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Koirala B, Concas A, Cincotti A, Sun Y, Hernández A, Goodwin ML, Gladden LB, Lai N. Estimation of differential pathlength factor from NIRS measurement in skeletal muscle. Respir Physiol Neurobiol 2024; 326:104283. [PMID: 38788987 DOI: 10.1016/j.resp.2024.104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/28/2024] [Accepted: 05/19/2024] [Indexed: 05/26/2024]
Abstract
The utilization of continuous wave (CW) near-infrared spectroscopy (NIRS) device to measure non-invasively muscle oxygenation in healthy and disease states is limited by the uncertainties related to the differential path length factor (DPF). DPF value is required to quantify oxygenated and deoxygenated heme groups' concentration changes from measurement of optical densities by NIRS. An integrated approach that combines animal and computational models of oxygen transport and utilization was used to estimate the DPF value in situ. The canine model of muscle oxidative metabolism allowed measurement of both venous oxygen content and tissue oxygenation by CW NIRS under different oxygen delivery conditions. The experimental data obtained from the animal model were integrated in a computational model of O2 transport and utilization and combined with Beer-Lambert law to estimate DPF value in contracting skeletal muscle. A 2.1 value was found for DPF by fitting the mathematical model to the experimental data obtained in contracting muscle (T3) (Med.Sci.Sports.Exerc.48(10):2013-2020,2016). With the estimated value of DPF, model simulations well predicted the optical density measured by NIRS on the same animal model but with different blood flow, arterial oxygen contents and contraction rate (J.Appl.Physiol.108:1169-1176, 2010 and 112:9-19,2013) and demonstrated the robustness of the approach proposed in estimating DPF value. The approach used can overcome the semi-quantitative nature of the NIRS and estimate non-invasively DPF to obtain an accurate concentration change of oxygenated and deoxygenated hemo groups by CW NIRS measurements in contracting skeletal muscle under different oxygen delivery and contraction rate.
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Affiliation(s)
- B Koirala
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, USA; Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA
| | - A Concas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - A Cincotti
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - Yi Sun
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai 200241, China; School of Physical Education & Health Care, East China Normal University, Shanghai 200241, China
| | - A Hernández
- Faculty Research Liaison School of Social Sciences, Humanities and Arts University of California, USA
| | - M L Goodwin
- Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA
| | - L B Gladden
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA
| | - N Lai
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy; Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, VA, USA; Biomedical Engineering Institute; Old Dominion University, Norfolk, VA, USA; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
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2
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Golub AS, Song BK, Nugent WH, Pittman RN. Dynamics of PO 2 and VO 2 in resting and contracting rat spinotrapezius muscle. Front Physiol 2023; 14:1172834. [PMID: 37538372 PMCID: PMC10396398 DOI: 10.3389/fphys.2023.1172834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
This study examined changes in interstitial PO2, which allowed calculation of VO2 during periods of rest, muscle contraction and recovery using an in situ rat spinotrapezius muscle preparation. The PO2 was measured using phosphorescence quenching microscopy and the muscle VO2 was calculated as the rate of O2 disappearance during brief periods of muscle compression to stop blood flow with a supra-systolic pressure. The PO2 and VO2 measurements were made during "5 s compression and 15 s recovery" (CR) cycles. With all three stimulation frequencies, 1, 2 and 4 Hz, the fall in interstitial PO2 and rise in VO2 from resting values occurred within the first 20 s of contraction. The PO2 during contraction became lower as stimulation frequency increased from 1 to 4 Hz. VO2 was higher at 2 Hz than at 1 Hz contraction. With cessation of stimulation, PO2 began increasing exponentially towards baseline values. After 1 and 2 Hz contraction, the fall in muscle VO2 was delayed by one CR cycle and then exponentially decreased towards resting values. After 4 Hz stimulation, VO2 increased for 2 cycles and then decreased. The post-contraction transients of PO2 and VO2 were not synchronous and had different time constants. With further analysis two distinct functional responses were identified across all stimulation frequencies having PO2 during contraction above or below 30 mmHg. The corresponding VO2 responses were different - for "high" PO2, muscle VO2 reached high levels, while for the "low" PO2 data set muscle VO2 remained low. Recovery patterns were similar to those described above. In summary, local microscopic PO2 and VO2 were measured in resting and contracting muscle in situ and the post-contraction transients of PO2 and VO2 were all much slower than the onset transients.
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Affiliation(s)
- Aleksander S. Golub
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, United States
- Song Biotechnologies LLC, Cockeysville, MD, United States
| | - Bjorn K. Song
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, United States
- Song Biotechnologies LLC, Cockeysville, MD, United States
| | - William H. Nugent
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, United States
- Song Biotechnologies LLC, Cockeysville, MD, United States
| | - Roland N. Pittman
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA, United States
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3
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Koirala B, Concas A, Sun Y, Gladden LB, Lai N. Relationship between muscle venous blood oxygenation and near-infrared spectroscopy: quantitative analysis of the Hb and Mb contributions. J Appl Physiol (1985) 2023; 134:1063-1074. [PMID: 36927143 PMCID: PMC10125031 DOI: 10.1152/japplphysiol.00406.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
A linear relationship between skeletal muscle venous ([Formula: see text]) and oxygenated (ΔHbMbO2,N) or deoxygenated (ΔHHbMbN) near-infrared spectroscopy (NIRS) signals suggest a main hemoglobin (Hb) contribution to the NIRS signal. However, experimental, and computational evidence supports a significant contribution of myoglobin (Mb) to the NIRS. Venous and NIRS measurements from a canine model of muscle oxidative metabolism (Sun Y, Ferguson BS, Rogatzki MJ, McDonald JR, Gladden LB. Med Sci Sports Exerc 48(10):2013-2020, 2016) were integrated into a computational model of muscle O2 transport and utilization to evaluate whether the relationship between venous and NIRS oxygenation can be affected by a significant Mb contribution to the NIRS signals. The mathematical model predicted well the measure of the changes of [Formula: see text] and NIRS signals for different O2 delivery conditions (blood flow, arterial O2 content) in muscle at rest (T1, T2) and during contraction (T3). Furthermore, computational analysis indicates that for adequate O2 delivery, Mb contribution to NIRS signals was significant (20%-30%) even in the presence of a linear [Formula: see text]-NIRS relationship; for a reduced O2 delivery the nonlinearity of the [Formula: see text]-NIRS relationship was related to the Mb contribution (50%). In this case (T3), the deviation from linearity is observed when O2 delivery is reduced from 1.3 to 0.7 L kg-1·min-1 ([Formula: see text] < 10 mLO2 100 mL-1) and Mb saturation decreased from 85% to 40% corresponding to an increase of the Mb contribution to ΔHHbMbN from 15% to 50% and the contribution to ΔHbMbO2,N from 0% to 30%. In contrast to a common assumption, our model indicates that both NIRS signals (ΔHHbMbN and ΔHbMbO2,N are significantly affected by Hb and Mb oxygenation changes.NEW & NOTEWORTHY Within the near-infrared spectroscopy (NIRS) signal, the contribution from hemoglobin is indistinguishable from that of myoglobin. A computation analysis indicates that a linear relationship between muscle venous oxygen content and NIRS signals does not necessarily indicate a negligible myoglobin contribution to the NIRS signal. A reduced oxygen delivery increases the myoglobin contribution to the NIRS signal. The integrative approach proposed is a powerful way to assist in interpreting the elements from which the NIRS signals are derived.
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Affiliation(s)
- Bhabuk Koirala
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia United States
- Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia, United States
| | - Alessandro Concas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
| | - Yi Sun
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China
- School of Physical Education & Health Care, East China Normal University, Shanghai, People's Republic of China
| | - L Bruce Gladden
- School of Kinesiology, Auburn University, Auburn, Alabama United States
| | - Nicola Lai
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Italy
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia United States
- Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia, United States
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Koirala B, Concas A, Sun Y, Gladden LB, Lai N. Reply to Grassi and Quaresima. J Appl Physiol (1985) 2022; 132:222-223. [PMID: 35030045 DOI: 10.1152/japplphysiol.00841.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Bhabuk Koirala
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia.,Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia
| | - Alessandro Concas
- Center for Advanced Studies, Research and Development in Sardinia, Cagliari, Italy.,Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Yi Sun
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, China.,School of Physical Education & Health Care, East China Normal University, Shanghai, China
| | | | - Nicola Lai
- Department of Electrical and Computer Engineering, Old Dominion University, Norfolk, Virginia.,Biomedical Engineering Institute, Old Dominion University, Norfolk, Virginia.,Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
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Koirala B, Concas A, Sun Y, Gladden LB, Lai N. Blood volume versus deoxygenated NIRS signal: computational analysis of the effects muscle O 2 delivery and blood volume on the NIRS signals. J Appl Physiol (1985) 2021; 131:1418-1431. [PMID: 34528461 PMCID: PMC8906537 DOI: 10.1152/japplphysiol.00105.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/02/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022] Open
Abstract
Near-infrared spectroscopy (NIRS) signals quantify the oxygenated (ΔHbMbO2) and deoxygenated (ΔHHbMb) heme group concentrations. ΔHHbMb has been preferred to ΔHbMbO2 in evaluating skeletal muscle oxygen extraction because it is assumed to be less sensitive to blood volume (BV) changes, but uncertainties exist on this assumption. To analyze this assumption, a computational model of oxygen transport and metabolism is used to quantify the effect of O2 delivery and BV changes on the NIRS signals from a canine model of muscle oxidative metabolism (Sun Y, Ferguson BS, Rogatzki MJ, McDonald JR, Gladden LB. Med Sci Sports Exerc 48: 2013-2020, 2016). The computational analysis accounts for microvascular (ΔHbO2, ΔHHb) and extravascular (ΔMbO2, ΔHMb) oxygenated and deoxygenated forms. Simulations predicted muscle oxygen uptake and NIRS signal changes well for blood flows ranging from resting to contracting muscle. Additional NIRS signal simulations were obtained in the absence or presence of BV changes corresponding to a heme groups concentration changes (ΔHbMb = 0-48 µM). Under normal delivery (Q = 1.0 L·kg-1·min-1) in contracting muscle, capillary oxygen saturation (So2) was 62% with capillary ΔHbO2 and ΔHHb of ± 41 µΜ for ΔHbMb = 0. An increase of BV (ΔHbMb = 24 µΜ) caused a ΔHbO2 decrease (16µΜ) almost twice as much as the increase observed for ΔHHb (9 µΜ). When So2 increased to more than 80%, only ΔHbO2 was significantly affected by BV changes. The analysis indicates that microvascular So2 is a key factor in determining the sensitivity of ΔHbMbO2 and deoxygenated ΔHHbMb to BV changes. Contrary to a common assumption, the ΔHHbMb is affected by BV changes in normal contracting muscle and even more in the presence of impaired O2 delivery.NEW & NOTEWORTHY Deoxygenated is preferred to the oxygenated near-infrared spectroscopy signal in evaluating skeletal muscle oxygen extraction because it is assumed to be insensitive to blood volume changes. The quantitative analysis proposed in this study indicates that even in absence of skin blood flow effects, both NIRS signals in presence of either normal or reduced oxygen delivery are affected by blood volume changes. These changes should be considered to properly quantify muscle oxygen extraction by NIRS methods.
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Affiliation(s)
- B. Koirala
- Department of Electrical and Computer Engineering,
Old Dominion University, Norfolk, Virginia
- Biomedical Engineering Institute, Old
Dominion University, Norfolk, Virginia
| | - A. Concas
- Center for Advanced Studies, Research and
Development in Sardinia (CRS4), Cagliari,
Italy
| | - Yi Sun
- Key Laboratory of Adolescent Health Assessment and
Exercise Intervention of Ministry of Education, East China Normal
University, Shanghai, China
- School of Physical Education & Health Care,
East China Normal University, Shanghai,
China
| | - L. B. Gladden
- School of Kinesiology, Auburn
University, Auburn, Alabama
| | - N. Lai
- Department of Mechanical, Chemical and Materials
Engineering, University of Cagliari, Cagliari,
Italy
- Department of Electrical and Computer Engineering,
Old Dominion University, Norfolk, Virginia
- Biomedical Engineering Institute, Old
Dominion University, Norfolk, Virginia
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Koirala B, Saidel GM, Hernández A, Gladden LB, Lai N. Effect of Blood Flow on Hemoglobin and Myoglobin Oxygenation in Contracting Muscle Using Near-Infrared Spectroscopy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1269:367-372. [PMID: 33966244 DOI: 10.1007/978-3-030-48238-1_58] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Insufficient O2 delivery to, and uptake by skeletal muscle can produce mobility limitations for patients with chronic diseases. Near-infrared spectroscopy (NIRS) can be used to noninvasively quantify the balance between skeletal muscle O2 delivery and utilization during contraction. However, it is not clear how the oxygenated or deoxygenated NIRS signal should be used to assess muscle O2 changes. This issue is related to the fact that the contributions of hemoglobin (Hb) and myoglobin (Mb) cannot be distinguished. This conundrum can be resolved by quantitative analysis of experimental data by computer simulations with a mechanistic, mathematical model. Model simulations distinguish dynamic responses of the oxygenated (HbO2, MbO2) and deoxygenated (HHb, HMb) contributions to the NIRS signal components (HbMbO2, HHbMb). Simulations of muscle O2 uptake and NIRS kinetics correspond closely to published experimental data (Hernández et al., J Appl Physiol 108: 1169-1176, 2010). Simulated muscle O2 uptake and oxygenation kinetics with different blood flows indicate (1) faster O2 delivery is responsible for slower muscle oxygenation kinetics; (2) Hb and Mb contributions to the HbMbO2 are similar (40-60%); and (3) Hb and Mb contributions to the HHbMb are significantly different, 80% and 20%, respectively. The effect of slow blood flow kinetics on oxygenated Hb and Mb contributions is minimal. However, the effect on the imbalance between O2 delivery and utilization rates causes significant overshoots and undershoots of deoxygenated Hb and Mb contributions. Model analysis in combination with NIRS measurements and information on hemodynamic and microvascular distribution can help to determine the use of NIRS signal in evaluating the factors limiting exercise tolerance in health and disease states.
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Affiliation(s)
- B Koirala
- Department of Electrical and Computer Engineering and Institute of Biomedical Engineering, Old Dominion University, Norfolk, VA, USA
| | - G M Saidel
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - A Hernández
- Office of Research and Economic Development, University of California, Merced, Merced, CA, USA
| | - L B Gladden
- Department of Kinesiology, Auburn University, Auburn, AL, USA
| | - N Lai
- Department of Electrical and Computer Engineering and Institute of Biomedical Engineering, Old Dominion University, Norfolk, VA, USA. .,Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
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7
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Lewis MT, Kasper JD, Bazil JN, Frisbee JC, Wiseman RW. Skeletal muscle energetics are compromised only during high-intensity contractions in the Goto-Kakizaki rat model of type 2 diabetes. Am J Physiol Regul Integr Comp Physiol 2019; 317:R356-R368. [PMID: 31188651 PMCID: PMC6732426 DOI: 10.1152/ajpregu.00127.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 12/24/2022]
Abstract
Type 2 diabetes (T2D) presents with hyperglycemia and insulin resistance, affecting over 30 million people in the United States alone. Previous work has hypothesized that mitochondria are dysfunctional in T2D and results in both reduced ATP production and glucose disposal. However, a direct link between mitochondrial function and T2D has not been determined. In the current study, the Goto-Kakizaki (GK) rat model of T2D was used to quantify mitochondrial function in vitro and in vivo over a broad range of contraction-induced metabolic workloads. During high-frequency sciatic nerve stimulation, hindlimb muscle contractions at 2- and 4-Hz intensities, the GK rat failed to maintain similar bioenergetic steady states to Wistar control (WC) rats measured by phosphorus magnetic resonance spectroscopy, despite similar force production. Differences were not due to changes in mitochondrial content in red (RG) or white gastrocnemius (WG) muscles (cytochrome c oxidase, RG: 22.2 ± 1.6 vs. 23.3 ± 1.7 U/g wet wt; WG: 10.8 ± 1.1 vs. 12.1 ± 0.9 U/g wet wt; GK vs. WC, respectively). Mitochondria isolated from muscles of GK and WC rats also showed no difference in mitochondrial ATP production capacity in vitro, measured by high-resolution respirometry. At lower intensities (0.25-1 Hz) there were no detectable differences between GK and WC rats in sustained energy balance. There were similar phosphocreatine concentrations during steady-state contraction and postcontractile recovery (τ = 72 ± 6 s GK versus 71 ± 2 s WC). Taken together, these results suggest that deficiencies in skeletal muscle energetics seen at higher intensities are not due to mitochondrial dysfunction in the GK rat.
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Affiliation(s)
- Matthew T Lewis
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Jonathan D Kasper
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Jason N Bazil
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Jefferson C Frisbee
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada
| | - Robert W Wiseman
- Department of Physiology, Michigan State University, East Lansing, Michigan
- Department of Radiology, Michigan State University, East Lansing, Michigan
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8
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Golub AS, Dodhy SC, Pittman RN. Oxygen dependence of respiration in rat spinotrapezius muscle contracting at 0.5-8 twitches per second. J Appl Physiol (1985) 2018; 125:124-133. [PMID: 29494286 DOI: 10.1152/japplphysiol.01136.2016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The oxygen dependence of respiration was obtained in situ in microscopic regions of rat spinotrapezius muscle for different levels of metabolic activity produced by electrical stimulation at rates from 0.5 to 8 Hz. The rate of O2 consumption (V̇o2) was measured with phosphorescence quenching microscopy (PQM) as the rate of O2 disappearance in a muscle with rapid flow arrest. The phosphorescent oxygen probe was loaded into the interstitial space of the muscle to give O2 tension (Po2) in the interstitium. A set of sigmoid curves relating the Po2 dependence of V̇o2 was obtained with a Po2-dependent region below a characteristic Po2 (~30 mmHg) and a Po2-independent region above this Po2. The V̇o2(Po2) plots were fit by the Hill equation containing O2 demand (rest to 8 Hz: 216 ± 26 to 636 ± 77 nl O2/cm3 s) and the Po2 value corresponding to O2 demand/2 (rest to 8 Hz: 22 ± 4 to 11 ± 1 mmHg). The initial Po2 and V̇o2 pairs of values measured at the moment of flow arrest formed a straight line, determining the rate of oxygen supply. This line had a negative slope, equal to the oxygen conductance for the O2 supply chain. For each level of tissue blood flow the set of possible values of Po2 and V̇o2 consists of the intersection points between this O2 supply line and the set of V̇o2 curves. An electrical analogy for the intraorgan O2 supply and consumption is an inverting transistor amplifier, which allows the use of graphic analysis methods for prediction of the behavior of the oxygen processing system in organs. NEW & NOTEWORTHY The sigmoidal shape of curves describing oxygen dependence of muscle respiration varies from basal to maximal workload and characterizes the oxidative metabolism of muscle. The rate of O2 supply depends on extracellular O2 tension and is determined by the overall oxygen conductance in the muscle. The dynamics of oxygen consumption is determined by the supply line that intersects the oxygen demand curves. An electrical analogy for the oxygen supply/consumption system is an inverting transistor amplifier.
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Affiliation(s)
- Aleksander S Golub
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University , Richmond, Virginia
| | - Sami C Dodhy
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University , Richmond, Virginia
| | - Roland N Pittman
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University , Richmond, Virginia
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Hart CR, Layec G, Trinity JD, Le Fur Y, Gifford JR, Clifton HL, Richardson RS. Oxygen availability and skeletal muscle oxidative capacity in patients with peripheral artery disease: implications from in vivo and in vitro assessments. Am J Physiol Heart Circ Physiol 2018; 315:H897-H909. [PMID: 29932772 DOI: 10.1152/ajpheart.00641.2017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Evidence suggests that the peak skeletal muscle mitochondrial ATP synthesis rate ( Vmax) in patients with peripheral artery disease (PAD) may be attenuated due to disease-related impairments in O2 supply. However, in vitro assessments suggest intrinsic deficits in mitochondrial respiration despite ample O2 availability. To address this conundrum, Doppler ultrasound, near-infrared spectroscopy, phosphorus magnetic resonance spectroscopy, and high-resolution respirometry were combined to assess convective O2 delivery, tissue oxygenation, Vmax, and skeletal muscle mitochondrial capacity (complex I + II, state 3 respiration), respectively, in the gastrocnemius muscle of 10 patients with early stage PAD and 11 physical activity-matched healthy control (HC) subjects. All participants were studied in free-flow control conditions (FF) and with reactive hyperemia (RH) induced by a period of brief ischemia during the last 30 s of submaximal plantar flexion exercise. Patients with PAD repeated the FF and RH trials under hyperoxic conditions (FF + 100% O2 and RH + 100% O2). Compared with HC subjects, patients with PAD exhibited attenuated O2 delivery at the same absolute work rate and attenuated tissue reoxygenation and Vmax after relative intensity-matched exercise. Compared with the FF condition, only RH + 100% O2 significantly increased convective O2 delivery (~44%), tissue reoxygenation (~54%), and Vmax (~60%) in patients with PAD ( P < 0.05), such that Vmax was now not different from HC subjects. Furthermore, there was no evidence of an intrinsic mitochondrial deficit in PAD, as assessed in vitro with adequate O2. Thus, in combination, this comprehensive in vivo and in vitro investigation implicates O2 supply as the predominant factor limiting mitochondrial oxidative capacity in early stage PAD. NEW & NOTEWORTHY Currently, there is little accord as to the role of O2 availability and mitochondrial function in the skeletal muscle dysfunction associated with peripheral artery disease. This is the first study to comprehensively use both in vivo and in vitro approaches to document that the skeletal muscle dysfunction associated with early stage peripheral artery disease is predominantly a consequence of limited O2 supply and not the impact of an intrinsic mitochondrial defect in this pathology.
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Affiliation(s)
- Corey R Hart
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Exercise and Sport Science, University of Utah , Salt Lake City, Utah
| | - Gwenael Layec
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Joel D Trinity
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
| | - Yann Le Fur
- Centre de Résonance Magnétique Biologique et Médicale Unité Mixte de Recherché 7339, Aix-Marseille Université, Centre National de la Recherche Scientifique, Marseille , France
| | - Jayson R Gifford
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah
| | - Heather L Clifton
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah
| | - Russell S Richardson
- Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center , Salt Lake City, Utah.,Department of Medicine, Division of Geriatrics, University of Utah , Salt Lake City, Utah.,Department of Nutrition and Integrative Physiology, University of Utah , Salt Lake City, Utah
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