TRANSCUTANEOUS OXYGEN-TENSION AND DOPPLER ANKLE PRESSURE DURING UPPERAND LOWER-BODY EXERCISE IN PATIENTS WITH PERIPHERAL ARTERIAL OCCLUSIVE DISEASE

The effects of upper and lower body exercise on blood supply to the lo wer extremities were investigated in patients with peripheral arterial occlusive disease (PAOD) by measurements of transcutaneous oxygen ten sion (tcPO(2)) and Doppler ankle pressure (DAP). Twenty patients with PAOD (PAOD group) and 10 subjects without PAOD (control group) perform ed treadmill test (TT), recumbent cycle ergometry (CE), and rowing erg ometry (RE) with a fixed seat. The tcPO(2) was registered on the calf and DAP was measured at the end of each step of CE and RE. The walking distance in TT of the control group was not limited (>1000 m), wherea s that of the PAOD group was 161 m in median. In the control group the re was no significant difference of performance between CE (125 +/-33 W) and RE (111 +/-24 W), whereas in the PAOD group, performance was lo wer in CE (72 +/-31 W) than in RE (102 +/-28 W) (P<0.01). DAP of contr ols increased during both CE (136 to 165 mmHg) and RE (170 to 213 mmHg ), whereas the DAP of the PAOD group decreased during CE (from 85 to 4 4 mmHg) and remained relatively constant during RE (113 to 101 mmHg). In controls, tcPO(2) did not distinctly change during TT (70 to 66 mmH g) and increased during CE (58 to 73 mmHg) and RE (69 to 82 mmHg), whe reas in the PAOD group, tcPO(2) decreased during TT (66 to 33 mmHg) an d CE (50 to 22 mmHg) and remained almost unchanged in RE (64 to 60 mmH g). A hyperbolic relationship was found between tcPO(2) and DAP. In co nclusion, during upper body exercise, blood supply to the lower extrem ities in patients with PAOD was not affected, whereas lower body exerc ise led to exhaustion of the functional reserve of blood supply. Becau se of a hyperbolic relationship between tcPO(2) and DAP, tcPO(2) remai ned relatively constant if blood supply was sufficient, but in disturb ed blood supply a small change of DAP was accompanied by a great chang e of tcPO(2). Therefore, in critical ischemia the change of tcPO(2) wa s more sensitive than that of DAP.