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Reduced External Iliac Venous Blood Flow Rate Is Associated with Asymptomatic Compression of the Common Iliac Veins. MEDICINA-LITHUANIA 2021; 57:medicina57080835. [PMID: 34441041 PMCID: PMC8398029 DOI: 10.3390/medicina57080835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/14/2021] [Accepted: 08/15/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Compression of the common iliac veins (CIV) is not always associated with lower extremity symptoms. This study analyzed this issue from the perspective of patient venous blood flow changes using quantitative flow magnetic resonance imaging. Materials and Methods: After we excluded patients with active deep vein thrombosis, the mean flux (MF) and mean velocity (MV) of the popliteal vein, femoral vein, and external iliac vein (EIV) were compared between the left and right sides. Results: Overall, 26 of the patients had unilateral CIV compression, of which 16 patients had symptoms. No significant differences were noted in the MF or MV of the veins between the two sides. However, for the 10 patients without symptoms, the EIV MF of the compression side was significantly lower than the EIV MF of the non-compression side (p = 0.04). The receiver operating characteristic curve and chi-squared analyses showed that when the percentage difference of EIV MF between the compression and non-compression sides was ≤-18.5%, the relative risk of associated lower extremity symptoms was 0.44 (p = 0.016). Conclusions: If a person has compression of the CIV, a decrease in EIV blood flow rate on the compression side reduces the rate of symptom occurrence.
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Kim S, Kim M, Kim JG. Development of simple diffuse optical metabolic spectroscopy for tissue metabolism measurement. BIOMEDICAL OPTICS EXPRESS 2019; 10:2956-2966. [PMID: 31259065 PMCID: PMC6583354 DOI: 10.1364/boe.10.002956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/21/2019] [Accepted: 05/13/2019] [Indexed: 05/05/2023]
Abstract
In the field of biomedicine, there are optical systems that provide the tissue metabolic rate of oxygen consumption (tMRO2) by the simultaneous measurement of blood flow and oxygenation level. However, current optical systems are costly and require complex optical alignments, which are inconvenient for clinical applications. Therefore, in this study, we developed a simple diffuse optical metabolic spectroscopy system by combining a broadband light source and a laser and by sharing a spectrometer as a detector for both diffuse optical spectroscopy and diffuse speckle contrast analysis. This system simultaneously measures blood flow, volume, and oxygenation in a simple and cost-effective manner. The system response to flow is demonstrated through the flow phantom experiments. The results of the experiments show that flow response is in the range 0~0.9 ml/min, with a resolution better than 0.1 ml/min. During the blood phantom study, the blood volume fraction increased linearly with blood accumulation. Further, the change in oxygenation was monitored with the modulation of the oxygen level in the gas supply. Finally, tMRO2 changes were measured during ischemia, induced by the upper arm cuff and the results showed a decrease and a recovery of tMRO2 with cuff inflation and deflation, respectively. This simple diffuse optical metabolic spectroscopic system can easily be applied in medical environments by providing a simple and convenient solution for measuring tMRO2.
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Messere A, Tschakovsky M, Seddone S, Lulli G, Franco W, Maffiodo D, Ferraresi C, Roatta S. Hyper-Oxygenation Attenuates the Rapid Vasodilatory Response to Muscle Contraction and Compression. Front Physiol 2018; 9:1078. [PMID: 30158874 PMCID: PMC6104350 DOI: 10.3389/fphys.2018.01078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
A single muscle compression (MC) with accompanying hyperemia and hyper-oxygenation results in attenuation of a subsequent MC hyperemia, as long as the subsequent MC takes place when muscle oxygenation is still elevated. Whether this is due to the hyper-oxygenation, or compression-induced de-activation of mechano-sensitive structures is unclear. We hypothesized that increased oxygenation and not de-activation of mechano-sensitive structures was responsible for this attenuation and that both compression and contraction-induced hyperemia attenuate the hyperemic response to a subsequent muscle contraction, and vice-versa. Protocol-1) In eight subjects two MCs separated by a 25 s interval were delivered to the forearm without or with partial occlusion of the axillary artery, aimed at preventing hyperemia and increased oxygenation in response to the first MC. Tissue oxygenation [oxygenated (hemoglobin + myoglobin)/total (hemoglobin + myoglobin)] from forearm muscles and brachial artery blood flow were continuously monitored by means of spatially-resolved near-infrared spectroscopy (NIRS) and Doppler ultrasound, respectively. With unrestrained blood flow, the hyperemic response to the second MC was attenuated, compared to the first (5.7 ± 3.3 vs. 14.8 ± 3.9 ml, P < 0.05). This attenuation was abolished with partial occlusion of the auxillary artery (14.4 ± 3.9 ml). Protocol-2) In 10 healthy subjects, hemodynamic changes were assessed in response to MC and electrically stimulated contraction (ESC, 0.5 s duration, 20 Hz) of calf muscles, as single stimuli or delivered in sequences of two separated by a 25 s interval. When MC or ESC were delivered 25 s following MC or ESC the response to the second stimulus was always attenuated (range: 60–90%). These findings support a role for excess tissue oxygenation in the attenuation of mechanically-stimulated rapid dilation and rule out inactivation of mechano-sensitive structures. Furthermore, both MC and ESC rapid vasodilatation are attenuated by prior transient hyperemia, regardless of whether the hyperemia is due to MC or ESC. Previously, mechanisms responsible for this dilation have not been considered to be oxygen sensitive. This study identifies muscle oxygenation state as relevant blunting factor, and reveals the need to investigate how these feedforward mechanisms might actually be affected by oxygenation.
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Affiliation(s)
| | - Michael Tschakovsky
- Human Vascular Control Lab, School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Stefano Seddone
- Department of Neuroscience, University of Turin, Turin, Italy
| | - Gabriella Lulli
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Walter Franco
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Daniela Maffiodo
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
| | - Carlo Ferraresi
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy
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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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Chatterjee S. Endothelial Mechanotransduction, Redox Signaling and the Regulation of Vascular Inflammatory Pathways. Front Physiol 2018; 9:524. [PMID: 29930512 PMCID: PMC5999754 DOI: 10.3389/fphys.2018.00524] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 04/24/2018] [Indexed: 12/13/2022] Open
Abstract
The endothelium that lines the interior of blood vessels is directly exposed to blood flow. The shear stress arising from blood flow is “sensed” by the endothelium and is “transduced” into biochemical signals that eventually control vascular tone and homeostasis. Sensing and transduction of physical forces occur via signaling processes whereby the forces associated with blood flow are “sensed” by a mechanotransduction machinery comprising of several endothelial cell elements. Endothelial “sensing” involves converting the physical cues into cellular signaling events such as altered membrane potential and activation of kinases, which are “transmission” signals that cause oxidant production. Oxidants produced are the “transducers” of the mechanical signals? What is the function of these oxidants/redox signals? Extensive data from various studies indicate that redox signals initiate inflammation signaling pathways which in turn can compromise vascular health. Thus, inflammation, a major response to infection or endotoxins, can also be initiated by the endothelium in response to various flow patterns ranging from aberrant flow to alteration of flow such as cessation or sudden increase in blood flow. Indeed, our work has shown that endothelial mechanotransduction signaling pathways participate in generation of redox signals that affect the oxidant and inflammation status of cells. Our goal in this review article is to summarize the endothelial mechanotransduction pathways that are activated with stop of blood flow and with aberrant flow patterns; in doing so we focus on the complex link between mechanical forces and inflammation on the endothelium. Since this “inflammation susceptible” phenotype is emerging as a trigger for pathologies ranging from atherosclerosis to rejection post-organ transplant, an understanding of the endothelial machinery that triggers these processes is very crucial and timely.
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Affiliation(s)
- Shampa Chatterjee
- Department of Physiology, Perelman School of Medicine, Institute for Environmental Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Abstract
OBJECTIVE To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26-27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop. DATA SOURCES Literature review, research data, and expert opinion. STUDY SELECTION Not applicable. DATA EXTRACTION Moderated by an expert from the field, issues relevant to the association of multiple organ dysfunction syndrome with a variety of conditions and therapies were presented, discussed, and debated with a focus on identifying knowledge gaps and the research priorities. DATA SYNTHESIS Summary of presentations and discussion supported and supplemented by relevant literature. CONCLUSIONS Sepsis and trauma are the two conditions most commonly associated with multiple organ dysfunction syndrome both in children and adults. However, many other pathophysiologic processes may result in multiple organ dysfunction syndrome. In this article, we discuss conditions such as liver failure and pancreatitis, pathophysiologic processes such as ischemia and hypoxia, and injuries such as trauma and burns. Additionally, therapeutic interventions such as medications, blood transfusions, transplantation may also precipitate and contribute to multiple organ dysfunction syndrome. The purpose of this article is to describe the association of multiple organ dysfunction syndrome with a variety of conditions and therapies in an attempt to identify similarities, differences, and opportunities for therapeutic intervention.
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Joyner MJ, Casey DP. Regulation of increased blood flow (hyperemia) to muscles during exercise: a hierarchy of competing physiological needs. Physiol Rev 2015; 95:549-601. [PMID: 25834232 DOI: 10.1152/physrev.00035.2013] [Citation(s) in RCA: 426] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This review focuses on how blood flow to contracting skeletal muscles is regulated during exercise in humans. The idea is that blood flow to the contracting muscles links oxygen in the atmosphere with the contracting muscles where it is consumed. In this context, we take a top down approach and review the basics of oxygen consumption at rest and during exercise in humans, how these values change with training, and the systemic hemodynamic adaptations that support them. We highlight the very high muscle blood flow responses to exercise discovered in the 1980s. We also discuss the vasodilating factors in the contracting muscles responsible for these very high flows. Finally, the competition between demand for blood flow by contracting muscles and maximum systemic cardiac output is discussed as a potential challenge to blood pressure regulation during heavy large muscle mass or whole body exercise in humans. At this time, no one dominant dilator mechanism accounts for exercise hyperemia. Additionally, complex interactions between the sympathetic nervous system and the microcirculation facilitate high levels of systemic oxygen extraction and permit just enough sympathetic control of blood flow to contracting muscles to regulate blood pressure during large muscle mass exercise in humans.
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Affiliation(s)
- Michael J Joyner
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; and Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa
| | - Darren P Casey
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; and Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, Iowa
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Dinenno FA. Skeletal muscle vasodilation during systemic hypoxia in humans. J Appl Physiol (1985) 2015; 120:216-25. [PMID: 26023228 DOI: 10.1152/japplphysiol.00256.2015] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/21/2015] [Indexed: 11/22/2022] Open
Abstract
In humans, the net effect of acute systemic hypoxia in quiescent skeletal muscle is vasodilation despite significant reflex increases in muscle sympathetic vasoconstrictor nerve activity. This vasodilation increases tissue perfusion and oxygen delivery to maintain tissue oxygen consumption. Although several mechanisms may be involved, we recently tested the roles of two endothelial-derived substances during conditions of sympathoadrenal blockade to isolate local vascular control mechanisms: nitric oxide (NO) and prostaglandins (PGs). Our findings indicate that 1) NO normally plays a role in regulating vascular tone during hypoxia independent of the PG pathway; 2) PGs do not normally contribute to vascular tone during hypoxia, however, they do affect vascular tone when NO is inhibited; 3) NO and PGs are not independently obligatory to observe hypoxic vasodilation when assessed as a response from rest to steady-state hypoxia; and 4) combined NO and PG inhibition abolishes hypoxic vasodilation in human skeletal muscle. When the stimulus is exacerbated via combined submaximal rhythmic exercise and systemic hypoxia to cause further red blood cell (RBC) deoxygenation, skeletal muscle blood flow is augmented compared with normoxic exercise via local dilator mechanisms to maintain oxygen delivery to active tissue. Data obtained in a follow-up study indicate that combined NO and PG inhibition during hypoxic exercise blunts augmented vasodilation and hyperemia compared with control (normoxic) conditions by ∼50%; however, in contrast to hypoxia alone, the response is not abolished, suggesting that other local substances are involved. Factors associated with greater RBC deoxygenation such as ATP release, or nitrite reduction to NO, or both likely play a role in regulating this response.
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Affiliation(s)
- Frank A Dinenno
- Human Cardiovascular Physiology Laboratory, Department of Health and Exercise Science, Center for Cardiovascular Research, Colorado State University, Fort Collins, Colorado
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Buerk DG, Hirai DM, Roseguini BT, Silva BM, Vagula MC, Roy TK, Secomb TW. Commentaries on viewpoint: A paradigm shift for local blood flow regulation. J Appl Physiol (1985) 2014; 116:706-7. [PMID: 24633729 DOI: 10.1152/japplphysiol.01360.2013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Golub AS, Pittman RN. Last word on viewpoint: A paradigm shift for local blood flow regulation. J Appl Physiol (1985) 2014; 116:708. [PMID: 24633730 DOI: 10.1152/japplphysiol.00006.2014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Aleksander S Golub
- Department of Physiology and Biophysics, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia
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