Relationship Between Foot Transcutaneous Oxygen Tension and Ankle Systolic Blood Pressure at Rest and Following Exercise

Abstract

To determine whether foot transcutaneous oxygen tension (TcPO2) and ankle systolic blood pressure (SBP) measure similar aspects of peripheral vascular occlusive disease (PVOD), the authors examined their relationship at rest and following treadmill exercise. Thirty-seven PVOD patients (mean age 69.2 +/- 0.8 years) rested supine for twenty minutes, followed by a progressive treadmill walking test at a constant speed of 2 mph. The initial grade was 0%; this increased 2% every two minutes until maximal claudication pain (n = 19) or until the occurrence of such limiting symptoms as volitional fatigue (n = 6), ST segment depression (n = 4), dyspnea (n = 3), multiple premature ventricular contractions (n = 2), and angina (n = 2). Patients then rested supine for fifteen minutes. Foot TcPO2 was recorded before, during, and after exercise, whereas ankle SBP was measured before and after exercise. At rest, a curvilinear relationship was found between foot TcPO2 and ankle SBP (foot TcPO2 = 41.89 + 0.22(ankle SBP) + 0.0005 (ankle SBP2); SEE = 9.2, R = 0.64, R2 = 0.41, p less than 0.001). In contrast, the relationship was stronger and more linear during recovery, particularly at the sixth minute (foot TcPO2) = 8.33 + 0.35 (ankle SBP); SEE = 13.6, R = 0.86, R2 = 0.73, p less than 0.001). At rest, foot TcPO2 and ankle SBP characterized different aspects of PVOD because they shared only 41% common variance. During recovery, they provided similar information because up to 73% of the variance was shared. It is concluded that foot TcPO2 should also be used to assess PVOD patients because unique information is obtained at rest and values can be recorded during exercise.

Impaired Peripheral Circulation in Veterans with Claudication is Associated with Smoking

“…The veterans had greater declines in the absolute and percentage changes in calf TcPO2 from rest to hyperemia than the non-veterans. The reduction in the calf TcPO 2 following the occlusion phase of the reactive hyperemic test indicates that ischemia persists in the cutanaeous tissue for several minutes during hyperemia, and supports our previous observations noted with post-occlusive reactive hyperemia tests and treadmill exercise tests [18,28,29]. The reduction in calf TcPO 2 is due to the vasodilation in the calf musculature, thereby compromising the oxygen delivery to the cutaneous tissue of the calf a phenomenon known as vascular steal [30].…”

“…Our data indicates that the veterans with PAD had greater compromise in the microcirculation of the cutaneous tissue in the calf compared to the non-veterans. The lower calf TcPO 2 in the veterans is related to their more severe PAD and their greater prevalence of smoking, as both of these factors are associated with TcPO 2 measures of the lower extremity [27,28]. When all of the peripheral vascular measures are considered, the veterans appear to be particularly compromised in their perfusion of their lower extremities because they have more severe PAD than the non-veterans, as well as greater impairments in both macro vascular function and microvascular function.…”

Comparison of Three Progressive Exercise Protocols in Peripheral Vascular Occlusive Disease

“…Patients rested supine for twenty minutes, after which hemodynamic measurements were recorded as previously described. [16][17][18] TcP02 was measured on the dorsum of the foot over the third cuneiform bone with a polarographic electrode and a transcutaneous oxygen monitor. Ankle SBP was measured in the posterior tibial and dorsalis pedis arteries of both lower extremities by a bidirectional Doppler and bidirectional 8 MHZ probe.…”

Transkutane Sauerstoffpartialdruckund Kohlendioxidpartialdruckmessung – Verfahrenstechnik- und Anwendungsgebiete

“…So sinken die tcpO 2 -Werte trotz der deutlichen Abnahme des Knöchelarteriendrucks zunächst nur langsam. Wahrschein-lich wird die arterielle Minderperfusion, die sich in der Abnahme der arteriellen Knöchelarteriendrucke widerspiegelt, durch eine verstärkte Abgabe von Sauerstoff in den Kapillaren kompensiert (25). Kommt es zu einem stärkeren Durchblutungsdefizit, z.…”

“…Zusätzlich verringert der erhöhte Sauerstoffbedarf in der Muskulatur die Kapazitäten zur Sauerstoffabgabe im kutanen Strombett. Gemäß der hyperbolischen Funktion ändert sich der tcpO 2 bei sehr niedrigen Knöchelarteriendrucken überproportional stark, so dass der tcpO 2 -Wert in diesen Druckbereichen der sensiblere Parameter ist (25,34).…”