Abstract
Resumo Contexto O relato de sintoma claudicante em pacientes com doença arterial periférica é utilizado como modulador da intensidade de exercício físico para o tratamento clínico, entretanto os valores de oxigenação tecidual nesse momento são desconhecidos. Objetivo Descrever o suprimento tecidual de oxigênio por meio da espectroscopia de luz próxima ao infravermelho ou Near-Infrared Spectroscopy (NIRS) nos momentos em que o paciente relata sintoma claudicante inicial e máximo em testes de exercício. Métodos Nove pacientes, oito homens com 65,63 ± 6,02 anos de idade, previamente diagnosticados com doença arterial periférica, realizaram teste de exercício de carga constante e de carga incremental com monitorização do nível de oxigenação tecidual através da NIRS. As saturações de oxigênio obtidas no momento em que o paciente relata sintoma claudicante inicial e no momento em que relata sintoma claudicante máximo foram comparadas com os valores de saturação da manobra de oclusão arterial por meio do intervalo de confiança de 95% da diferença. Resultados Verificou-se que os valores de saturação nos momentos de sintoma claudicante inicial e máximo são estatisticamente distintos quando comparados àqueles obtidos na manobra de oclusão arterial, entretanto, através da análise percentual do quão distante esses valores encontram-se é possível observar que, do ponto de vista clínico, eles estão próximos. Conclusões A saturação no momento em que o paciente relata sintomas claudicantes inicial e máximo é bastante próxima do valor de saturação no momento de oclusão e do ponto de vista clínico o relato subjetivo de sintoma do paciente é adequado como parâmetro para a prescrição do exercício físico.
Highlights
Peripheral arterial disease (PAD) is caused by arterial obstruction, frequently of atherosclerotic origin, resulting in reduced blood flow to the lower limbs.[1]
Intermittent claudication is defined as sensations of discomfort, pain, tingling or cramps in muscles in the area affected at times of greater aerobic demand.[2,3]
Nine patients previously diagnosed with PAD were recruited at a support service for people with peripheral arterial disease run by a University Hospital in Minas Gerais, Brazil, and were invited to take part in the study voluntarily
Summary
Peripheral arterial disease (PAD) is caused by arterial obstruction, frequently of atherosclerotic origin, resulting in reduced blood flow to the lower limbs.[1]. The time at which claudication symptoms are reported is used to modulate exercise intensity in clinical treatment of patients with peripheral arterial disease, but tissue oxygenation values at that point are unknown. Objective: To describe tissue oxygen supply measured using Near-Infrared Spectroscopy (NIRS) when patients report initial and maximum claudication symptoms during exercise tests. Results: It was found that saturation values at the time of both initial and maximum claudication symptoms were statistically different from saturation during the arterial occlusion maneuver, but on the basis of percentage analysis they were similar from a clinical point of view. Conclusions: Oxygen saturations at the time patients report initial and maximum claudication symptoms are very close to saturations during arterial occlusion.
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