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Udgivet

Effect of revascularization on lower extremity muscle function in combined type 2 diabetes and critical limb threatening ischemia

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Mitochondrial dysfunction in calf muscles of patients with combined peripheral arterial disease and diabetes type 2

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Deep venous thrombosis of the upper extremity. A review

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Does patency after a vein collar and PTFE-bypass depend on sex and age? Re-analysis of a randomised trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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BACKGROUND: Critical limb-threatening ischemia (CLTI) and type 2 diabetes (T2D) frequently co-exist and often with less favorable outcome after revascularization. The objective was to evaluate the effects of revascularization on muscle function, perfusion and mitochondrial respiration in patients with combined CLTI and T2D.

METHODS: A prospective translational observational study. Two groups of patients facing unilateral peripheral revascularization was included: Patients suffering from combined disease with CLTI+T2D (N.=14) and patients suffering from CLTI (N.=15). During pedal exercise testing, calf muscle perfusion was monitored with near-infrared spectroscopy (NIRS) and leg arterial volume flow in the common femoral artery with duplex ultrasound. Calf muscle biopsy and subsequent assessment of mitochondrial respiratory capacity on isolated muscle fibers was performed. Tests was performed before and six weeks after revascularization.

RESULTS: After revascularization, patients CLTI+T2D improved in muscle force from 8.48 kg (CI: 7.49-9.46) to 13.11 kg (CI: 11.58-14.63), (P<0.001). Conversely, muscle force in patients suffering from non-diabetic CLTI decreased from 10.03 kg (CI: 9.1-10.96) to 9.73 kg (CI: 8.77-10.69), (P=0.042). Muscle oxygenation during exercise improved more in the CLTI+T2D group (6.36 µM/kg/s [CI: 5.71-7.01] compared to 2.11 µM/kg/s [CI:1.38-2.83] in the CLTI group; P=0.002). No improvement or difference between groups regarding mitochondrial function was detected.

CONCLUSIONS: Patients with combined CLTI+T2D, had an unsuspected better effect of revascularization compared to patients with non-diabetic CLTI, in terms of increased muscle force and improved muscle perfusion. Further studies are needed to elucidate the apparent interaction of the CLTI and T2D syndromes.

OriginalsprogEngelsk
TidsskriftInternational angiology : a journal of the International Union of Angiology
Vol/bind40
Udgave nummer4
Sider (fra-til)323-334
Antal sider12
ISSN0392-9590
DOI
StatusUdgivet - aug. 2021

ID: 67939864