Calf muscle hemoglobin oxygen saturation characteristics and exercise performance in patients with intermittent claudication

• Published in: Journal of vascular surgery Vol. 48; no. 3; pp. 644 - 649
• Main Authors: Gardner, Andrew W., PhD, Parker, Donald E., PhD, Webb, Nykita, BS, Montgomery, Polly S., MS, Scott, Kristy J., BS, Blevins, Steve M., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-09-2008; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Exercise Test; Exercise Tolerance; Female; General and cellular metabolism. Vitamins; Humans; Intermittent Claudication - etiology; Intermittent Claudication - metabolism; Intermittent Claudication - physiopathology; Ischemia - etiology; Ischemia - metabolism; Ischemia - physiopathology; Leg - blood supply; Male; Medical sciences; Middle Aged; Muscle Contraction; Muscle, Skeletal - metabolism; Muscle, Skeletal - physiopathology; Oxyhemoglobins - metabolism; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - metabolism; Peripheral Vascular Diseases - physiopathology; Pharmacology. Drug treatments; Recovery of Function; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Physical exercise; Human; Claudication; Oxygen; Saturation; Calf; Ox; Cardiovascular disease; Vertebrata; Mammalia; Intermittent; Surgery; Hemoglobin; Artiodactyla; Ungulata
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2008.04.005

Purpose This study was conducted to determine the association between the characteristics of calf muscle hemoglobin oxygen saturation (StO2 ) and exercise performance in patients with intermittent claudication. Methods The study comprised 39 patients with peripheral arterial disease limited by intermittent claudication. Patients were characterized on calf muscle StO2 before, during, and after a graded treadmill test, as well as on demographic and cardiovascular risk factors, ankle-brachial index (ABI), ischemic window, initial claudication distance (ICD), and absolute claudication distance (ACD). Results Calf muscle StO2 decreased 72%, from 55% ± 18% (mean ± SD) saturation at rest to the minimum value of 17% ± 19% saturation attained 459 ± 380 seconds after the initiation of exercise. After exercise, recovery half-time of calf muscle StO2 was attained at 129 ± 98 seconds, whereas full recovery to the resting value was reached at 225 ± 140 seconds. After adjusting for sex, race, and grouping according to the initial decline constant in calf muscle StO2 during exercise, the exercise time to minimum calf muscle StO2 was correlated with the ischemic window ( r = −0.493, P = .002), ICD ( r = 0.339, P = .043), and ACD ( r = 0.680, P < .001). After treadmill exercise, the recovery half-time of calf muscle StO2 was correlated with the ischemic window ( r = 0.531, P < .001), ICD ( r = −0.598, P < .001), and ACD ( r = −0.491, P = .003). Conclusion In patients limited by intermittent claudication, shorter ICD and ACD values are associated with reaching a minimum value in calf muscle StO2 sooner during treadmill exercise and with having a delayed recovery in calf muscle StO2 after exercise.