Calf Tissue Oxygenation During Exercise in Men with and Without Risk Factors for Developing Peripheral Arterial Disease

Miranda, Alberto; Figoni, Stephen F.; Cha, Tha; Flanagan, Terrance; Mandal, Oanh; Silva, Mariana; Scremin, A.M. Erika; Scremin, Oscar U.

doi:10.1097/phm.0b013e3182411df9

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Miranda et al 48 . compared calf tissue StO 2 changes during exercise on a calf ergometer between subjects with risk factors for PAD (diabetes, hypertension, hyperlipidaemia, obesity, smoker, and age > 65) and those without.…”

Section: Resultsmentioning

confidence: 99%

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Near infrared spectroscopy in peripheral artery disease and the diabetic foot: A systematic review

Joseph

Munshi

Agarini

et al. 2022

Diabetes Metabolism Res

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With the need for tools that assess microvascular status in diabetic foot disease (DFD) being clear, near infrared spectroscopy (NIRS) is a putative method for noninvasive testing of the diabetic foot. The use of NIRS in patients with peripheral arterial disease (PAD) has extended to its role in studying the pathophysiology of DFD. NIRS generates metrics such as recovery time, deoxygenation, oxygen consumption (VO 2 ), tissue oxygen saturation (StO 2 ), total haemoglobin (HbT), and oxyhaemoglobin area under the curve (O 2 Hb AUC ). NIRS may potentially help the multidisciplinary team stratify limbs as high-risk, especially in diabetic patients with symptoms masked by peripheral neuropathy. NIRS may be useful for assessing treatment effectiveness and preventing deterioration of patients with PAD.

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Section: Resultsmentioning

confidence: 99%

“…Miranda et al48 compared calf tissue StO 2 changes during exercise on a calf ergometer between subjects with risk factors for PAD (diabetes, hypertension, hyperlipidaemia, obesity, smoker, and age > 65) and those without. The at-risk group demonstrated greater decrements in StO 2 during exercise compared to healthy subjects (9% greater decrease, p < 0.001).…”

mentioning

confidence: 99%

Near infrared spectroscopy in peripheral artery disease and the diabetic foot: A systematic review

Joseph

Munshi

Agarini

et al. 2022

Diabetes Metabolism Res

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“…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%

“…Since exercise increases oxygen demand, it can be used to provoke PAD symptoms, enabling symptom assessment using a numerical rating scale (NRS) to capture the onset and progression in symptom intensity. To date, researchers have collected data on symptom rating (Treat-Jacobson, Henly, Bronas, Leon, & Henly, 2011) and perceived exertion during graded treadmill exercise (Collins et al, 2012)—in some cases, simultaneously measuring changes in tissue saturation index (TSI) (Miranda et al, 2012). However, analyzing TSI changes in relationship to symptom intensity or perceived exertion data is lacking.…”

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confidence: 99%

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 with a provocative maneuver to detect the presence of severe peripheral arterial disease

Reiter,

Andersen

2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Calf Tissue Oxygenation During Exercise in Men with and Without Risk Factors for Developing Peripheral Arterial Disease

Cited by 4 publications

References 26 publications

Near infrared spectroscopy in peripheral artery disease and the diabetic foot: A systematic review

Near infrared spectroscopy in peripheral artery disease and the diabetic foot: A systematic review

The Relationship Between Peripheral Artery Disease Symptomatology and Ischemia

Near-infrared spectroscopy with a provocative maneuver to detect the presence of severe peripheral arterial disease

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