High prevalence of exercise-induced ischemia in the asymptomatic limb of patients with apparently strictly unilateral symptoms and unilateral peripheral artery disease.

IF 4.7 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2019-01-01 DOI:10.1177/1753944718819063

Samir Henni, Pascal Bauer, Tanguy Le Meliner, Jeanne Hersant, Xavier Papon, Mickael Daligault, Jean-Marie Chretien, Myriam Ammi, Jean Picquet, Pierre Abraham

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Abstract

Background:: The prevalence of exercise-induced ischemia in the asymptomatic limb of patients with unilateral claudication based on history and treadmill evaluation, and with unilateral ipsilateral peripheral artery disease (i.e ankle-to-brachial systolic pressure index <0.90) is unknown.

Methods:: We detected exercise-induced ischemia in the asymptomatic limb of patients with apparently unilateral claudication. Among 6059 exercise-oximetry tests performed in 3407 nondiabetic and 961 diabetic patients. We estimated the intensity of ischemia in the both limb (buttocks and calves) using the lowest minimum value of the decrease from rest of oxygen pressure (DROP; limb changes minus chest changes from rest), with significant ischemia defined as DROP lower than -15 mmHg.

Results:: We found 152 tests performed in 142 nondiabetic patients and 40 tests performed in 38 diabetic patients. The asymptomatic limb showed significant ischemia in 46.7% and 37.5% of the tests. Strictly unilateral exercise-induced claudication with apparently unilateral peripheral artery disease was rare (<4% of all tests). However, among these highly selected tests, significant ischemia was found in the asymptomatic limb in more than one-third of cases.

Conclusion:: The asymptomatic limb of patients with peripheral artery disease should not be considered a normal limb.

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在有明显单侧症状和单侧外周动脉疾病的患者的无症状肢体中，运动诱发缺血的发生率很高。

背景根据病史和跑步机评估，在患有单侧跛行和单侧同侧外周动脉疾病（即踝-臂收缩压指数）的患者的无症状肢体中，运动诱发缺血的发生率方法：我们检测了明显单侧跛行患者的无症状肢体中运动诱发缺血的发生率：我们检测了明显单侧跛行患者无症状肢体的运动诱发缺血。在对 3407 名非糖尿病患者和 961 名糖尿病患者进行的 6059 次运动氧饱和度测试中。我们使用氧压从静息状态下降的最低最小值（DROP；肢体变化减去胸部从静息状态的变化）来估计双侧肢体（臀部和小腿）缺血的强度，DROP低于-15 mmHg即为明显缺血：我们发现 142 名非糖尿病患者进行了 152 次测试，38 名糖尿病患者进行了 40 次测试。在 46.7% 和 37.5% 的测试中，无症状肢体出现明显缺血。严格意义上的单侧运动性跛行和明显的单侧外周动脉疾病很少见（结论：：外周动脉疾病患者的无症状肢体不应被视为正常肢体。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.