Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines2023, 11, 2181.
Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines 2023, 11, 2181.
Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines2023, 11, 2181.
Biró, K.; Sándor, B.; Tótsimon, K.; Koltai, K.; Fendrik, K.; Endrei, D.; Vékási, J.; Tóth, K.; Késmárky, G. Examination of Lower Limb Microcirculation in Diabetic Patients with and without Intermittent Claudication. Biomedicines 2023, 11, 2181.
Abstract
Background: Intermittent claudication is a frequent complaint in lower extremity artery disease, but approximately two thirds of patients are asymptomatic, mostly in diabetic population. Non-invasive angiological and microrheological tests among diabetic patients with and without intermittent claudication were studied.
Methods: 98 diabetic patients were included and divided into two groups: 20 patients (63.5±8.8 yrs, 55% men, 45% women) had intermittent claudication, 78 patients (65.5±9.3 yrs, 61.5% men, 38.5% women) were asymptomatic. Hand-held Doppler, transcutaneous tissue partial oxygen pressure (tcpO2) measurement, tuning fork test and 6-minute walk test were performed and erythrocyte aggregation was investigated.
Results: Ankle/brachial index (p<0.02), and tcpO2 measured during provocational tests (p<0.003), 6-minute walk test (p<0.0001) were significantly deteriorated in the symptomatic group. Higher erythrocyte aggregation index and faster aggregate formation could be observed among claudicant patients (p<0.02). In spite of the statistically better results of the asymptomatic group, 13% of these patients had severe limb ischemia based on the result of tcpO2 measurement.
Conclusion: Claudication could be associated with worse hemodynamical and hemorheological status in diabetics; nevertheless, severe ischemia can develop even in asymptomatic subjects which can be revealed by noninvasive vascular tests, which highlights the importance of the early instrumental screening of the lower limbs.
Public Health and Healthcare, Public Health and Health Services
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