Reliability of the passive leg movement assessment of vascular function in men

Abstract

New Findings What is the central question of this study?Use of the passive leg movement (PLM) test, a non‐invasive assessment of microvascular function, is on the rise. However, PLM reliability in men has not been adequately investigated, nor has such reliability data, in men, been compared to the most commonly employed vascular function assessment, flow‐mediated vasodilation (FMD). What is the main finding and its importance?PLM is a reliable method to assess vascular function in men, and is comparable to values previously reported for PLM in women, and for FMD. Given the importance of vascular function as a predictor of cardiovascular disease risk, these data support the utility of PLM as a clinically relevant measurement. Abstract Although vascular function is an independent predictor of cardiovascular disease risk, and therefore has significant prognostic value, there is currently not a single clinically accepted method of assessment. The passive leg movement (PLM) assessment predominantly reflects microvascular endothelium‐dependent vasodilation and can identify decrements in vascular function with advancing age and pathology. Reliability of the PLM model was only recently determined in women, and has not been adequately investigated in men. Twenty healthy men (age: 27 ± 2 year) were studied on three separate experimental days, resulting in three within‐day and three between‐day trials. The hyperemic response to PLM was assessed with Doppler ultrasound, and expressed as the absolute peak in leg blood flow (LBFpeak), change from baseline to peak (ΔLBFpeak), absolute area under the curve (LBFAUC), and change in AUC from baseline (ΔLBFAUC). PLM‐induced hyperemia yielded within‐day coefficients of variation (CV) from 10.9 to 22.9%, intraclass correlation coefficients (ICC) from 0.82 to 0.90, standard error of the measurement (SEM) from 8.3 to 17.2%, and Pearson's correlation coefficients (r) from 0.56 to 0.81. Between‐day assessments of PLM hyperemia resulted in CV from 14.4 to 25%, ICC from 0.75 to 0.87, SEM from 9.8 to 19.8%, and r from 0.46 to 0.75. Similar to previous reports in women, the hyperemic responses to PLM in men display moderate‐to‐high reliability, and are comparable to reliability data for brachial artery flow mediated vasodilation. These positive reliability findings further support the utility of PLM as a clinical measurement of vascular function and cardiovascular disease risk.

Tracking peripheral vascular function for six months in young adults following SARS‐CoV‐2 infection

“…Baseline, peak, change from baseline to peak (ΔPeak), and 60‐s AUC (AUC60) were determined for all variables of interest. In pilot testing, the average coefficient of variation for 3 individuals in triplicate assessments for baseline blood flow, peak blood flow, delta blood flow, and area under the curve for sPLM (2.6%, 3.8%, 18.0%, and 18.7%, respectively) and cPLM (7.3%, 12.2%, 29.6%, and 22.2%, respectively) was similar to recently published reproducibility assessments of cPLM (Groot et al, 2022; Lew et al, 2021).…”

Acute sympathetic activation blunts the hyperemic and vasodilatory response to passive leg movement

“…Nearly 80% of the hyperemic and vasodilatory response to PLM is nitric oxide (NO) dependent signifying the utility of this method to provide a valid assessment of NO-mediated vascular endothelial function (16,19,20). Moreover, the hyperemic and vasodilatory responses to PLM are signi cantly reduced by aging, heart failure, and spinal cord injury indicating that PLM provides a sensitive assessment of vascular function across a range of conditions and groups (21)(22)(23)(24). As previously described, acute and chronic elevations in MSNA are associated with reductions in vascular function (13,15,25).…”

We like to move it, move it: A perspective on performing passive leg movement as a non-invasive assessment of vascular function in pediatric populations

“…The passive leg movement (PLM) technique is a reliable, non-invasive assessment of lower limb vascular function ( Gifford and Richardson, 2017 ; Lew, Liu et al, 2021 ; Groot, Broxterman et al, 2022 ). PLM requires the use of Doppler ultrasound to evaluate common femoral artery (CFA) diameter and blood velocity at rest and during passive movement of the lower leg at the knee joint through a 180-90-180-degree range of motion ( Gifford and Richardson, 2017 ).…”