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Published on: February 20, 2018
Skeletal Muscle Oxygenation During Exercise and Its Association With Early Improvement in Exercise Tolerance After
Yasutomo Tanaka1,2, Takako Tanaka1, Yudai Yano1,2
1Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
Background:
This study aimed to: (1) assess changes in peripheral skeletal muscle oxygenation during exercise after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS); and (2) identify characteristics of patients who exhibited improved exercise tolerance.
Methods And Results:
In this single-center prospective study, 20 patients with severe symptomatic AS underwent evaluation before and 1 week after TAVI. Exercise tolerance was assessed using the incremental shuttle walk test (ISWT), and the incremental shuttle walk distance (ISWD) was recorded. Calf muscle oxygenation during the ISWT was continuously measured using near-infrared spectroscopy (NIRS). ISWD increased significantly after TAVI (P<0.01). During the ISWT, the change in oxygenated hemoglobin (∆O2Hb) was greater after TAVI than before TAVI. Compared with non-responders, responders demonstrated lower ∆O2Hb and greater increases in deoxygenated hemoglobin (∆HHb) from rest to peak exercise before TAVI (all P<0.05).
Conclusions:
Peripheral skeletal muscle oxygenation during exercise improved early after TAVI. Moreover, a pre-TAVI pattern characterized by reduced oxygen delivery (lower ∆O2Hb) and enhanced oxygen extraction/utilization (higher ∆HHb) during exercise was associated with greater improvement in exercise tolerance after TAVI.
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