Skeletal muscle oxygenation and fluid content in upper extremity postthrombotic syndrome: a proof-of-concept study

IF 3.4 3区 医学 Q2 HEMATOLOGY
Laura Avila , Scott Thomas , Athena Mancini , Gina Wong , Brenna Wong , Leonardo R. Brandão , Angelika Stavrakoukas , Leigh Ward , Robert F. Bentley
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Abstract

Background

Little is known about the pathophysiology of upper extremity (UE) postthrombotic syndrome (PTS).

Objectives

We aimed to investigate the effect of PTS severity on UE muscle oxygen saturation (SmO2) and fluid content during exercise and recovery in adolescents and young adults.

Methods

Eleven cases with unilateral or bilateral UE-PTS who sustained deep vein thrombosis (DVT) in childhood, and 11 age- and sex-matched controls from the general population were recruited for this case-control study. PTS was measured using CAPTSure (0-100-point score). SmO2 and segmental extracellular fluid content were measured in both UEs using near-infrared spectroscopy (NIRS) and bioimpedance spectroscopy (BIS), respectively. Incremental and constant load UE exercise tests were completed using an ergometer while monitoring NIRS and BIS parameters in both UEs. NIRS and BIS changes throughout exercise and recovery were analyzed using mixed models to account for nested data.

Results

Median age of DVT diagnosis among cases was 5.6 years (quartile [Q]1-Q3, 0.2-16.1 years). At the time of the study, median CAPTSure score in the DVT-affected UE was 39 points (Q1-Q3, 27-55 points); 55% of DVTs were associated with a central venous catheter. Mixed models showed that increasing PTS severity was associated with lower SmO2 during both incremental and constant load exercise and exercise recovery. We found no evidence of fluid accumulation during exercise.

Conclusion

The lower SmO2 suggests that UE-PTS severity is associated with muscle microvascular dysfunction and impaired blood flow during and following exercise.
上肢血栓形成后综合征骨骼肌氧合和液体含量:一项概念验证研究
背景:关于上肢(UE)血栓后综合征(PTS)的病理生理学知之甚少。目的探讨青少年和青壮年运动和恢复过程中PTS严重程度对UE肌氧饱和度(SmO2)和液体含量的影响。方法本研究招募了11例儿童时期患有深静脉血栓形成(DVT)的单侧或双侧UE-PTS患者,以及11名年龄和性别匹配的普通人群作为对照。PTS采用CAPTSure(0-100分)测量。利用近红外光谱(NIRS)和生物阻抗光谱(BIS)分别测量了两种ue中SmO2和细胞外液的含量。在监测两个UE的NIRS和BIS参数的同时,使用力量计完成增量和恒负荷UE运动测试。使用混合模型分析NIRS和BIS在运动和恢复过程中的变化,以解释嵌套数据。结果病例诊断DVT的中位年龄为5.6岁(四分位数[Q]1 ~ q3, 0.2 ~ 16.1岁)。在研究时,深静脉血栓影响UE的中位CAPTSure评分为39分(Q1-Q3, 27-55分);55%的深静脉血栓与中心静脉导管有关。混合模型显示,在增加和恒定负荷运动和运动恢复期间,PTS严重程度的增加与较低的SmO2相关。我们没有发现运动中液体积聚的证据。结论较低的SmO2提示UE-PTS严重程度与运动期间和运动后肌肉微血管功能障碍和血流受损有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
13.00%
发文量
212
审稿时长
7 weeks
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