Parameters of Postocclusive Reactive Hyperemia Measured by Near Infrared Spectroscopy in Patients with Peripheral Vascular Disease and in Healthy Volunteers

AbstractThe main purpose of our study was to determine the parameters of the postocclusive reactive hyperemia test that could help and provide the clinician with information about the tissue oxygenation, the severity of the disease, and the results of the applied therapies. Near infrared spectroscopy (NIRS) proved to be a valid noninvasive trend monitor useful for investigating the physiology of oxygen transport to tissue. Important advantages of NIRS over transcutaneous oximetry (TcpO2) are: (a) a more dynamic nature of the NIRS signals which reflects more closely the actual response of the peripheral vasculature to the occlusive provocation; (b) larger sampling volume; and (c) the ability of assessing tissue oxygenation at deeper tissue levels. We demonstrated that the time parameters of reactive hyperemia, the rate of reactive hyperemia, and the maximal change during reactive hyperemia, all calculated from the oxyhemoglobin (HbO2) signal of the NIRS, clearly distinguish between healthy volunteers and patients with vascular disorder. The time parameters of reactive hyperemia were significantly longer (p < 0.01), and the rate of reactive hyperemia (p = 0.01) as well as the maximal change during reactive hyperemia (p = 0.02) were significantly lower in patient group compared to healthy volunteers. These parameters were also in good correlation with the values of ankle brachial index (ABI) and the resting values of oxygen partial pressure (TcpO2). Values of the chosen parameters obtained from the HbO2 signal were further compared between groups of diabetic and nondiabetic patients with peripheral vascular disease. Although longer time parameters of reactive hyperemia and lower rates of hyperemic response were detected, the difference between both groups was not statistically significant. © 2001 Biomedical Engineering Society. PAC01: 8764Je, 8719Xx

[1]  H. Shigematsu,et al.  An objective assessment of intermittent claudication by near-infrared spectroscopy. , 1994, European journal of vascular surgery.

[2]  J. Leigh,et al.  In vivo MRS measurement of deoxymyoglobin in human forearms , 1990, Magnetic resonance in medicine.

[3]  A. Guyton,et al.  Textbook of Medical Physiology , 1961 .

[4]  J. Griffin,et al.  Textbook of Medical Physiology 4th Ed , 1971 .

[5]  K. Brismar,et al.  Pronounced skin capillary ischemia in the feet of diabetic patients with bad metabolic control , 1998, Diabetologia.

[6]  B. Oeseburg,et al.  Determination of oxygen consumption in muscle during exercise using near infrared spectroscopy , 1995, Acta anaesthesiologica Scandinavica. Supplementum.

[7]  S Nioka,et al.  Time-resolved spectroscopy of hemoglobin and myoglobin in resting and ischemic muscle. , 1988, Analytical biochemistry.

[8]  L. Frenkel,et al.  Noninvasive quantification of muscle oxygen in subjects with and without claudication. , 1997, Journal of rehabilitation research and development.

[9]  M. Cope,et al.  Oxygen consumption of human skeletal muscle by near infrared spectroscopy during tourniquet-induced ischemia in maximal voluntary contraction. , 1992, Advances in experimental medicine and biology.

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

[11]  B Chance,et al.  Noninvasive measures of oxidative metabolism on working human muscles by near-infrared spectroscopy. , 1996, Journal of applied physiology.

[12]  M. Ferrari,et al.  Cerebral blood volume and hemoglobin oxygen saturation monitoring in neonatal brain by near IR spectroscopy. , 1986, Advances in experimental medicine and biology.

[13]  G. Yosipovitch,et al.  Skin Reactive Hyperemia in Diabetic Patients: A Study by Laser Doppler Flowmetry , 1991, Diabetes Care.

[14]  A. M. Weindling,et al.  Measurement of venous oxyhaemoglobin saturation in the adult human forearm by near infrared spectroscopy with venous occlusion , 1997, Medical and Biological Engineering and Computing.

[15]  C. Piantadosi,et al.  Near infrared monitoring of human skeletal muscle oxygenation during forearm ischemia. , 1988, Journal of applied physiology.

[16]  A. Nicolaides,et al.  Noninvasive Investigations in Vascular Disease , 1998 .

[17]  Susan Wray,et al.  QUANTIFICATION OF CEREBRAL OXYGENATION AND HAEMODYNAMICS IN SICK NEWBORN INFANTS BY NEAR INFRARED SPECTROPHOTOMETRY , 1986, The Lancet.

[18]  I D Swain,et al.  Methods of measuring skin blood flow. , 1989, Physics in medicine and biology.

[19]  R. Maniewski,et al.  Multichannel laser-Doppler probe for blood perfusion measurements with depth discrimination , 1998, Medical and Biological Engineering and Computing.

[20]  W. Aue,et al.  Phosphocreatine content and intracellular pH of calf muscle measured by phosphorus NMR spectroscopy in occlusive arterial disease of the legs , 1985, European journal of clinical investigation.

[21]  J. Craggs,et al.  Time-Resolved Spectroscopy , 1961, Nature.

[22]  D T Delpy,et al.  Measurement of hemoglobin flow and blood flow by near-infrared spectroscopy. , 1993, Journal of applied physiology.

[23]  F. Jöbsis Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. , 1977, Science.

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

[25]  S. Arridge,et al.  Estimation of optical pathlength through tissue from direct time of flight measurement , 1988 .

[26]  K. McCully,et al.  Exercise-induced changes in oxygen saturation in the calf muscles of elderly subjects with peripheral vascular disease. , 1994, Journal of gerontology.

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

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

[29]  Effect of Fetal Hemoglobin on the Determination of Neonatal Cerebral Oxygenation by Near-Infrared Spectroscopy , 1993, Pediatric Research.

[30]  D. Slaaf,et al.  Can transcutaneous oximetry detect nutritive perfusion disturbances in patients with lower limb ischemia? , 1995, Microvascular research.

[31]  J. Brazy,et al.  Near-infrared spectroscopy. , 1991, Clinics in perinatology.

[32]  C J Green,et al.  Measurements of tissue viability in transplantation. , 1997, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[33]  D. Delpy,et al.  Quantitation of cerebral blood volume in human infants by near-infrared spectroscopy. , 1990, Journal of applied physiology.

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

[35]  Alan Murray,et al.  Editorial: Cellular engineering and the future , 2006, Medical and Biological Engineering and Computing.

[36]  L Bolinger,et al.  Validation of near-infrared spectroscopy in humans. , 1994, Journal of applied physiology.

[37]  K. Kvernebo,et al.  Laser Doppler flowmetry in evaluation of skin post-ischaemic reactive hyperaemia. A study in healthy volunteers and atherosclerotic patients. , 1989, The Journal of cardiovascular surgery.

[38]  C. Piantadosi,et al.  Near‐infrared spectrophotometric monitoring of oxygen distribution to intact brain and skeletal muscle tissues , 1986, Critical care medicine.

[39]  B Chance,et al.  Recovery from exercise-induced desaturation in the quadriceps muscles of elite competitive rowers. , 1992, The American journal of physiology.

[40]  R. Ross The pathogenesis of atherosclerosis: a perspective for the 1990s , 1993, Nature.

[41]  Marco Ferrari,et al.  Noninvasive measurement of human forearm oxygen consumption by near infrared spectroscopy , 1993, European Journal of Applied Physiology and Occupational Physiology.