Clinical application of transcutaneous oxygen pressure measurements during exercise

Ábrahám, Pierre; Gu, Yongquan; Guo, Lianrui; Kroeger, Knut; Ouédraogo, Nafi; Wennberg, Paul W.; Henni, Samir

doi:10.1016/j.atherosclerosis.2018.07.023

Cited by 21 publications

(16 citation statements)

References 40 publications

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“…Increased T 2 could also contribute to the increased BOLD effect. Consistent with previous reports, 27 our study showed that TcPO 2 was decreased during exercise and then started to rise when exercise was finished, which was totally different from the

T_{2}^{*}

BOLD CMR results. During muscle contraction, more O 2 consumption at the muscle level could account for the reduced surface TcPO 2 recordings.…”

Section: Discussionsupporting

confidence: 80%

Blood oxygenation level‐dependent cardiovascular magnetic resonance of the skeletal muscle in healthy adults: Different paradigms for provoking signal alterations

Suo

Tang

Lü

et al. 2020

Magnetic Resonance in Med

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Purpose: Stress blood oxygenation level-dependent (BOLD) cardiovascular magnetic resonance allows for quantitative evaluation of blood flow reserve in skeletal muscles. This study aimed to prospectively compare three commonly used skeletal BOLD cardiovascular magnetic resonance paradigms in healthy adults: gas inhalation, cuff compression-induced ischemia and postocclusive reactive hyperemia, and exercise. Methods: Twelve young (22 ± 0.9 years) and 10 elderly (58 ± 5.0 years) healthy subjects underwent BOLD cardiovascular magnetic resonance under the three paradigms. T * 2 signal intensity time curves were generated and quantitative parameters were calculated. Meanwhile, stress transcutaneous oxygen pressure measurements were obtained as comparison. Measurement reproducibility was assessed with intraclass correlation coefficients. Differences in the T * 2 BOLD variation, the correlation with transcutaneous oxygen pressure, and the age-related change between paradigms were statistically analyzed. Results: Minimum ischemic value and maximum hyperemic peak value showed the highest interobserver and interscan reproducibilities (intraclass correlation coefficient >0.90). The plantar dorsiflexion exercise paradigm elicited the largest T * 2 BOLD variation (15.48% ± 10.56%), followed by ischemia (8.30% ± 6.33%). Negligible to weak changes were observed during gas inhalation. Correlations with transcutaneous oxygen pressure measurements were found in the ischemic phase

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T_{2}^{*}

BOLD CMR results. During muscle contraction, more O 2 consumption at the muscle level could account for the reduced surface TcPO 2 recordings.…”

Section: Discussionsupporting

confidence: 80%

Blood oxygenation level‐dependent cardiovascular magnetic resonance of the skeletal muscle in healthy adults: Different paradigms for provoking signal alterations

Suo

Tang

Lü

et al. 2020

Magnetic Resonance in Med

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“…This patient developed exertional muscular pain after extensive aortic coverage. Although the TcPO 2 minimal DROP did not reach the threshold of –15 mm Hg used for a positive buttock claudication study, 7 the drop was highly suggestive of decreased perfusion. The hypothesis of paraspinal claudication owing to diminished perfusion after aortic coverage is consistent with the exertional nature of her pain.…”

Section: Discussionmentioning

confidence: 87%

“…However, the use of exercise TcPO 2 to assess buttock perfusion in lower extremity ischemia has been assessed and validated. 7 , 15 , 16 Similarly, near infrared spectroscopy intraoperative monitoring uses similar principles with a greater depth of penetration to assess paraspinal perfusion as a surrogate for neuromonitoring, as several studies have shown correlation with traditional motor-evoked and somatosensory-evoked potentials. 11 , 12 , 13 Another limitation of this study is the inability to explain the absence of any SCI, given that neural tissue is typically more sensitive to changes in perfusion than skeletal muscle.…”

Section: Discussionmentioning

confidence: 99%

“…The Delta from Resting Oxygen Pressure (DROP) index, which is the absolute change in TcPO 2 from resting value ( Appendix ) was measured. 7 A minimal DROP value during exercise that indicates presence of buttock muscle ischemia is less than –15 mm Hg, whereas a normal study demonstrates DROP values at or close to 0 mm Hg. In this patient, the DROP value was less than 0 mm Hg but greater than –15 mm Hg during exercise, with the most significant decreases (–10 to –12 mm Hg) occurring in the lumbar areas ( Fig 2 ).…”

Section: Case Presentationmentioning

confidence: 99%

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Paraspinal muscle claudication after fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms

Mirza

Tenorio

Kärkkäinen

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Fenestrated-branched endovascular repair of thoracoabdominal aneurysms carries a risk of spinal cord ischemia owing to extensive coverage of intercostal arteries, but other consequences of decreased flow to the paraspinal muscles have not been delineated. We describe a 54-year-old woman treated by multibranched thoracoabdominal aneurysm repair who developed severe disabling exertional thoracic and lumbar back pain after the operation. Despite physical therapy, the patient remains with disabling symptoms at 2 years of follow-up. Transcutaneous oxygen pressures confirmed exercise-induced decrease in oxygen pressure, consistent with decreased muscle perfusion. We propose the term paraspinal muscle claudication to describe these symptoms.

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“…Aetiological diagnosis of claudication of the lower limb is important. We have used transcutaneous oxygen pressure (TcpO2) at exercise in the last 20 years, to argue for the vascular origin of exercise‐related pain during treadmill tests (Abraham et al, 2018; Gernigon et al, 2013; Henni et al, 2018; Jaquinandi et al, 2007; Signolet et al, 2016). As a routine, we use a constant load (3.2 km/hr, 10% slope) standard procedure.…”

Section: Introductionmentioning

confidence: 99%

Specific slow tests are not mandatory in patients with extremely short standard (3.2 km/hr 10% slope) test durations during exercise oximetry

Sempore

Ramondou

Hersant

et al. 2020

Clin Physio Funct Imaging

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Aim To compare the transcutaneous oxygen pressure results observed in patients with severe walking limitation during standard procedures (3.2 km/hr, 10% slope) versus during a test performed at a low speed (2 km/hr, 10% slope). Methods In 31 patients, the decrease from rest of oxygen pressure (DROP) index was measured on both buttocks, both thighs and both calves during two consecutive tests on treadmill. The maximal walking time (MWT) and the minimal DROP values (DROPmin) observed during the 2 tests were compared with t test. Correlation of DROPmin values during the slow and standard procedure was performed with linear regression. The −15 mmHg cut‐off value defined for standard test interpretation was used arbitrarily for the interpretation of slow test results. Results MWT was 80 ± 52 s versus 376 ± 269 s at standard and slow speed, respectively (p < .001). No difference on all recorded DROPmin values at a standard (−9.5 ± 6.9 mmHg) and slow (−10.5 ± 7.9 mmHg) speed was found; n = 186, p = .168. Coefficient of correlation between DROPmins found at the two tests was r = 0.820 (p < .01), with regression line close to the line of identity. With the identical −15 mmHg cut‐off, 166 (89.2%) of 186 the results were classified similarly after standard and slow procedures. Conclusion Specific slow treadmill procedures are not mandatory in patients with extremely short test durations when performing standard (3.2 km/hr 10% slope) exercise oximetry. In patients expected to be unable to walk at standard speed, the −15 mmHg normal limit seems to be valid for the interpretation of tests with a slow procedure (2.0 km/hr).

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Clinical application of transcutaneous oxygen pressure measurements during exercise

Cited by 21 publications

References 40 publications

Blood oxygenation level‐dependent cardiovascular magnetic resonance of the skeletal muscle in healthy adults: Different paradigms for provoking signal alterations

Blood oxygenation level‐dependent cardiovascular magnetic resonance of the skeletal muscle in healthy adults: Different paradigms for provoking signal alterations

Paraspinal muscle claudication after fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms

Specific slow tests are not mandatory in patients with extremely short standard (3.2 km/hr 10% slope) test durations during exercise oximetry

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