A pilot study of regional perfusion and oxygenation in calf muscles of individuals with diabetes with a noninvasive measure

Objective To assess alterations in the regional perfusion and oxygenation of the calf muscles in individuals with diabetes. Methods Age-matched individuals with (n = 5) and without diabetes (n = 6) were investigated. Skeletal muscle perfusion, oxygen extraction fraction, and oxygen consumption rate...

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Bibliographic Details
Published in:Journal of vascular surgery 2014-02, Vol.59 (2), p.419-426
Main Authors: Zheng, Jie, PhD, Hasting, Mary K., PT, DPT, MSCI, Zhang, Xiaodong, PhD, Coggan, Andrew, PhD, An, Hongyu, PhD, Snozek, Darrah, BS, Curci, John, MD, Mueller, Michael J., PT, PhD
Format: Article
Language:English
Subjects:
Aged
Biomarkers - blood
Case-Control Studies
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - diagnosis
Diabetes Mellitus, Type 1 - physiopathology
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - physiopathology
Diabetic Angiopathies - blood
Diabetic Angiopathies - diagnosis
Diabetic Angiopathies - physiopathology
Feasibility Studies
Glycated Hemoglobin A - metabolism
Hemodynamics
Humans
Isometric Contraction
Leg
Magnetic Resonance Imaging
Middle Aged
Muscle, Skeletal - blood supply
Muscle, Skeletal - metabolism
Muscle, Skeletal - physiopathology
Oxygen Consumption
Patient Positioning
Perfusion Imaging - methods
Pilot Projects
Regional Blood Flow
Supine Position
Surgery
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Summary:Objective To assess alterations in the regional perfusion and oxygenation of the calf muscles in individuals with diabetes. Methods Age-matched individuals with (n = 5) and without diabetes (n = 6) were investigated. Skeletal muscle perfusion, oxygen extraction fraction, and oxygen consumption rate were measured by newly developed noncontrast magnetic resonance imaging (MRI) techniques. The subjects lay supine on the MRI table with their foot firmly strapped to a custom-built isometric exercise device. The measurements were performed at rest and during an isometric plantar flexion muscle contraction. Results Individuals without diabetes had up to a 10-fold increase in muscle perfusion, 25% elevation in muscle oxygen extraction fraction, and a 12-fold increase in oxygen consumption rate in the calf during the plantar flexion isometric contraction. In patients with diabetes, the increases in these parameters were only up to sixfold, 2%, and sixfold, respectively. Exercise oxygen consumption rate was inversely associated with blood HbA1c levels ( r2  = .91). Conclusions This is the first study to quantify regional skeletal muscle oxygenation in patients with diabetes using noncontrast MRI and warrants additional study. Attenuation of perfusion and oxygenation during exercise may have implications for understanding diabetic complications in the lower extremities.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2013.07.115