Original Articles
The effect of body heating and cooling on the ankle and toe systolic pressures in arterial disease,☆☆

https://doi.org/10.1016/0741-5214(92)90102-EGet rights and content

Abstract

Although changes in body temperature alter limb blood flow, little information exists on the effect of body heating and cooling on systolic pressures in limbs with arterial disease. Ten patients with stable claudication were studied. Mean ankle systolic pressure index during body cooling (0.79 ± 0.04) exceeded (p < 0.01) both the value during routine test (0.69 ± 0.03) and during heating (0.65 ± 0.04). The individual, paired difference in ankle systolic pressure index between cooling and heating exceeded 0.15 in seven limbs and between cooling and routine test in five. Mean toe systolic pressure index during heating, but not during cooling, was lower than during routine test (p < 0.01). There was no significant difference in the mean toe systolic pressure index between heating and cooling. However, compared with heating, toe systolic pressure index increased with cooling in 12 limbs and decreased in eight, including three with loss of measurable pressure. The paired difference in toe systolic pressure index between cooling and heating exceeded 0.15 in 10 limbs and between cooling and routine test in eight; whereas between heating and routine test the paired difference was within 0.15 in all but three limbs. The results indicate that changes in body temperature have significant effects on distal pressures in arterial disease. Preliminary warming in routine tests should improve reproducibility. (J Vasc Surg 1992;16:148–53.)

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.

. Systolic pressures during body cooling and heating and on a routine test

PressureCooling (20)Heating (20)Routine (16)
Systolic (mm Hg)
 Brachial149 ± 6130 ± 6*139 ± 8
 Ankle§119 ± 885 ± 6100 ± 7*‡
 Toe56 ± 944 ± 357 ± 4
Index
 Ankle§0.79 ± 0.040.65 ± 0.0410.69 ± 0.03
 Toe0.37 ± 0.060.34 ± 0.020.43 ± 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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    Supported by a grant from the Manitoba Heart and Stroke Foundation.

    ☆☆

    Reprint requests: Stefan A. Carter, MD, Vascular Laboratory, St. Boniface General Hospital, 409 Tache Ave., Winnipeg, Manitoba, Canada, R2H 2A6.

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