Assessment of working skeletal muscle oxygenation in patients with chronic heart failure

Matsui, Shinobu; Tamura, Nobuki; Hirakawa, Tomoyuki; Kobayashi, Saeko; Takekoshi, Noboru; Murakami, Eiji

doi:10.1016/0002-8703(95)90317-8

Cited by 47 publications

(33 citation statements)

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“…Although several previous studies reported exercise tests using a sitting ergometer without describing inflection points for oxy-Hb and deoxy-Hb changes in working muscles of the lower limbs, 8,10,24,25 Belardinelli et al 11 and Takahashi et al 13 demonstrated the point at which oxy-Hb started to decrease, and its high correlation with the AT. Honma et al determined the AT in 6 of 10 normal male subjects, and although they did not detect a relationship between oxy-Hb decrease and AT, they observed an oxyHb decrease near the AT in 3 cases.…”

Section: Generalization Of the Nir Spectroscopy Parametersmentioning

confidence: 99%

“…8 Matsui et al reported an earlier occurrence of oxy-Hb decrease in femoral muscles in patients with heart failure compared to normal subjects. 10 However, NIR spectroscopy measures the relative changes of oxy-Hb, deoxygenated hemoglobin (deoxy-Hb) and total hemoglobin volume (total-Hb) using NIR light absorption changes, and quantification of these parameters in human is difficult to achieve.Belardinelli et al performed constant load exercise tests in normal subjects, and reported that oxy-Hb reached a constant state at a workload lower than the anaerobic threshold (AT; obtained from expired gas analysis) but decreased at a workload higher than the AT. 11 Another study that used a ramp load in normal subjects, identified the inflection point of oxy-Hb decrease in the femoral quadriceps muscle and reported a high correlation with the AT.…”

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Skeletal Muscle Deoxygenation During Exercise Assessed by Near-Infrared Spectroscopy and its Relation to Expired Gas Analysis Parameters

et al. 1998

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xercise intolerance and left ventricular dysfunction are both significant predictors of prognosis in patients with heart failure. 1 In these patients, exercise capacity is limited by abnormalities of cardiac function, ventilation, skeletal muscle blood flow, skeletal muscle oxygen extraction, or skeletal muscle metabolism. 2 Methods to assess blood flow and oxygen kinetics in the lower limbs have utilized femoral vein catheter techniques (including thermodilution, dye-dilution and determination of the difference between arterial and venous oxygen), 3 venous plethsmography 4 and the 133 Xe technique. 5 However, all these methods are difficult to apply to working muscles during exercise. Since the application of near-infrared (NIR) spectroscopy in vivo by Jöbsis, 6 it has been used as a non-invasive method to assess the oxygen kinetics in tissues, mainly through monitoring the oxygenation and deoxygenation of hemoglobin, 7 although this method cannot measure myoglobin and hemoglobin separately. In animal and human skeletal muscles during exercise, the changes in oxygenated hemoglobin (oxy-Hb) content measured by NIR spectroscopy bears a high correlation with the changes in venous hemoglobin oxygen saturation, and could be used to determine the oxygen kinetics in working muscles during exercise. 8,9 Wilson et al reported greater oxy-Hb decrease in the vastus lateralis muscles in heart failure patients than in sedentary normal subjects at the same work rate, and demonstrated the possible clinical applications of the method. 8 Matsui et al reported an earlier occurrence of oxy-Hb decrease in femoral muscles in patients with heart failure compared to normal subjects. 10 However, NIR spectroscopy measures the relative changes of oxy-Hb, deoxygenated hemoglobin (deoxy-Hb) and total hemoglobin volume (total-Hb) using NIR light absorption changes, and quantification of these parameters in human is difficult to achieve.Belardinelli et al performed constant load exercise tests in normal subjects, and reported that oxy-Hb reached a constant state at a workload lower than the anaerobic threshold (AT; obtained from expired gas analysis) but decreased at a workload higher than the AT. 11 Another study that used a ramp load in normal subjects, identified the inflection point of oxy-Hb decrease in the femoral quadriceps muscle and reported a high correlation with the AT. 12 Takahashi et al performed ramp load exercise tests in athletes, normal subjects and patients with heart failure, and reported an inflection point of oxy-Hb decrease in the femoral quadriceps muscle and a high correlation with the AT. 13 If an inflection point can be identified from the NIR spectroscopy measurements of oxy-Hb changes in working muscles, then quantification may be possible by simultaneously analyzing the expired gas which provides the oxygen uptake (V • O2) at specific points of oxy-Hb and deoxy-Hb changes. Although the AT and the respiratory compensation point (RCP), which is the starting point of respiratory compensation against metabolic acid...

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Section: Generalization Of the Nir Spectroscopy Parametersmentioning

confidence: 99%

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confidence: 99%

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Skeletal Muscle Deoxygenation During Exercise Assessed by Near-Infrared Spectroscopy and its Relation to Expired Gas Analysis Parameters

et al. 1998

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“…NIRS has been applied to infants and adults to measure hemodynamics and oxygenation in many fields such as the brain, but one particularly promising field is the skeletal muscle (2)(3)(4)(5). Studies in the skeletal muscle have included measurements in sports medicine (6,7) and in patients with peripheral vascular disease (8 -17), myopathies (18 -20), and heart failure (21)(22)(23).…”

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confidence: 99%

Regional Differences of Hemodynamics and Oxygenation in the Human Calf Muscle Detected with Near-Infrared Spectrophotometry

Wolf¹,

Wolf²,

Choi³

et al. 2007

Journal of Vascular and Interventional Radiology

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PURPOSE: Measurements in muscle tissue are often performed at a selected single location over the muscle of interest. The hypothesis is that the values obtained reflect the status within the entire muscle or muscle group. This, however, may not be the case. The study was performed to investigate whether this hypothesis is true for hemodynamics and oxygenation in the healthy human calf muscle at rest. MATERIALS AND METHODS:Hemoglobin flow, blood flow, oxygen consumption, and venous hemoglobin oxygen saturation were mapped at 22 locations in 30 legs of 15 healthy subjects (nine women, six men aged 26 -37 years) simultaneously by using frequency-domain near-infrared spectrophotometry with a specially designed probe during venous occlusion. RESULTS: For all parameters, spatial heterogeneity was found between subjects and within individual legs. All parameters were highly significantly different when comparing proximal and distal regions. Differences were also found between medial and lateral regions. The global mean values (؎standard deviation) over all measurements were as follows: hemoglobin flow, 1.27 mol per 100 mL/min ؎ 0.88; blood flow, 0.56 mL per 100 g/min ؎ 0.38; oxygen consumption, 0.016 mL per 100 g/min ؎ 0.011; and venous oxygen saturation, 77.6% ؎ 5.9. The thickness of the overlying adipose tissue had an influence on the measurements and must be considered. CONCLUSION: Highly significant spatial heterogeneity of hemodynamics and oxygenation was found in the healthy human calf muscle. J Vasc Interv Radiol 2007; 18:1094 -1101Abbreviations: ATT ϭ adipose tissue thickness, DPF ϭ differential pathlength factor, NIRS ϭ near-infrared spectrophotometry, SvO 2 ϭ venous oxygen saturation, TRV ϭ test-retest variability, VO 2 ϭ oxygen consumption NEAR-INFRARED spectrophotometry (NIRS) is a valuable tool for measuring hemodynamics and oxygenation in human tissue. NIRS is noninvasive, provides real-time measurements, is costeffective, is feasible at the bedside, and is easily repeatable and reproducible and, therefore, suitable for use in the clinical setting. Because NIRS provides measurements at the level of arterioles, capillaries, and venules (1) several centimeters deep in the tissue, it is a complementary method to Doppler, which probes larger blood vessels, laser Doppler flowmetry, which measures superficial blood vessels, and imaging techniques such as magnetic resonance (MR) imaging, positron emission tomography (PET), and radiography, which depend on the use of ionizing radiation and/or contrast media. NIRS has been applied to infants and adults to measure hemodynamics and oxygenation in many fields such as the brain, but one particularly promising field is the skeletal muscle (2-5). Studies in the skeletal muscle have included measurements in sports medicine (6,7) and in patients with peripheral vascular disease (8 -17), myopathies (18 -20), and heart failure (21-23).Measurements in muscle tissue are often performed at a selected single location over the muscle of interest. The values obtained are consider...

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“…However, this deficit was seemingly greater after cold water immersion compared with active recovery, possibly as a result of lower cardiac output, muscle blood volume and/or oxidative capacity. In support of this notion, other research indicates that SmO 2 desaturation in muscle during exercise occurs more rapidly when central blood flow is limited (Matsui et al, 1995). Similarly, SmO 2 resaturation in muscle after exercise occurs more slowly as a result of reduced central (Hanada et al, 2000) and peripheral (McCully et al, 1997) blood flow.…”

Section: O N T R a C T I O Nmentioning

confidence: 76%

Cellular, molecular and physiological effects of post-resistance exercise cold water immersion: Implications for subsequent perofrmance

Roberts¹

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The objective of this thesis was to examine the efficacy of cold water immersion as a recovery therapy after resistance exercise. To achieve this objective, the research had two distinct aims, (1) to investigate how cold water immersion influences acute (short-term) physiological and performance responses following a single bout of resistance exercise, and (2) to investigate how regular (longer-term) use of cold water immersion following resistance training sessions may effect training-induced adaptation.Recovery following resistance exercise is a complex, multi-faceted process that can involve the combination of a variety of recovery therapies, all with the common goal of restoring physiological and psychological homeostasis. The timing of subsequent exercise bout(s) and the desired outcome from the preceding exercise bout will heavily determine the recovery duration, and whether emphasis is placed upon a single recovery therapy over another. Cold water immersion is a popular post-exercise recovery therapy with extensive use worldwide, largely due to its simplicity, and cost-effective nature of implementation. However, the use of cold water immersion is largely supported only by anecdotal evidence from athletes and practitioners. Little physiological evidence is available as to its mechanisms of action following exercise, both in acute, and long term settings.There is a paucity of physiological knowledge available regarding post-exercise cold water immersion per se, and this is accompanied with a disparity in the reported physiological and performance responses. The degree of disparity can be attributed not only to the use of cold water immersion protocols differing in e.g. temperature (5 -15 o C), duration (5 -20 min), immersion depth (individual limb(s) compared with whole-body) and application frequency (single compared with multiple post-exercise immersions), but also to exercise protocols with varied degrees of ecological validity.In a first experimental study, detailed in chapter 2, I investigated how a bout of active recovery (stationary, low-intensity cycling) compared with a 10 min bout of CWI at 10 o C performed after a single high-intensity resistance training session in influencing physiological and performance responses over a 6-hour recovery period. Large physiological responses were observed over the initial period of recovery that could be attributed to a decrease in central (cardiac output) and peripheral (muscle artero-venous) blood flow following cold water immersion. Despite such physiological responses, participants were able to perform more work during a resistance exercise training simulation exercise when cold water immersion was used. Therefore, a second iii experimental study, detailed in chapter 3 was undertaken to more closely investigate how performing cold water immersion or active recovery after resistance exercise influence physiological responses over the initial 60 min following the recovery therapy, and how these physiological responses correspond with exercise perf...

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Assessment of working skeletal muscle oxygenation in patients with chronic heart failure

Cited by 47 publications

References 29 publications

Skeletal Muscle Deoxygenation During Exercise Assessed by Near-Infrared Spectroscopy and its Relation to Expired Gas Analysis Parameters

Skeletal Muscle Deoxygenation During Exercise Assessed by Near-Infrared Spectroscopy and its Relation to Expired Gas Analysis Parameters

Regional Differences of Hemodynamics and Oxygenation in the Human Calf Muscle Detected with Near-Infrared Spectrophotometry

Cellular, molecular and physiological effects of post-resistance exercise cold water immersion: Implications for subsequent perofrmance

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