Sympathetic inhibitory drugs effects in experimental left ventricular dysfunction

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Sympathetic inhibitory drugs effects in experimental left ventricular dysfunction

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Mutiprobe devices for exercise transcutaneous oxymetry in patients complaining claudication: interest and limits of unusual probe positions

International audienc

Comparison of two devices for measuring exercise transcutaneous oxygen pressures in patients with claudication

International audienceBackground: We aimed at estimating the agreement between the Medicap® (photo-optical) and Radiometer® (electro-chemical) sensors during exercise transcutaneous oxygen pressure (tcpO2) tests. Our hypothesis was that although absolute starting values (tcpO2rest: mean over 2 minutes) might be different, tcpO2-changes over time and the minimal value of the decrease from rest of oxygen pressure (DROPmin) results at exercise shall be concordant between the two systems. Patients and methods: Forty seven patients with arterial claudication (65 + / - 7 years) performed a treadmill test with 5 probes each of the electro-chemical and photo-optical devices simultaneously, one of each system on the chest, on each buttock and on each calf. Results: Seventeen Medicap® probes disconnected during the tests. tcpO2rest and DROPmin values were higher with Medicap® than with Radiometer®, by 13.7 + / - 17.1 mm Hg and 3.4 + / - 11.7 mm Hg, respectively. Despite the differences in absolute starting values, changes over time were similar between the two systems. The concordance between the two systems was approximately 70 % for classification of test results from DROPmin. Conclusions: Photo-optical sensors are promising alternatives to electro-chemical sensors for exercise oximetry, provided that miniaturisation and weight reduction of the new sensors are possible

Exercise transcutaneous oximetry significantly modifies the diagnostic hypotheses and impacts scheduled investigations or treatments of patients with exertional limb pain

International audienceIntroduction In lower extremity peripheral artery disease (PAD), transcutaneous oximetry at exercise (Ex-TcpO2) has been largely validated in research practice, but evidence of routine practice in various vascular laboratories is missing. We hypothesized that Ex-TcPO2 would change the diagnosis hypotheses, investigations and treatments for patients referred for exertional limb pain. Material and methods A multicenter prospective trial was conducted in nine different referral centers. Investigators performed Ex-TcpO2 and recorded investigations and treatments already scheduled for the patient. We encoded referral physician's diagnostic hypothesis. Before Ex-TcpO2, vascular physicians were asked to give their diagnosis hypotheses. A minimal decrease from rest of oxygen pressure (DROP) < minus 15 mm Hg defined the presence of exercise-induced ischemia on the area of interest. After Ex-TcPO2, we recorded post-test diagnostic hypothesis and investigations and treatments to be cancelled or performed. We compared the diagnosis hypotheses, scheduled investigations and treatments, before and after the Ex-TcpO2. Results We included 603 patients (485 males 80.4%), aged 64.7 +/- 9.8 years. The post-test diagnosis hypothesis differed in 266 patients (44.1%; p < 0.0001) and in 96 patients (15.9%) from the pre-test hypothesis of referring and vascular physician, respectively. This led to the recommendation to cancel 27 scheduled investigations or treatments of a total cost of --130,000 euros. Discussion Ex-TcPO2 in patients with exertional limb pain is applicable in various vascular institutions, and significantly modifies the diagnostic hypotheses and impacts scheduled investigations or treatments of patients with exertional limb pain