Near-Infrared Spectroscopy Is Promising to Detect Iliac Artery Flow Limitations in Athletes: A Pilot Study

Martijn van Hooff, Goof Schep, Eduard Meijer, Mart Bender, Hans Savelberg

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career.These flow limitations are due to extreme hemodynamic stresswhichmay result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair. However, current diagnostic techniques have unsatisfactory sensitivity and cannot be applied during exercise. Near-infrared spectroscopy (NIRS) has shown great diagnostic potential in peripheral vascular disease and might bring a solution since it measures tissue oxygenation in real time during and after exercise.This report describes the first experiences of the application of NIRS in the vastus lateralis muscle during and after maximal graded cycling exercise in ten healthy participants and in three patients with flow limitations due to (1) subtle functional kinking, (2) an intravascular lesion, and (3) severe functional kinking.The results are put into perspective based on an empirically fitted model. Delayed recovery, showing clearly different types of patterns of tissue reoxygenation after exercise, was found in the affected athletes compared with the healthy participants. In the patients that had kinking of the arteries, tissue reoxygenation was clearlymore delayed if NIRS was measured in provocative position with flexed hip. In this pilot experiment, clearly distinctive
reoxygenation patterns are observed during recovery consistentwith severity of flowlimitation, indicating that NIRS is a promising diagnostic tool to detect and grade arterial flow limitations in athletes. Our findings may guide research and optimization of NIRS for future clinical application.
Original languageEnglish
Article number8965858
Pages (from-to)1-11
Number of pages11
JournalJournal of Sports Medicine
Volume2018
DOIs
Publication statusPublished - 2018

Cite this

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title = "Near-Infrared Spectroscopy Is Promising to Detect Iliac Artery Flow Limitations in Athletes: A Pilot Study",
abstract = "Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career.These flow limitations are due to extreme hemodynamic stresswhichmay result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair. However, current diagnostic techniques have unsatisfactory sensitivity and cannot be applied during exercise. Near-infrared spectroscopy (NIRS) has shown great diagnostic potential in peripheral vascular disease and might bring a solution since it measures tissue oxygenation in real time during and after exercise.This report describes the first experiences of the application of NIRS in the vastus lateralis muscle during and after maximal graded cycling exercise in ten healthy participants and in three patients with flow limitations due to (1) subtle functional kinking, (2) an intravascular lesion, and (3) severe functional kinking.The results are put into perspective based on an empirically fitted model. Delayed recovery, showing clearly different types of patterns of tissue reoxygenation after exercise, was found in the affected athletes compared with the healthy participants. In the patients that had kinking of the arteries, tissue reoxygenation was clearlymore delayed if NIRS was measured in provocative position with flexed hip. In this pilot experiment, clearly distinctivereoxygenation patterns are observed during recovery consistentwith severity of flowlimitation, indicating that NIRS is a promising diagnostic tool to detect and grade arterial flow limitations in athletes. Our findings may guide research and optimization of NIRS for future clinical application.",
author = "{van Hooff}, Martijn and Goof Schep and Eduard Meijer and Mart Bender and Hans Savelberg",
year = "2018",
doi = "10.1155/2018/8965858",
language = "English",
volume = "2018",
pages = "1--11",
journal = "Journal of Sports Medicine",
issn = "2314-6176",
publisher = "Hindawi Publishing Corporation",

}

Near-Infrared Spectroscopy Is Promising to Detect Iliac Artery Flow Limitations in Athletes : A Pilot Study. / van Hooff, Martijn; Schep, Goof; Meijer, Eduard; Bender, Mart; Savelberg, Hans.

In: Journal of Sports Medicine, Vol. 2018, 8965858, 2018, p. 1-11.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Savelberg, Hans

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N2 - Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career.These flow limitations are due to extreme hemodynamic stresswhichmay result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair. However, current diagnostic techniques have unsatisfactory sensitivity and cannot be applied during exercise. Near-infrared spectroscopy (NIRS) has shown great diagnostic potential in peripheral vascular disease and might bring a solution since it measures tissue oxygenation in real time during and after exercise.This report describes the first experiences of the application of NIRS in the vastus lateralis muscle during and after maximal graded cycling exercise in ten healthy participants and in three patients with flow limitations due to (1) subtle functional kinking, (2) an intravascular lesion, and (3) severe functional kinking.The results are put into perspective based on an empirically fitted model. Delayed recovery, showing clearly different types of patterns of tissue reoxygenation after exercise, was found in the affected athletes compared with the healthy participants. In the patients that had kinking of the arteries, tissue reoxygenation was clearlymore delayed if NIRS was measured in provocative position with flexed hip. In this pilot experiment, clearly distinctivereoxygenation patterns are observed during recovery consistentwith severity of flowlimitation, indicating that NIRS is a promising diagnostic tool to detect and grade arterial flow limitations in athletes. Our findings may guide research and optimization of NIRS for future clinical application.

AB - Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career.These flow limitations are due to extreme hemodynamic stresswhichmay result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair. However, current diagnostic techniques have unsatisfactory sensitivity and cannot be applied during exercise. Near-infrared spectroscopy (NIRS) has shown great diagnostic potential in peripheral vascular disease and might bring a solution since it measures tissue oxygenation in real time during and after exercise.This report describes the first experiences of the application of NIRS in the vastus lateralis muscle during and after maximal graded cycling exercise in ten healthy participants and in three patients with flow limitations due to (1) subtle functional kinking, (2) an intravascular lesion, and (3) severe functional kinking.The results are put into perspective based on an empirically fitted model. Delayed recovery, showing clearly different types of patterns of tissue reoxygenation after exercise, was found in the affected athletes compared with the healthy participants. In the patients that had kinking of the arteries, tissue reoxygenation was clearlymore delayed if NIRS was measured in provocative position with flexed hip. In this pilot experiment, clearly distinctivereoxygenation patterns are observed during recovery consistentwith severity of flowlimitation, indicating that NIRS is a promising diagnostic tool to detect and grade arterial flow limitations in athletes. Our findings may guide research and optimization of NIRS for future clinical application.

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