Andrade-Lima Aluísio, Chehuen Marcel, Silva Junior Natan, Fecchio Rafael Y, Peçanha Tiago, Brito Leandro C, Miyasato Roberto, Leicht Anthony S, Forjaz Cláudia L M
Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Ann Vasc Surg. 2019 May;57:144-151. doi: 10.1016/j.avsg.2018.08.089. Epub 2018 Nov 23.
The aim of this study is to identify, in patients with peripheral artery disease and intermittent claudication (IC), the reproducibility of heart rate (HR), blood pressure (BP), rate pressure product, heart rate variability (HRV), and forearm and calf blood flow (BF) and vasodilatory assessments.
Twenty-nine patients with IC underwent test and retest sessions, 8-12 days apart. During each session, HR, BP, HRV, BF, and vasodilatory responses were measured by electrocardiogram, auscultation, spectral analysis of HRV (low frequency, LF; high frequency, HF), and strain gauge plethysmography (baseline BF, post-occlusion BF, post-occlusion area under the curve). Reproducibility was determined by intra-class correlation coefficient (ICC), typical error, coefficient of variation (CV), and limits of agreement.
The ICC for HR and BP was >0.8 with CV <9%. For most HRV measures, ICC was >0.9 while CV was <7%, except for LF/HF (ICC = 0.737, CV = 93.8%). The ICC for forearm and calf baseline BF assessments was >0.9 while CV was <19%; variable ICC and CV for vasodilatory responses were exhibited for calf (0.653-0.770, 35.2-37.7%) and forearm (0.169-0.265, 46.2-55.5%).
In male patients with IC, systemic hemodynamics (HR and BP), cardiac autonomic modulation (LF and HF), and forearm and calf baseline BF assessments exhibited excellent reproducibility, whereas the level of reproducibility for vasodilatory responses were moderate to poor. Assessment reproducibility has highlighted appropriate clinical tools for the regular monitoring of disease/intervention progression in patients with IC.
本研究旨在确定外周动脉疾病和间歇性跛行（IC）患者心率（HR）、血压（BP）、心率血压乘积、心率变异性（HRV）以及前臂和小腿血流量（BF）与血管舒张评估的可重复性。
29例IC患者在间隔8 - 12天的时间里接受了两次测试。每次测试期间，通过心电图、听诊、HRV频谱分析（低频，LF；高频，HF）以及应变片体积描记法（基线BF、阻断后BF、阻断后曲线下面积）测量HR、BP、HRV、BF和血管舒张反应。通过组内相关系数（ICC）、典型误差、变异系数（CV）和一致性界限来确定可重复性。
HR和BP的ICC>0.8，CV<9%。对于大多数HRV测量指标，ICC>0.9而CV<7%，除了LF/HF（ICC = 0.737，CV = 93.8%）。前臂和小腿基线BF评估的ICC>0.9而CV<19%；小腿（0.653 - 0.770，35.2 - 37.7%）和前臂（0.169 - 0.265，46.2 - 55.5%）的血管舒张反应表现出不同的ICC和CV。
在男性IC患者中，全身血流动力学（HR和BP）、心脏自主神经调节（LF和HF）以及前臂和小腿基线BF评估具有出色的可重复性，而血管舒张反应的可重复性水平为中等至较差。评估的可重复性突出了用于定期监测IC患者疾病/干预进展的合适临床工具。
