Analysis of ischemic muscle in patients with peripheral artery disease using X-ray spectroscopy

Abstract

Background Peripheral artery disease (PAD) is a vascular disease caused by atherosclerosis resulting in decreased blood flow to the lower extremities. The ankle brachial index (ABI) is a standard PAD diagnostic test, but only identifies reduced blood flow based on blood pressure differences. The early signs of PAD manifest themselves not only clinically, but also at an elemental and biochemical level. However, the biochemical and elemental alterations to PAD muscle are not well understood. The objective of this study was to compare fundamental changes in intracellular elemental compositions between control, claudicating, and critical limb ischemia muscle tissue. Materials and methods Gastrocnemius biopsies from three subjects including one control (ABI≥0.9), one claudicating (0.4≤ABI<0.9) and one critical limb ischemia patient (ABI<0.4) were evaluated using a scanning electron microscope and energy dispersive X-ray spectroscopy to quantify differences in elemental compositions. Spectra were collected for 5 myofibers per specimen. An analysis of variance was performed to identify significant differences in muscle elemental compositions. Results This study revealed that intracellular magnesium and calcium were lower in PAD compared to control myofibers while sulfur was higher. Magnesium and calcium are antagonistic, meaning, if magnesium concentrations go down calcium concentrations should go up. However, our findings do not support this antagonism in PAD. Our analysis found decreases in sodium and potassium, in PAD myofibers. Conclusions These findings may provide insight into the pathologic mechanisms that may operate in ischemic muscle and aid in the development of specialized preventive and rehabilitative treatment plans for PAD patients.

Elemental Composition of Skeletal Muscle Fibres Studied with Synchrotron Radiation X-ray Fluorescence (SR-XRF)

“…Copper deficiency causes muscle weakness and anaemia. Zinc, as an antioxidant that affects the development and regeneration of muscle tissue, also stabilises the protein structures from which fibres are made [ 9 , 10 , 11 , 12 , 13 , 14 ].…”

“…Copper deficiency causes muscle weakness and anaemia. Zinc, as an antioxidant that affects the development and regeneration of muscle tissue, also stabilises the protein structures from which fibres are made [9][10][11][12][13][14]. In order to find out which elements have the greatest influence on differentiation, a multivariate discriminate analysis (MDA) was performed for the analysed fibres.…”

Co-Registration of Peripheral Atherosclerotic Plaques Assessed by Conventional CT Angiography, MicroCT and Histology in Patients with Chronic Limb Threatening Ischaemia

“…Other non-invasive imaging modalities have characterised PAOD lesions, e.g., Becker et al used xray spectroscopy to compare fundamental changes in intracellular elemental compositions between control, claudicants, and critical limb ischaemia muscle tissue. 30 The study showed that intracellular magnesium and calcium were lower in PAOD compared with control myofibres, whereas sulphur was higher. A combination of microCT with evaluation of the muscles of the ischaemic leg could lead to greater accuracy and better understanding of PAOD.…”

Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency

“…However, it is important to report that these techniques allow researchers to simultaneously detect magnesium and other trace elements in several tissues. Clinical application of analytical scanning electron microscopy (ASEM) using computerized elemental x-ray analysis on sublingual epithelial cells was used for the simultaneous detection of magnesium and potassium in diabetes patients treated with magnesium supplementation [ 287 ]; energy dispersive x-ray spectroscopy coupled to scanning electron microscopy enables researchers to quantify differences in elemental composition in muscle biopsies of patients with peripheral artery disease (PAD), finding significative difference particularly in calcium, magnesium, and sulfur content, while C, O, K, and Na do not change within the different samples [ 288 ].…”