Localized irregularities in hemoglobin flow and oxygenation in calf muscle in patients with peripheral vascular disease detected with near-infrared spectrophotometry.

PURPOSE Near-infrared spectrophotometry is used to measure flow, concentration, and oxygenation of hemoglobin in arterioles, capillaries, and venules several centimeters deep in tissue. The purpose of this study was to investigate the distribution of flow, concentration, and oxygenation of hemoglobin in calf muscle in patients with documented peripheral arterial occlusive disease (PVD), patients with risk factors for PVD,and healthy younger subjects at rest. METHOD With a frequency-domain near-infrared spectrophotometer and a specially designed probe, we generated maps at 22 locations simultaneously of hemoglobin flow, concentration, and oxygenation, with the venous occlusion method. Eight legs of 7 patients with diagnosed PVD (PVD group), 10 legs of 8 patients with normal ankle-brachial index but with risk factors for PVD (RF group), and 16 legs of 8 healthy subjects (H group) were studied. RESULTS Global mean values were significantly (P <.05) different between the three groups for oxygen consumption (PVD group, 0.027 +/- 0.009 mL/100 g/min; RF group, 0.038 +/- 0.017 mL/100 g/min; H group, 0.022 +/- 0.020 mL/100 g/min), venous oxygen saturation (PVD, 59.7% +/- 15.4%; RF, 69.6% +/- 10.5%; H, 80.8% +/- 4.5%), and, at 60 s of venous occlusion, concentration changes in oxyhemoglobin (PVD, 4.48 +/- 3.25 micromol/L; RF, 8.44 +/- 2.33 micromol/L; H, 6.85 +/- 4.57 micromol/L), deoxyhemoglobin (PVD, 3.60 +/- 0.73 micromol/L; RF, 4.39 +/- 1.30 micromol/L; H, 2.36 +/- 1.79 micromol/L), and total hemoglobin (PVD, 8.07 +/- 3.83 micromol/L; RF, 12.83 +/- 2.75 micromol/L; H, 9.21 +/- 6.34 micromol/L). No significant difference was found between the three groups for hemoglobin flow (PVD, 0.92 +/- 0.69 micromol/100 mL/min; RF, 1.68 +/- 0.50 micromol/100 mL/min; H, 1.44 +/- 1.17 micromol/100 mL/min) and blood flow (PVD, 0.45 +/- 0.28 mL/100 g/min; RF, 0.77 +/- 0.21 mL/100 g/min; H, 0.62 +/- 0.50 mL/100 g/min). All parameters featured a distribution dependent on location. CONCLUSION Mean value for venous oxygen saturation was higher in healthy subjects compared to patients with documented PVD. In patients with PVD, areas of lower oxygenation were clearly discernible. At distal locations of calf muscle, significant correlations between reduced hemoglobin flow, venous oxygen saturation, oxyhemoglobin, and total hemoglobin and reduced ankle-brachial index were found. Maps revealed localized irregularities in oxyhemoglobin, total hemoglobin, and venous oxygen saturation in patients with PVD. Near-infrared spectrophotometry is a noninvasive bedside technique that can enable determination of blood flow and oxygenation in tissue and may provide a method for evaluating patients with PVD.

[1]  Damijan Miklavčič,et al.  Reproducibility of Parameters of Postocclusive Reactive Hyperemia Measured by Near Infrared Spectroscopy and Transcutaneous Oximetry , 2000, Annals of Biomedical Engineering.

[2]  Martin Wolf,et al.  Mapping of hemodynamics on the human calf with near infrared spectroscopy and the influence of the adipose tissue thickness. , 2003, Advances in experimental medicine and biology.

[3]  M. Ferrari,et al.  Nonuniform quadriceps O2 consumption revealed by near infrared multipoint measurements. , 2001, Biochemical and biophysical research communications.

[4]  K. Yasuda,et al.  Near Infrared Spectrophotometry Reflects Cerebral Metabolism during Hypothermic Circulatory Arrest in Adults , 2001, ASAIO journal.

[5]  Cornelius Weiller,et al.  Dysfunction of vasomotor reactivity in severe sepsis and septic shock , 2001, Intensive Care Medicine.

[6]  S Nioka,et al.  Hemoglobin/myoglobin oxygen desaturation during Alpine skiing. , 2001, Medicine and science in sports and exercise.

[7]  W. Colier,et al.  Performance of near-infrared spectroscopy in measuring local O(2) consumption and blood flow in skeletal muscle. , 2001, Journal of applied physiology.

[8]  C. Cobelli,et al.  Muscle blood flow and flow heterogeneity during exercise studied with positron emission tomography in humans , 2000, European Journal of Applied Physiology.

[9]  H. Langberg,et al.  Regional blood flow during exercise in humans measured by near-infrared spectroscopy and indocyanine green. , 2000, Journal of applied physiology.

[10]  E Gratton,et al.  Blood flow and oxygen consumption with near-infrared spectroscopy and venous occlusion: spatial maps and the effect of time and pressure of inflation. , 2000, Journal of biomedical optics.

[11]  M. Wolf,et al.  Can near infrared spectroscopy of the liver monitor tissue oxygenation? , 2000, European Journal of Pediatrics.

[12]  T. Brothers,et al.  Symptoms of chronic arterial insufficiency correlate with absolute ankle pressure better than with ankle: brachial index. , 2000, Minerva cardioangiologica.

[13]  H. Shigematsu,et al.  Near‐infrared spectroscopy grades the severity of intermittent claudication in diabetics more accurately than ankle pressure measurement , 2000, The British journal of surgery.

[14]  Albert E. Cerussi,et al.  New optical probe designs for absolute (self-calibrating) NIR tissue hemoglobin measurements , 1999, Photonics West - Biomedical Optics.

[15]  Shoko Nioka,et al.  Functional muscle imaging in elite and untrained subjects , 1999, Photonics West - Biomedical Optics.

[16]  Beniamino B. Barbieri,et al.  Results of a 95-subject human clinical trial for the diagnosis of peripheral vascular disease using a near-infrared frequency domain hemoglobin spectrometer , 1999, Biomedical optics.

[17]  Sergio Fantini,et al.  Calf muscle blood flow and oxygen consumption measured with near-infrared spectroscopy during venous occlusion , 1999, Photonics West - Biomedical Optics.

[18]  E. Gratton,et al.  Non-invasive optical monitoring of the newborn piglet brain using continuous-wave and frequency-domain spectroscopy. , 1999, Physics in medicine and biology.

[19]  V. Vécsei,et al.  New instrument that uses near-infrared spectroscopy for the monitoring of human muscle oxygenation. , 1999, The Journal of trauma.

[20]  Stephen O. Heard,et al.  Continuous measurement of gut pH with near-infrared spectroscopy during hemorrhagic shock. , 1998, The Journal of trauma.

[21]  P. M. Lugarà,et al.  Application of near-infrared tissue oxymetry to the diagnosis of peripheral vascular disease. , 1999, Clinical hemorheology and microcirculation.

[22]  Assessment of quadriceps oxygenation in patients with myopathies by near red infrared spectroscopy , 1998, Neurology.

[23]  R. Belardinelli Muscle oxygenation kinetics measured by near-infrared spectroscopy during recovery from exercise in chronic heart failure. , 1998, Giornale italiano di cardiologia.

[24]  C J Green,et al.  The use of near-infrared spectroscopy for assessing flap viability during reconstructive surgery. , 1998, British journal of plastic surgery.

[25]  Sergio Fantini,et al.  Quantitative near-infrared spectroscopy on patients with peripheral vascular disease , 1998, European Conference on Biomedical Optics.

[26]  A. Villringer,et al.  Non-invasive optical spectroscopy and imaging of human brain function , 1997, Trends in Neurosciences.

[27]  Y. Matsuo,et al.  Measurement of tissue oxygen consumption in patients with mitochondrial myopathy by noninvasive tissue oximetry , 1997, Neurology.

[28]  P. Niederer,et al.  Continuous noninvasive measurement of cerebral arterial and venous oxygen saturation at the bedside in mechanically ventilated neonates. , 1997, Critical care medicine.

[29]  M. Hopman,et al.  Near infrared spectroscopy for noninvasive assessment of claudication. , 1997, The Journal of surgical research.

[30]  T Binzoni,et al.  Oxidative metabolism in muscle. , 1997, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[31]  K. McCully,et al.  Identification of peripheral vascular disease in elderly subjects using optical spectroscopy. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[32]  T. Fukunaga,et al.  Influence of adipose tissue thickness on near infrared spectroscopic signal in the measurement of human muscle. , 1996, Journal of biomedical optics.

[33]  M Depairon,et al.  The Quantitation of Blood Flow/Metabolism Coupling at Rest and After Exercise in Peripheral Arterial Insufficiency, Using PET and 15-0 Labeled Tracers , 1996, Angiology.

[34]  Britton Chance,et al.  Influence of blood vessels on the measurement of hemoglobin oxygenation as determined by time-resolved reflectance spectroscopy. , 1995, Medical physics.

[35]  Mark Cope,et al.  Measurement of changes in optical pathlength through human muscle during cuff occlusion on the arm , 1995 .

[36]  D. Delpy,et al.  Optical pathlength measurements on adult head, calf and forearm and the head of the newborn infant using phase resolved optical spectroscopy. , 1995, Physics in medicine and biology.

[37]  N. Takekoshi,et al.  Assessment of working skeletal muscle oxygenation in patients with chronic heart failure. , 1994, American heart journal.

[38]  E. Gratton,et al.  Frequency-domain multichannel optical detector for noninvasive tissue spectroscopy and oximetry , 1995 .

[39]  W. Bank,et al.  An oxidative defect in metabolic myopathies: Diagnosis by noninvasive tissue oximetry , 1994, Annals of neurology.

[40]  D. Mancini,et al.  In Vivo Magnetic Resonance Spectroscopy Measurement of Deoxymyoglobin During Exercise in Patients With Heart Failure: Demonstration of Abnormal Muscle Metabolism Despite Adequate Oxygenation , 1994, Circulation.

[41]  M. Ferrari,et al.  Noninvasive measurement of forearm blood flow and oxygen consumption by near-infrared spectroscopy. , 1994, Journal of applied physiology.

[42]  G Zaccanti,et al.  Time-resolved spectroscopy of the human forearm. , 1992, Journal of photochemistry and photobiology. B, Biology.

[43]  D. Delpy,et al.  Near‐infrared spectroscopy in peripheral vascular disease , 1991, The British journal of surgery.

[44]  S. Arridge,et al.  Estimation of optical pathlength through tissue from direct time of flight measurement. , 1988, Physics in medicine and biology.