High-energy phosphate metabolism during incremental calf exercise in patients with unilaterally symptomatic peripheral arterial disease measured by phosphor.

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High-energy phosphate metabolism during incremental calf exercise in patients with unilaterally symptomatic peripheral arterial disease measured by phosphor 31 magnetic resonance spectroscopy Andreas Greiner, MD, Regina Esterhammer, MD, Hubert Messner, MD, Mathias Biebl, MD, Hannes Mühlthaler, MD, Gustav Fraedrich, MD, Werner R. Jaschke, MD, Michael F.H. Schocke, MD Journal of Vascular Surgery Volume 43, Issue 5, Pages 978-986 (May 2006) DOI: 10.1016/j.jvs.2006.01.020 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 The self-built exercise bench permits isotonic stress exercises of the calf muscle with a defined workload, which is measured via force at the piston and via distance and is adjusted by a feedback control system. The volunteer lying on the exercise bench indicates the correct positioning for the phosphor 31 magnetic resonance spectroscopy examination. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 Magnetic resonance angiogram of a 64-year-old patient of the patient group who presented with a left symptomatic leg and a right asymptomatic leg. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Time course of phosphocreatine (PCr) during incremental calf exercise at 2, 3, 4, and 5 W in the peripheral arterial disease patient whose magnetic resonance angiogram is presented in Fig 2. Please note the lower PCr level and the progressive PCr decrease shortly before exercise stop in the symptomatic left leg. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 The boxplots present the ΔPCrss values, meaning the phosphocreatine (PCr) difference between the baseline and steady-state level, and the PCr time constants τ for each workload increment (1-4) and the recovery phase (rec). Significant effects are marked. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 5 The boxplots show the pH changes over time during the recovery phase, separately for each group (symptomatic, asymptomatic, and control legs). Significant differences are marked. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 6 The scatterplot shows the relationship between runoff resistance (ROR) and ankle-brachial pressure index (ABPI) separated for the symptomatic and asymptomatic legs. Journal of Vascular Surgery 2006 43, 978-986DOI: (10.1016/j.jvs.2006.01.020) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions