Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease

Aluísio Andrade-Lima; Gabriel G Cucato; Wagner J R Domingues; Antônio H Germano-Soares; Bruno R Cavalcante; Marilia A Correia; Glauco F Saes; Nelson Wolosker; Andrew W Gardner; Antônio E Zerati; Raphael M Ritti-Dias

doi:10.1016/j.avsg.2018.03.038

Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease

Aluísio Andrade-Lima, Gabriel G Cucato, Wagner J R Domingues, Antônio H Germano-Soares, Bruno R Cavalcante, Marilia A Correia, Glauco F Saes, Nelson Wolosker, Andrew W Gardner, Antônio E Zerati, Raphael M Ritti-Dias

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients.

METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations.

RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048).

CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.

Original language	English
Pages (from-to)	147-152
Number of pages	6
Journal	Annals of Vascular Surgery
Volume	52
Early online date	21 May 2018
DOIs	https://doi.org/10.1016/j.avsg.2018.03.038
Publication status	Published - Oct 2018
Externally published	Yes

Keywords

Aged
Exercise Tolerance
Female
Humans
Intermittent Claudication/diagnosis
Leg
Male
Microcirculation
Middle Aged
Muscle Contraction
Muscle, Skeletal/blood supply
Oxygen Consumption
Peripheral Arterial Disease/diagnosis
Predictive Value of Tests
Time Factors
Walk Test
Walking

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10.1016/j.avsg.2018.03.038

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Andrade-Lima, A., Cucato, G. G., Domingues, W. J. R., Germano-Soares, A. H., Cavalcante, B. R., Correia, M. A., Saes, G. F., Wolosker, N., Gardner, A. W., Zerati, A. E., & Ritti-Dias, R. M. (2018). Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease. Annals of Vascular Surgery, 52, 147-152. https://doi.org/10.1016/j.avsg.2018.03.038

@article{964fb70ae5d04d94a8cb0f53d2747d2d,

title = "Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease",

abstract = "BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients.METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations.RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048).CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.",

keywords = "Aged, Exercise Tolerance, Female, Humans, Intermittent Claudication/diagnosis, Leg, Male, Microcirculation, Middle Aged, Muscle Contraction, Muscle, Skeletal/blood supply, Oxygen Consumption, Peripheral Arterial Disease/diagnosis, Predictive Value of Tests, Time Factors, Walk Test, Walking",

author = "Alu{\'i}sio Andrade-Lima and Cucato, {Gabriel G} and Domingues, {Wagner J R} and Germano-Soares, {Ant{\^o}nio H} and Cavalcante, {Bruno R} and Correia, {Marilia A} and Saes, {Glauco F} and Nelson Wolosker and Gardner, {Andrew W} and Zerati, {Ant{\^o}nio E} and Ritti-Dias, {Raphael M}",

year = "2018",

month = oct,

doi = "10.1016/j.avsg.2018.03.038",

language = "English",

volume = "52",

pages = "147--152",

journal = "Annals of Vascular Surgery",

issn = "0890-5096",

publisher = "Elsevier",

}

Andrade-Lima, A, Cucato, GG, Domingues, WJR, Germano-Soares, AH, Cavalcante, BR, Correia, MA, Saes, GF, Wolosker, N, Gardner, AW, Zerati, AE & Ritti-Dias, RM 2018, 'Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease', Annals of Vascular Surgery, vol. 52, pp. 147-152. https://doi.org/10.1016/j.avsg.2018.03.038

TY - JOUR

T1 - Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease

AU - Andrade-Lima, Aluísio

AU - Cucato, Gabriel G

AU - Domingues, Wagner J R

AU - Germano-Soares, Antônio H

AU - Cavalcante, Bruno R

AU - Correia, Marilia A

AU - Saes, Glauco F

AU - Wolosker, Nelson

AU - Gardner, Andrew W

AU - Zerati, Antônio E

AU - Ritti-Dias, Raphael M

PY - 2018/10

Y1 - 2018/10

N2 - BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients.METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations.RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048).CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.

AB - BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients.METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations.RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048).CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.

KW - Aged

KW - Exercise Tolerance

KW - Female

KW - Humans

KW - Intermittent Claudication/diagnosis

KW - Leg

KW - Male

KW - Microcirculation

KW - Middle Aged

KW - Muscle Contraction

KW - Muscle, Skeletal/blood supply

KW - Oxygen Consumption

KW - Peripheral Arterial Disease/diagnosis

KW - Predictive Value of Tests

KW - Time Factors

KW - Walk Test

KW - Walking

U2 - 10.1016/j.avsg.2018.03.038

DO - 10.1016/j.avsg.2018.03.038

M3 - Article

C2 - 29793014

SN - 0890-5096

VL - 52

SP - 147

EP - 152

JO - Annals of Vascular Surgery

JF - Annals of Vascular Surgery

ER -

Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease

Abstract

Keywords

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