Original ArticlesThe effect of body heating and cooling on the ankle and toe systolic pressures in arterial disease☆,☆☆
Section snippets
Patients studied
Ten patients with arterial occlusive disease were studied. All gave informed consent, and the protocol was approved by the Committee of the Faculty of Medicine, University of Manitoba, for the Use of Human Subjects in Research. The average age was 66 years (range, 54 to 78 years). Eight patients had bilateral and two had unilateral arterial obstruction. All had stable intermittent claudication but no pain at rest or skin lesions. The ankle systolic pressure index (ASPI) averaged 0.71 ± SE 0.03
Results
Table I shows the mean values of the systolic pressures and of the ASPI and TSPI during body heating and cooling and during the routine tests.
Pressure Cooling (20) Heating (20) Routine (16) Systolic (mm Hg) Brachial 149 ± 6 130 ± 6* 139 ± 8 Ankle§ 119 ± 8 85 ± 6† 100 ± 7*‡ Toe 56 ± 9 44 ± 3 57 ± 4‡ Index Ankle§ 0.79 ± 0.04 0.65 ± 0.041† 0.69 ± 0.03† Toe 0.37 ± 0.06 0.34 ± 0.02 0.43 ± 0.03‡ *p < 0.05, cooling compared with heating or routine test. †p
Discussion
Possible effects of the changes in body temperature on the distal systolic pressures have received relatively little attention. The ankle and brachial systolic pressures were both reported to increase significantly with body cooling without a significant effect on ASPI.3 Toe pressures were shown to be significantly higher during body cooling than during body heating in healthy subjects.13 Extremes of temperature associated both with heating and cooling were reported to be associated with
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Cited by (29)
Fabric-infused array of reduced graphene oxide sensors for mapping of skin temperatures
2018, Sensors and Actuators, A: PhysicalCitation Excerpt :Skin temperature variations, in both temporal and spatial aspects, can be measured to infer and monitor the state of our pathophysiological developments. For example, cardiovascular diseases can weaken blood circulation, thus lowering skin temperatures of ankles and toes [1–3]. In another example, a plantar temperature rise has proven to be a measurable indicator of diabetic foot ulceration [4–7].
Response to comment
2011, European Journal of Vascular and Endovascular SurgeryThe Validity and Reliability of Automated and Manually Measured Toe Blood Pressure in Ischemic Legs of Diabetic Patients
2008, European Journal of Vascular and Endovascular SurgeryCitation Excerpt :Skin heating results in higher TBP values than non-heating but it do not influence the variability between PPG and LD.17 These findings contradict to earlier made studies on body-heating and cooling where the measured TBP value was lower after heating.18,19 It has been speculated if this reaction could depend on lower resistance in the vascular bed during body warming.
When is a more proximal amputation needed?
2005, Clinics in Podiatric Medicine and SurgeryA new automated toe blood pressure monitor for assessment of limb ischemia
2002, European Journal of Vascular and Endovascular SurgeryThe value of toe pulse waves in determination of risks for limb amputation and death in patients with peripheral arterial disease and skin ulcers or gangrene
2001, Journal of Vascular SurgeryCitation Excerpt :This finding also supports the notion that analyses of wave amplitude recorded with other systems would produce similar results. Because the amplitude of the waves and the values of distal pressures are affected by temperature,15,21,27 it is important to measure after the patient rests under a warming blanket to obtain reliable results. It is unclear why low toe pulse wave amplitude is associated with lower patient survival and worse prognosis to the limb.
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Supported by a grant from the Manitoba Heart and Stroke Foundation.
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Reprint requests: Stefan A. Carter, MD, Vascular Laboratory, St. Boniface General Hospital, 409 Tache Ave., Winnipeg, Manitoba, Canada, R2H 2A6.