental walking test (1.7–3.0 km/h walking speed) 12 . The AUC generated from all Hb signals, except for total Hb, were able to detect accentuated deoxygenation in PAD compared to healthy individuals.…”

Section: Exercise-induced Blood Volume Changes In Padmentioning

confidence: 99%

“…Unfortunately the spectral absorbance of the oxy- and deoxy-Hb and Mb is almost indistinguishable 8 so attenuation by skeletal muscle is attributable to both chromophores. Estimates of relative contribution from Hb and Mb to the NIRS signal are conflicting: Hb has been proposed to contribute as much as ∼90%9, 10 or as little as ∼10–20%11, 12, 13 to the signal. A recent paper by Davis and Barstow 14 critically reviewed the topic and estimated the likely contributions of Hb and Mb to NIRS signals based on anatomical and experimental data.…”

Section: Introductionmentioning

confidence: 99%

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Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen

Jones

Chiesa

Chaturvedi

et al. 2016

ARTRES

132

122

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Purpose of reviewContinuous wave near infrared spectroscopy (CW NIRS) provides non-invasive technology to measure relative changes in oxy- and deoxy-haemoglobin in a dynamic environment. This allows determination of local skeletal muscle O2 saturation, muscle oxygen consumption (trueV˙O2) and blood flow. This article provides a brief overview of the use of CW NIRS to measure exercise-limiting factors in skeletal muscle.Recent findingsNIRS parameters that measure O2 delivery and capacity to utilise O2 in the muscle have been developed based on response to physiological interventions and exercise. NIRS has good reproducibility and agreement with gold standard techniques and can be used in clinical populations where muscle oxidative capacity or oxygen delivery (or both) are impaired. CW NIRS has limitations including: the unknown contribution of myoglobin to the overall signals, the impact of adipose tissue thickness, skin perfusion during exercise, and variations in skin pigmentation. These, in the main, can be circumvented through appropriate study design or measurement of absolute tissue saturation.SummaryCW NIRS can assess skeletal muscle O2 delivery and utilisation without the use of expensive or invasive procedures and is useable in large population-based samples, including older adults.

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Section: Exercise-induced Blood Volume Changes In Padmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen

Jones

Chiesa

Chaturvedi

et al. 2016

ARTRES

132

122

View full text Add to dashboard Cite

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“…The PortaMon NIRS could not account for factors such as collaterals, cardiac function, inotropic and chronotropic response to therapeutic agents, vessel wall stiffness, and the presence of comorbid conditions that could have influenced calf tissue oxygenation during exercise (Manfredini et al, 2009). Additionally, calf adipose tissue thickness and skin temperature were not measured in this study.…”

Section: Discussionmentioning

confidence: 99%

“…NIRS has been shown to be an inexpensive, noninvasive, accurate, stable, and sensitive tool to study the interactions between oxygen delivery and utilization in human skeletal muscle (Wariar, Gaffke, Haller, & Bertocci, 2000). Among individuals with PAD, NIRS has demonstrated moderate-to-high test-retest reliability (Miranda et al, 2010; Miranda et al, 2012); parameters measured with NIRS can establish PAD presence, severity, and response to treatment, and correlate well with ABI (Ferrari, Mottola, & Quaresima, 2004; Manfredini et al, 2009; Vardi & Nini, 2008). …”

Section: Methodsmentioning

confidence: 99%

“…The PortaMon NIRS was covered with a black cloth, secured with Coban self-adherent wrap, and paired via Bluetooth with the dedicated study laptop computer. Equilibration as well as baseline and continuous measurements were obtained following methods consistent with previous studies (Gardner et al, 2009; Hamaoka, McCully, Quaresima, Yamamoto, & Chance, 2007; Manfredini et al, 2009; Van Beekvelt, Colier, Wevers, & Van Engelen, 2001), and the PI’s previously conducted feasibility evaluation. Participants remained in a seated position while baseline HR, BP, and TSI values were obtained.…”

Section: Methodsmentioning

confidence: 99%

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The Relationship Between Peripheral Artery Disease Symptomatology and Ischemia

Schorr¹,

Treat‐Jacobson

Lindquist

2017

Nursing Research

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Background Fewer than half of individuals with peripheral artery disease (PAD) experience classic claudication and the relationships between PAD typical or atypical symptom intensity, location, and description (classic or atypical) with ischemic changes have not previously been reported. Objective The primary purpose of this study was to evaluate the relationship between self-reported PAD symptom intensity and calf tissue ischemia measured using the tissue saturation index (TSI) during treadmill exercise. The location and descriptors of atypical PAD symptoms in the presence of calf tissue ischemia were also identified. Methods Adults with PAD with exercise-limiting ischemic symptoms were asked to: (a) rate symptom intensity using a numerical rating scale (NRS) from 0 to 5 (0 = no pain, 1 = onset of pain, 5 = maximal pain); (b) provide symptom locations and descriptors; and (c) wear a near-infrared spectroscopy device to obtain calf TSI values during treadmill exercise. Multilevel models with TSI as the outcome variable were estimated during exercise and recovery. Covariates included were: exercise time, recovery time, baseline TSI, exercise rating, recovery rating, ABI, age, race, sex, BMI, diabetes, neuropathy, and smoking. Results During three successive bouts of treadmill exercise for 40 participants (80% Caucasian males; average age 68 years, SD = 9.2), the most rapid decline in TSI occurred between the start of exercise and symptom onset (NRS = 1). The TSI nadir was often reached prior to report of maximum discomfort (NRS = 5) and changes in TSI were related to exercise time (p < .001), baseline TSI (p < .001), exercise ratings (p < .001), and ABI (p < .05). During recovery, TSI increased steadily for most participants as pain eased. In the recovery model, changes in TSI were associated with recovery ratings (p < .001) and ABI (p < .03). Out of 120 treadmill exercise tests, 69.2% were stopped due to discomfort in the calf with classic descriptors reported only half the time (55.4%). Discussion Exploratory analyses revealed ischemic symptoms extended beyond classic claudication locations and descriptors. Future research should evaluate changes in TSI relative to atypical locations and descriptors to improve understanding of the full range of ischemic symptoms experienced by individuals with PAD.

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Near‐infrared Spectroscopy, In Vivo Tissue Analysis by

Sowa¹,

Friesen²

2000

Encyclopedia of Analytical Chemistry

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Applications of in vivo near‐infrared (NIR) spectroscopy have emerged in various segments of clinical medicine and medical research. Developments in photonics, wireless connectivity, and smart devices that have been spurred on by the communication revolution have set the stage for even more rapid advancement of noninvasive or minimally invasive medical applications of NIR spectroscopy. The goal of this article is to review the current capabilities and limitations of in vivo NIR spectroscopy and highlight the impact of these capabilities and limitations in selected areas where NIR spectroscopy is being used to address clinical problems. The optical properties of tissues are briefly reviewed as these properties largely dictate the feasibility of an in vivo spectroscopic diagnostic approach and constrain the scope of problems that can be tackled using NIR spectroscopy. Some of the more successful applications of NIR spectroscopy in medicine are described. The number and magnitude of confounding factors that confuse in vivo spectroscopy can be daunting to the experimentalist and may represent the largest barrier in transforming in vivo spectroscopic measurements into clinically meaningful and reliable information. In vivo NIR spectroscopy abounds with opportunity and challenge.

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A Dynamic Objective Evaluation of Peripheral Arterial Disease by Near-Infrared Spectroscopy

Abstract: The dynamic NIRS-based test, quantifying muscle metabolic response according to presence and degree of PAD, allows the evaluation of patients with walking disabilities.

Cited by 57 publications

References 25 publications

Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen

Recent developments in near-infrared spectroscopy (NIRS) for the assessment of local skeletal muscle microvascular function and capacity to utilise oxygen

The Relationship Between Peripheral Artery Disease Symptomatology and Ischemia

Near‐infrared Spectroscopy, In Vivo Tissue Analysis by

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