Andrade-Lima Aluísio, Cucato Gabriel G, Domingues Wagner J R, Germano-Soares Antônio H, Cavalcante Bruno R, Correia Marilia A, Saes Glauco F, Wolosker Nelson, Gardner Andrew W, Zerati Antônio E, Ritti-Dias Raphael M
Department of Physical Education, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
Albert Einstein Israelite Hospital, São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2018 Oct;52:147-152. doi: 10.1016/j.avsg.2018.03.038. Epub 2018 May 21.
Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients.
Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO parameters and walking impairment were analyzed by Pearson or Spearman correlations.
Walking impairment was not associated with any StO parameters during exercise. In contrast, after 6MWT, recovery time of StO (r = -0.472, P = 0.008) and recovery time to maximal StO (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO (r = 0.347, P = 0.048).
In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO after exercise. Calf muscle StO parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.
在症状性外周动脉疾病（PAD）患者的平板运动试验中，微循环受损与步行能力差有关；然而，该试验并未模拟这些患者日常步行的用力情况。因此，本研究的目的是描述6分钟步行试验（6MWT）期间的微循环反应，并分析症状性PAD患者微循环指标与步行障碍之间的关系。
纳入34例患者（平均年龄 = 67.6 ± 11.2岁）。收集他们的临床特征，并进行6MWT，记录初始跛行距离（ICD）和总步行距离（TWD）。在6MWT期间和之后，连续监测小腿肌肉氧饱和度（StO）参数以测量微循环行为。通过Pearson或Spearman相关性分析小腿肌肉StO参数与步行障碍之间的关联。
运动期间步行障碍与任何StO参数均无关联。相反，在6MWT后，StO恢复时间（r = -0.472，P = 0.008）和恢复至最大StO的时间（r = -0.402，P = 0.019）与ICD呈负相关。此外，在跛行症状下行走的距离（ΔTWD-ICD）与恢复至最大StO的时间呈正相关（r = 0.347，P = 0.048）。
在症状性PAD患者中，6MWT期间较短的ICD值与运动后小腿肌肉StO的延迟恢复有关。在6MWT期间小腿肌肉StO参数略有下降，这表明在模拟日常步行用力的地面行走过程中，小腿肌肉的缺血程度相对较低。
