NONINVASIVE DETECTION OF SKELETAL-MUSCLE UNDERPERFUSION WITH NEAR-INFRARED SPECTROSCOPY IN PATIENTS WITH HEART-FAILURE
NONINVASIVE DETECTION OF SKELETAL-MUSCLE UNDERPERFUSION WITH NEAR-INFRARED SPECTROSCOPY IN PATIENTS WITH HEART-FAILURE
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DOI：
10.1161/01.cir.80.6.1668
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发表时间：
1989-12-01
期刊：
影响因子：
37.8
通讯作者：
CHANCE, B
中科院分区：
文献类型：
--
作者：
WILSON, JR;MANCINI, DM;CHANCE, B
本研究旨在确定近红外光谱是否可用于无创评估心力衰竭患者的骨骼肌氧合。使用760和800 nm处的光吸收之间的差异来评估血红蛋白-肌红蛋白氧合。在离体犬股薄肌中进行的初步研究表明，760 ± 800-nm吸收密切相关（r=-0.97 ± 0.97）。0.01）与静脉血红蛋白O2饱和度时，肌肉刺激收缩在0.25-5.0 Hz。在正常受试者（n=6）和患有心力衰竭的患者（n=8）中，在休息时、在进行性最大自行车运动期间和在大腿袖带充气至超收缩压力期间监测来自股外侧肌的760 sbd 800-nm吸收变化，所述干预设计成评估最小血红蛋白-肌红蛋白氧合。吸收变化相对于从休息到大腿袖带充气的整个生理范围表示。在运动过程中，正常受试者的血红蛋白-肌红蛋白氧合最初增加，随后氧合逐渐减少至27 ±-。在140. ±. 9 W.相比之下，患者在第一次工作负荷时血红蛋白-肌红蛋白氧合表现出初始降低，随后逐渐进一步降低至26 ± 1。在60 ± 0.001的峰值运动负荷下，为生理范围的13%。8 W，不到正常受试者中注意到的峰值工作量的一半。 在所有运动负荷下，患者的血红蛋白氧合显著低于正常受试者。这些数据表明，近红外光谱法可以检测心力衰竭患者骨骼肌O2输送受损。这项技术可以提供一种有价值的方法来评估患者的肌肉O2输送，特别是在治疗干预之前和之后。
The present study was undertaken to determine whether near-infrared spectroscopy can be used to noninvasively assess skeletal muscle oxygenation in patients with heart failure. The difference between light absorption at 760 and 800 nm was used to assess hemoglobin-myoglobin oxygenation. Initial studies conducted in isolated canine gracilis muscle demonstrated that 760.sbd.800-nm absorption correlated closely (r=-0.97.+-.0.01) with venous hemoglobin O2 saturation when the muscle was stimulated to contract at 0.25-5.0 Hz. In normal subjects (n=6) and patients with heart failure (n=8), 760.sbd.800-nm absorption changes from the vastus lateralis muscle were monitored at rest, during progressive maximal bicycle exercise, and during thigh cuff inflation to suprasystolic pressure, an intervention designed to assess minimal hemoglobin-myoglobin oxygenation. Absorption changes were expressed relative to the full physiologic range noted from rest to thigh cuff inflation. During exercise, normal subjects exhibited an initial increase in hemoglobin-myoglobin oxygenation followed by a progressive decrease in oxygenation to 27.+-.13% of the physiologic range at the peak exercise workload of 140.+-.9 W. In contrast, patients exhibited an intial decrease in hemoglobin-myoglobin oxygenation with the first workload, followed by a progressive further decrease to 26.+-.13% of the physiologic range at a peak exercise workload of 60.+-.8 W, less than half the peak workload noted in the normal subjects. At all exercise loads, hemoglobin-oxygenation was significantly less in the patients than in the normal subjects. These data suggest that near-infrared spectroscopy can detect impaired skeletal muscle O2 delivery in patients with heart failure. This technique could provide a valuable method of assessing muscle O2 delivery in patients, particularly before and after therapeutic interventions.