Objectives Near-Infrared Spectroscopy (NIRS), suitable for dynamic measurements, is not routinely utilised for peripheral arterial disease (PAD). We propose a dynamic NIRS-based measurement to quantify variations in muscle metabolism in PAD. Method: Sixty-seven consecutive PAD patients (males=56, age 71.6±8.7 years) and twenty-eight healthy subjects (males=12, age 30.4±11.9 years) were studied. An echo-colour doppler (ECD) was performed and the ankle-brachial-index (ABI) was calculated. Participants performed an incremental treadmill test with NIRS probes on the gastrocnemius. Variations in oxygenated (HbO2), deoxygenated (HHb), total (tHb=HbO2+HHb), and differential (dHb=HbO2-HHb) haemoglobin were recorded and quantified as area-under-curve (AUC) within the range 1.7-3.0 Km/h. Heart rate was recorded, and the number of beats in the same interval was calculated (dHr). Results: O2HbAUC, HHbAUC, and dHbAUC differed between diseased and non-diseased legs (P<0.0001) and exhibited different patterns related to PAD severity according to ABI value. A compensatory heart rate increase was observed in PAD patients. Compared to the ECD positivity for occlusions/stenoses or multiple plaques, only the receiver-operating characteristic analysis of dHbAUC (area=0.932, P<0.0001) showed a sensitivity/specificity of 87.6/93.4 for values ≤-197 (LR+LR–:13.36/0.13). Conclusion: The dynamic NIRS-based test, quantifying muscle metabolic response according to presence and degree of PAD, allows to evaluate patients with walking disabilities.
A dynamic objective evaluation of peripheral arterial disease by Near-Infrared Spectroscopy
MANFREDINI, Fabio;MALAGONI, Anna Maria;FELISATTI, Michele;MANDINI, Simona;MASCOLI, Francesco;MANFREDINI, Roberto;BASAGLIA, Nino;ZAMBONI, Paolo
2009
Abstract
Objectives Near-Infrared Spectroscopy (NIRS), suitable for dynamic measurements, is not routinely utilised for peripheral arterial disease (PAD). We propose a dynamic NIRS-based measurement to quantify variations in muscle metabolism in PAD. Method: Sixty-seven consecutive PAD patients (males=56, age 71.6±8.7 years) and twenty-eight healthy subjects (males=12, age 30.4±11.9 years) were studied. An echo-colour doppler (ECD) was performed and the ankle-brachial-index (ABI) was calculated. Participants performed an incremental treadmill test with NIRS probes on the gastrocnemius. Variations in oxygenated (HbO2), deoxygenated (HHb), total (tHb=HbO2+HHb), and differential (dHb=HbO2-HHb) haemoglobin were recorded and quantified as area-under-curve (AUC) within the range 1.7-3.0 Km/h. Heart rate was recorded, and the number of beats in the same interval was calculated (dHr). Results: O2HbAUC, HHbAUC, and dHbAUC differed between diseased and non-diseased legs (P<0.0001) and exhibited different patterns related to PAD severity according to ABI value. A compensatory heart rate increase was observed in PAD patients. Compared to the ECD positivity for occlusions/stenoses or multiple plaques, only the receiver-operating characteristic analysis of dHbAUC (area=0.932, P<0.0001) showed a sensitivity/specificity of 87.6/93.4 for values ≤-197 (LR+LR–:13.36/0.13). Conclusion: The dynamic NIRS-based test, quantifying muscle metabolic response according to presence and degree of PAD, allows to evaluate patients with walking disabilities.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
