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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
Published on: December 11, 2013
Reproducibility of Hemodynamic, Cardiac Autonomic Modulation, and Blood Flow Assessments in Patients with
Aluísio Andrade-Lima1, Marcel Chehuen1, Natan Silva Junior1
1Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
Insights
This study found that heart rate, blood pressure, and baseline blood flow measurements are reproducible in patients with intermittent claudication. However, vasodilatory responses showed poor reproducibility, indicating limitations for monitoring disease progression.
Area of Science:
- Cardiovascular Physiology
- Clinical Assessment
- Peripheral Artery Disease Research
Background:
- Peripheral artery disease (PAD) with intermittent claudication (IC) impacts patient mobility and quality of life.
- Accurate and reproducible clinical assessments are crucial for monitoring disease progression and treatment efficacy in IC patients.
Purpose of the Study:
- To evaluate the reproducibility of key physiological measurements in patients diagnosed with intermittent claudication.
- To assess the reliability of heart rate (HR), blood pressure (BP), heart rate variability (HRV), and blood flow (BF) assessments.
Main Methods:
- Twenty-nine IC patients underwent two test sessions 8-12 days apart.
- Measurements included HR, BP, HRV (spectral analysis), and forearm/calf BF (strain gauge plethysmography).
- Reproducibility was quantified using intra-class correlation coefficients (ICC) and coefficient of variation (CV).
Main Results:
- Excellent reproducibility (ICC >0.8, CV <9%) was observed for HR and BP.
- Most HRV measures (LFR-R, HFR-R) showed high reproducibility (ICC >0.9, CV <7%).
- Baseline forearm and calf BF also demonstrated high reproducibility (ICC >0.9, CV <19%), while vasodilatory responses exhibited moderate to poor reproducibility.
Conclusions:
- Systemic hemodynamics, cardiac autonomic function, and baseline blood flow assessments are highly reproducible in male IC patients.
- The reproducibility of vasodilatory responses is limited, suggesting caution when using these measures for monitoring.
- These findings support the use of reproducible measures for regular clinical monitoring of IC progression and intervention effects.
Background:
The aim of this study is to identify, in patients with peripheral artery disease and intermittent claudication (IC), the reproducibility of heart rate (HR), blood pressure (BP), rate pressure product, heart rate variability (HRV), and forearm and calf blood flow (BF) and vasodilatory assessments.
Methods:
Twenty-nine patients with IC underwent test and retest sessions, 8-12 days apart. During each session, HR, BP, HRV, BF, and vasodilatory responses were measured by electrocardiogram, auscultation, spectral analysis of HRV (low frequency, LFR-R; high frequency, HFR-R), and strain gauge plethysmography (baseline BF, post-occlusion BF, post-occlusion area under the curve). Reproducibility was determined by intra-class correlation coefficient (ICC), typical error, coefficient of variation (CV), and limits of agreement.
Results:
The ICC for HR and BP was >0.8 with CV <9%. For most HRV measures, ICC was >0.9 while CV was <7%, except for LF/HF (ICC = 0.737, CV = 93.8%). The ICC for forearm and calf baseline BF assessments was >0.9 while CV was <19%; variable ICC and CV for vasodilatory responses were exhibited for calf (0.653-0.770, 35.2-37.7%) and forearm (0.169-0.265, 46.2-55.5%).
Conclusions:
In male patients with IC, systemic hemodynamics (HR and BP), cardiac autonomic modulation (LFR-R and HFR-R), and forearm and calf baseline BF assessments exhibited excellent reproducibility, whereas the level of reproducibility for vasodilatory responses were moderate to poor. Assessment reproducibility has highlighted appropriate clinical tools for the regular monitoring of disease/intervention progression in patients with IC.
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