Diagnosing Sport-Related Flow Limitations in the Iliac Arteries Using Near-Infrared Spectroscopy

Martijn van Hooff; Jem Arnold; Eduard Meijer; Paul Schreuder; Marta Regis; Lin Xu; Marc Scheltinga; Hans Savelberg; Goof Schep

doi:10.3390/jcm11247462

Diagnosing Sport-Related Flow Limitations in the Iliac Arteries Using Near-Infrared Spectroscopy

Martijn van Hooff^*, Jem Arnold, Eduard Meijer, Paul Schreuder, Marta Regis, Lin Xu, Marc Scheltinga, Hans Savelberg, Goof Schep

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NIRS) is a non-invasive technique that measures skeletal muscle oxygenation as reflected by the balance of O2 delivery from microvascular blood flow and O2 uptake by metabolic activity. Therefore, NIRS potentially serves as a novel technique for diagnosing FLIA. The purpose of this study is to compare the diagnostic accuracy of NIRS-derived absolute, amplitude, and kinetic variables in legs during and after a maximal exercise test with ABIFlexed.

METHODS: ABIFlexed and NIRS were studied in 33 healthy subjects and 201 patients with FLIA diagnosed with echo-Doppler.

RESULTS: After maximal exercise, NIRS kinetic variables, such as the half value time and mean response time, resulted in a range of 0.921 to 0.939 AUC for the diagnosis of FLIA when combined with ABIFlexed. Conversely, ABIFlexed measurements alone conferred significantly worse test characteristics (AUC 0.717, p < 0.001).

CONCLUSIONS: NIRS may serve as a diagnostic adjunct in patients with possible FLIA.

Original language	English
Article number	7462
Number of pages	16
Journal	Journal of Clinical Medicine
Volume	11
Issue number	24
DOIs	https://doi.org/10.3390/jcm11247462
Publication status	Published - 16 Dec 2022

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10.3390/jcm11247462Licence: CC BY

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@article{22f064d0323d44c3a7c80bfa93757f53,

title = "Diagnosing Sport-Related Flow Limitations in the Iliac Arteries Using Near-Infrared Spectroscopy",

abstract = "BACKGROUND: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NIRS) is a non-invasive technique that measures skeletal muscle oxygenation as reflected by the balance of O2 delivery from microvascular blood flow and O2 uptake by metabolic activity. Therefore, NIRS potentially serves as a novel technique for diagnosing FLIA. The purpose of this study is to compare the diagnostic accuracy of NIRS-derived absolute, amplitude, and kinetic variables in legs during and after a maximal exercise test with ABIFlexed.METHODS: ABIFlexed and NIRS were studied in 33 healthy subjects and 201 patients with FLIA diagnosed with echo-Doppler.RESULTS: After maximal exercise, NIRS kinetic variables, such as the half value time and mean response time, resulted in a range of 0.921 to 0.939 AUC for the diagnosis of FLIA when combined with ABIFlexed. Conversely, ABIFlexed measurements alone conferred significantly worse test characteristics (AUC 0.717, p < 0.001).CONCLUSIONS: NIRS may serve as a diagnostic adjunct in patients with possible FLIA.",

author = "{van Hooff}, Martijn and Jem Arnold and Eduard Meijer and Paul Schreuder and Marta Regis and Lin Xu and Marc Scheltinga and Hans Savelberg and Goof Schep",

note = "Funding Information: ZonMw Project number: 75020017, Laan van Nieuw Oost-Indi{\"e} 334, 2593 CE Den Haag, Zuid Holland, The Netherlands, Telephone: 0031703495111, E-mail: info@zonmw.nl. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = dec,

day = "16",

doi = "10.3390/jcm11247462",

language = "English",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

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TY - JOUR

T1 - Diagnosing Sport-Related Flow Limitations in the Iliac Arteries Using Near-Infrared Spectroscopy

AU - van Hooff, Martijn

AU - Arnold, Jem

AU - Meijer, Eduard

AU - Schreuder, Paul

AU - Regis, Marta

AU - Xu, Lin

AU - Scheltinga, Marc

AU - Savelberg, Hans

AU - Schep, Goof

N1 - Funding Information: ZonMw Project number: 75020017, Laan van Nieuw Oost-Indië 334, 2593 CE Den Haag, Zuid Holland, The Netherlands, Telephone: 0031703495111, E-mail: info@zonmw.nl. Publisher Copyright: © 2022 by the authors.

PY - 2022/12/16

Y1 - 2022/12/16

N2 - BACKGROUND: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NIRS) is a non-invasive technique that measures skeletal muscle oxygenation as reflected by the balance of O2 delivery from microvascular blood flow and O2 uptake by metabolic activity. Therefore, NIRS potentially serves as a novel technique for diagnosing FLIA. The purpose of this study is to compare the diagnostic accuracy of NIRS-derived absolute, amplitude, and kinetic variables in legs during and after a maximal exercise test with ABIFlexed.METHODS: ABIFlexed and NIRS were studied in 33 healthy subjects and 201 patients with FLIA diagnosed with echo-Doppler.RESULTS: After maximal exercise, NIRS kinetic variables, such as the half value time and mean response time, resulted in a range of 0.921 to 0.939 AUC for the diagnosis of FLIA when combined with ABIFlexed. Conversely, ABIFlexed measurements alone conferred significantly worse test characteristics (AUC 0.717, p < 0.001).CONCLUSIONS: NIRS may serve as a diagnostic adjunct in patients with possible FLIA.

AB - BACKGROUND: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NIRS) is a non-invasive technique that measures skeletal muscle oxygenation as reflected by the balance of O2 delivery from microvascular blood flow and O2 uptake by metabolic activity. Therefore, NIRS potentially serves as a novel technique for diagnosing FLIA. The purpose of this study is to compare the diagnostic accuracy of NIRS-derived absolute, amplitude, and kinetic variables in legs during and after a maximal exercise test with ABIFlexed.METHODS: ABIFlexed and NIRS were studied in 33 healthy subjects and 201 patients with FLIA diagnosed with echo-Doppler.RESULTS: After maximal exercise, NIRS kinetic variables, such as the half value time and mean response time, resulted in a range of 0.921 to 0.939 AUC for the diagnosis of FLIA when combined with ABIFlexed. Conversely, ABIFlexed measurements alone conferred significantly worse test characteristics (AUC 0.717, p < 0.001).CONCLUSIONS: NIRS may serve as a diagnostic adjunct in patients with possible FLIA.

U2 - 10.3390/jcm11247462

DO - 10.3390/jcm11247462

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