A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure
Heart failure is characterized by the inability of the cardiovascular system to maintain oxygen (O2) delivery (i.e., muscle blood flow in non-hypoxemic patients) to meet O2 demands. The resulting increase in fractional O2 extraction can be non-invasively tracked by deoxygenated hemoglobin concentrat...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Associação Brasileira de Divulgação Científica
2017-10-01
|
Series: | Brazilian Journal of Medical and Biological Research |
Subjects: | |
Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017001200603&lng=en&tlng=en |
id |
doaj-140eb345be6b4cddbfc7d3e4cf5bf3dd |
---|---|
record_format |
Article |
spelling |
doaj-140eb345be6b4cddbfc7d3e4cf5bf3dd2020-11-24T23:18:00ZengAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological Research1414-431X2017-10-01501210.1590/1414-431x20176327S0100-879X2017001200603A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failureA.C. BarrocoP.A. SperandioM. ReisD.R. AlmeidaJ.A. NederHeart failure is characterized by the inability of the cardiovascular system to maintain oxygen (O2) delivery (i.e., muscle blood flow in non-hypoxemic patients) to meet O2 demands. The resulting increase in fractional O2 extraction can be non-invasively tracked by deoxygenated hemoglobin concentration (deoxi-Hb) as measured by near-infrared spectroscopy (NIRS). We aimed to establish a simplified approach to extract deoxi-Hb-based indices of impaired muscle O2 delivery during rapidly-incrementing exercise in heart failure. We continuously probed the right vastus lateralis muscle with continuous-wave NIRS during a ramp-incremental cardiopulmonary exercise test in 10 patients (left ventricular ejection fraction <35%) and 10 age-matched healthy males. Deoxi-Hb is reported as % of total response (onset to peak exercise) in relation to work rate. Patients showed lower maximum exercise capacity and O2 uptake-work rate than controls (P<0.05). The deoxi-Hb response profile as a function of work rate was S-shaped in all subjects, i.e., it presented three distinct phases. Increased muscle deoxygenation in patients compared to controls was demonstrated by: i) a steeper mid-exercise deoxi-Hb-work rate slope (2.2±1.3 vs 1.0±0.3% peak/W, respectively; P<0.05), and ii) late-exercise increase in deoxi-Hb, which contrasted with stable or decreasing deoxi-Hb in all controls. Steeper deoxi-Hb-work rate slope was associated with lower peak work rate in patients (r=–0.73; P=0.01). This simplified approach to deoxi-Hb interpretation might prove useful in clinical settings to quantify impairments in O2 delivery by NIRS during ramp-incremental exercise in individual heart failure patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017001200603&lng=en&tlng=enHeart failureExerciseOxygenMuscleNear-infrared spectroscopy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
A.C. Barroco P.A. Sperandio M. Reis D.R. Almeida J.A. Neder |
spellingShingle |
A.C. Barroco P.A. Sperandio M. Reis D.R. Almeida J.A. Neder A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure Brazilian Journal of Medical and Biological Research Heart failure Exercise Oxygen Muscle Near-infrared spectroscopy |
author_facet |
A.C. Barroco P.A. Sperandio M. Reis D.R. Almeida J.A. Neder |
author_sort |
A.C. Barroco |
title |
A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
title_short |
A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
title_full |
A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
title_fullStr |
A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
title_full_unstemmed |
A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
title_sort |
practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure |
publisher |
Associação Brasileira de Divulgação Científica |
series |
Brazilian Journal of Medical and Biological Research |
issn |
1414-431X |
publishDate |
2017-10-01 |
description |
Heart failure is characterized by the inability of the cardiovascular system to maintain oxygen (O2) delivery (i.e., muscle blood flow in non-hypoxemic patients) to meet O2 demands. The resulting increase in fractional O2 extraction can be non-invasively tracked by deoxygenated hemoglobin concentration (deoxi-Hb) as measured by near-infrared spectroscopy (NIRS). We aimed to establish a simplified approach to extract deoxi-Hb-based indices of impaired muscle O2 delivery during rapidly-incrementing exercise in heart failure. We continuously probed the right vastus lateralis muscle with continuous-wave NIRS during a ramp-incremental cardiopulmonary exercise test in 10 patients (left ventricular ejection fraction <35%) and 10 age-matched healthy males. Deoxi-Hb is reported as % of total response (onset to peak exercise) in relation to work rate. Patients showed lower maximum exercise capacity and O2 uptake-work rate than controls (P<0.05). The deoxi-Hb response profile as a function of work rate was S-shaped in all subjects, i.e., it presented three distinct phases. Increased muscle deoxygenation in patients compared to controls was demonstrated by: i) a steeper mid-exercise deoxi-Hb-work rate slope (2.2±1.3 vs 1.0±0.3% peak/W, respectively; P<0.05), and ii) late-exercise increase in deoxi-Hb, which contrasted with stable or decreasing deoxi-Hb in all controls. Steeper deoxi-Hb-work rate slope was associated with lower peak work rate in patients (r=–0.73; P=0.01). This simplified approach to deoxi-Hb interpretation might prove useful in clinical settings to quantify impairments in O2 delivery by NIRS during ramp-incremental exercise in individual heart failure patients. |
topic |
Heart failure Exercise Oxygen Muscle Near-infrared spectroscopy |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2017001200603&lng=en&tlng=en |
work_keys_str_mv |
AT acbarroco apracticalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT pasperandio apracticalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT mreis apracticalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT dralmeida apracticalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT janeder apracticalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT acbarroco practicalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT pasperandio practicalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT mreis practicalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT dralmeida practicalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure AT janeder practicalapproachtoassesslegmuscleoxygenationduringrampincrementalcycleergometryinheartfailure |
_version_ |
1725582181325078528 |