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INTERNATIONAL ANGIOLOGY

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

Copyright © 2002 EDIZIONI MINERVA MEDICA

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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