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Rivista di Angiologia

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2001 December;20(4):301-6

lingua: Inglese

A role for near infrared spectroscopy in the assessment of intermittent claudication

Seifalian A. M., Atwal A., White S. *, Mikhailidis D. P. *, Baker D., Hamilton G.

From the Vas­cu­lar Unit, Uni­ver­sity Depart­ment of Sur­gery, * Depart­ment of Molec­u­lar Pathol­o­gy and Clin­i­cal Bio­chem­is­try Royal Free and Uni­ver­sity Col­lege Med­i­cal ­School Uni­ver­sity Col­lege Lon­don and the Royal Free Hos­pi­tal, Lon­don, UK

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Back­ground. Near ­infrared spec­tros­co­py (NIRS) can be used to mon­i­tor mus­cle oxy­he­mog­lo­bin (HbO2), deoxy­he­mog­lo­bin (Hb) and cyto­chrome oxi­dase (CytOx) oxi­da­tion. We eval­u­at­ed the chang­es in NIRS in ­patients with inter­mit­tent claud­i­ca­tion (IC) pre- and post­ex­er­cise. Micro­al­bu­mi­nu­ria is an index of endo­the­lial dys­func­tion. There­fore, we also ­assessed wheth­er the uri­nary excre­tion of albu­min ­increased postexer­cise in ­patients with IC.
Meth­ods. Each par­tic­i­pant (14 ­patients with IC and 10 con­trols) under­went a tread­mill test; NIRS was con­tin­u­ous­ly record­ed. The uri­nary albu­min:crea­ti­nine ratio (ACR) and ankle:bra­chi­al sys­tol­ic pres­sure index (ABPI) were meas­ured pre- and postexer­cise.
­Results. The ABPI in the clau­di­cants ­dropped sig­nif­i­cant­ly (p<0.001) post­ex­er­cise. The pre-exer­cise ACR did not dif­fer ­between clau­di­cants and con­trols but postexer­cise, the ACR ­increased sig­nif­i­cant­ly (p<0.001) in the clau­di­cants. There was a sig­nif­i­cant (p<0.001) dif­fer­ence in the ­degree of HbO2 deoxy­gen­a­tion ­between clau­di­cants and con­trols; the rate of deoxy­gen­a­tion was sig­nif­i­cant­ly high­er in clau­di­cants than in con­trols (-8.4 vs -3.4 mol/L.min, p=0.024). The peri­od of recov­ery of HbO2 post­ex­er­cise was also sig­nif­i­cant­ly slow­er in clau­di­cants (192 vs 68 sec, p=0.003). There was a sig­nif­i­cant cor­re­la­tion ­between the ­increase in the ACR and time of recov­ery of HbO2 lev­els postexer­cise (r=0.86, p<0.001, n=24). A sim­i­lar pat­tern was seen with CytOx.
Con­clu­sions. NIRS may pro­vide a sim­ple, non-inva­sive assess­ment of the sever­ity of IC. Fur­ther­more, ­because the ACR is a mark­er of endo­the­lial dam­age, it is pos­sible that NIRS chang­es also ­reflect endo­the­lial integ­rity. These appli­ca­tions of NIRS tech­nique ­should be ­assessed in a larg­er study.

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