A practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failure

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dc.citation.issue12
dc.citation.volume50
dc.contributor.authorBarroco, Adriano Candido [UNIFESP]
dc.contributor.authorSperandio, Priscila Abreu [UNIFESP]
dc.contributor.authorReis, Michel Silva
dc.contributor.authorAlmeida, Dirceu Rodrigues de [UNIFESP]
dc.contributor.authorNeder, Jose Alberto [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.coverageSao Paulo
dc.date.accessioned2020-07-17T14:03:31Z
dc.date.available2020-07-17T14:03:31Z
dc.date.issued2017
dc.description.abstractHeart 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 rampincremental cardiopulmonary exercise test in 10 patients (left ventricular ejection fraction o35%) 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 (Po0.05). 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; Po0.05), 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.en
dc.description.affiliationUniv Fed Sao Paulo, Disciplina Cardiol, Sao Paulo, SP, Brazil
dc.description.affiliationInst Dante Pazzanese Cardiol, Dept Cardiol, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Setor Fisiol Clin Exercicio, Disciplina Pneumol, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Rio de Janeiro, Fac Med, Dept Fisioterapia, Rio De Janeiro, RJ, Brazil
dc.description.affiliationQueens Univ, Div Resp & Crit Care Med, Lab Clin Exercise Physiol, Kingston, ON, Canada
dc.description.affiliationUnifespUniv Fed Sao Paulo, Disciplina Cardiol, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Setor Fisiol Clin Exercicio, Disciplina Pneumol, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)pt
dc.identifierhttps://dx.doi.org/10.1590/1414-431X20176327
dc.identifier.citationBrazilian Journal Of Medical And Biological Research. Sao Paulo, v. 50, n. 12, p. -, 2017.
dc.identifier.doi10.1590/1414-431X20176327
dc.identifier.fileS0100-879X2017001200603.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2017001200603
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55457
dc.identifier.wosWOS:000411936600001
dc.language.isoeng
dc.publisherAssoc Bras Divulg Cientifica
dc.relation.ispartofBrazilian Journal Of Medical And Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHeart failureen
dc.subjectExerciseen
dc.subjectOxygenen
dc.subjectMuscleen
dc.subjectNear-infrared spectroscopyen
dc.titleA practical approach to assess leg muscle oxygenation during ramp-incremental cycle ergometry in heart failureen
dc.typeinfo:eu-repo/semantics/article
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