Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Original Article

Suitability of the muscle O2 resaturation parameters most used for assessing reactive hyperemia: a near-infrared spectroscopy study

Adequação de parâmetros de ressaturação muscular de O2 mais utilizados na avaliação da hiperemia reativa: um estudo por espectroscopia no infravermelho próximo

Gustavo Vieira de Oliveira; Mônica Volino-Souza; Renata Leitão; Vivian Pinheiro; Carlos Adam Conte-Júnior; Thiago Silveira Alvares

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Abstract: Background: There is a spectrum of possibilities for analyzing muscle O2 resaturation parameters for measurement of reactive hyperemia in microvasculature. However, there is no consensus with respect to the responsiveness of these O2 resaturation parameters for assessing reactive hyperemia.

Objectives: This study investigates the responsiveness of the most utilized muscle O2 resaturation parameters to assess reactive hyperemia in the microvasculature of a clinical group known to exhibit impairments of tissue O2 saturation (StO2).

Methods: Twenty-three healthy young adults, twenty-nine healthy older adults, and thirty-five older adults at risk of cardiovascular disease (CVD) were recruited. Near-infrared spectroscopy (NIRS) was used to assess StO2 after a 5-min arterial occlusion challenge and the following parameters were analyzed: StO2slope_10s, StO2slope_30s, and StO2slope_until_baseline (upslope of StO2 over 10s and 30s and until StO2 reaches the baseline value); time to StO2baseline and time to StO2max (time taken for StO2 to reach baseline and peak values, respectively); ∆StO2reperfusion (the difference between minimum and maximum StO2 values); total area under the curve (StO2AUCt); and AUC above the baseline value (StO2AUC_above_base).

Results: Only StO2slope_10s was significantly slower in older adults at risk for CVD compared to healthy young individuals (p < 0.001) and to healthy older adults (p < 0.001). Conversely, time to StO2max was significantly longer in healthy young individuals than in older adult at CVD risk.

Conclusions: Our findings suggest that StO2slope_10s may be a measure of reactive hyperemia, which provides clinical insight into microvascular function assessment.


cardiovascular physiology, capillary endothelial cells, vascular disease, hypertension, aging


Resumo: Contexto: Existe um espectro de possibilidades na análise dos parâmetros de ressaturação de O2 muscular como uma medida de hiperemia reativa na microvasculatura. No entanto, não há consenso com relação à responsividade desses parâmetros de ressaturação de O2 para avaliação de hiperemia reativa.

Objetivos: Este estudo investigou a capacidade de resposta dos parâmetros de ressaturação muscular de O2 mais utilizados para avaliar a hiperemia reativa na microvasculatura de um grupo clínico conhecido por apresentar comprometimento da saturação de O2 (StO2).

Métodos: Foram recrutados 23 jovens saudáveis, 29 idosos saudáveis e 35 idosos com risco para doença cardiovascular. A espectroscopia no infravermelho próximo foi usada para avaliar a StO2 após um teste de oclusão arterial de 5 minutos, no qual os seguintes parâmetros foram analisados: StO2slope_10s, StO2slope_30s e StO2slope_until_baseline (inclinação da StO2 em 10 s, 30 s e até StO2 atingir valores basais); tempo para StO2baseline e tempo para StO2máx (o tempo necessário para StO2 atingir os valores da linha de base e o máximo, respectivamente); ∆StO2reperfusão (a diferença entre o valor de StO2mínimo e StO2máximo); área total sob a curva (StO2AUCt); e área sob a curva acima do valor da linha de base (StO2AUC_above_base).

Resultados: Apenas StO2slope_10s foi significativamente mais lento em idosos em risco de doença cardiovascular comparados com indivíduos jovens saudáveis (p < 0,001) e idosos saudáveis (p < 0,001). Por outro lado, o tempo para StO2max foi significativamente maior em indivíduos jovens saudáveis do que em idosos em risco de doença cardiovascular.

Conclusões: Nossos achados sugerem que StO2slope_10s pode ser uma medida de hiperemia reativa, que fornece informações clínicas sobre a avaliação da função microvascular.


fisiologia cardiovascular, células endoteliais capilares, doenças vasculares, hipertensão arterial, envelhecimento


1 Martin BJ, Anderson TJ. Risk prediction in cardiovascular disease: the prognostic significance of endothelial dysfunction. Can J Cardiol. 2009;25(Suppl A):15A-20A. PMid:19521569.

2 Thijssen DHJ, Bruno RM, van Mil ACCM, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J. 2019;40(30):2534-47. PMid:31211361.

3 Rosenberry R, Nelson MD. Reactive hyperemia: a review of methods, mechanisms, and considerations. Am J Physiol Regul Integr Comp Physiol. 2020;318(3):R605-18. PMid:32022580.

4 Dipla K, Triantafyllou A, Koletsos N, et al. Impaired Muscle Oxygenation and Elevated Exercise Blood Pressure in Hypertensive Patients: Links With Vascular Stiffness. Hypertension. 2017;70(2):444-51. PMid:28607132.

5 Parmenter BJ, Mavros Y, Ritti Dias R, King S, Fiatarone Singh M. Resistance training as a treatment for older persons with peripheral artery disease: a systematic review and meta-analysis. Br J Sports Med. 2020;54(8):452-61. PMid:30979698.

6 Ferrari M, Mottola L, Quaresima V. Principles, techniques, and limitations of near infrared spectroscopy. Can J Appl Physiol. 2004;29(4):463-87. PMid:15328595.

7 de Oliveira GV, Volino-Souza M, Leitão R, Pinheiro V, Alvares TS. Is flow-mediated dilatation associated with near-infrared spectroscopy-derived magnitude of muscle O2 desaturation in healthy young and individuals at risk for cardiovascular disease? Microvasc Res. 2020;129:103967. PMid:31837305.

8 McLay KM, Fontana FY, Nederveen JP, et al. Vascular responsiveness determined by near-infrared spectroscopy measures of oxygen saturation. Exp Physiol. 2016;101(1):34-40. PMid:26498127.

9 Oliveira GV, Soares RN, Volino-Souza M, Murias JM, Alvares TS. The association between near-infrared spectroscopy assessment of microvascular reactivity and flow-mediated dilation is disrupted in individuals at high risk for cardiovascular disease. Microcirculation. 2019;26(7):e12556. PMid:31077636.

10 de Oliveira GV, Soares RN, Volino-Souza M, Leitão R, Murias JM, Alvares TS. The effects of aging and cardiovascular risk factors on microvascular function assessed by near-infrared spectroscopy. Microvasc Res. 2019;126:103911. PMid:31425692.

11 Soares RN, Somani YB, Proctor DN, Murias JM. The association between near-infrared spectroscopy-derived and flow-mediated dilation assessment of vascular responsiveness in the arm. Microvasc Res. 2019;122:41-4. PMid:30445134.

12 Papadopoulos S, Dipla K, Triantafyllou A, et al. Beetroot increases muscle performance and oxygenation during sustained isometric exercise, but does not alter muscle oxidative efficiency and microvascular reactivity at rest. J Am Coll Nutr. 2018;37(5):361-72. PMid:29425473.

13 Townsend DK, Deysher DM, Wu EE, Barstow TJ. Reduced insulin sensitivity in young, normoglycaemic subjects alters microvascular tissue oxygenation during postocclusive reactive hyperaemia. Exp Physiol. 2019;104(6):967-74. PMid:31020733.

14 Dipla K, Triantafyllou A, Grigoriadou I, et al. Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors. Diabetologia. 2017;60(1):192-201. PMid:27722775.

15 Le Roux-Mallouf T, Vibert F, Doutreleau S, Verges S. Effect of acute nitrate and citrulline supplementation on muscle microvascular response to ischemia-reperfusion in healthy humans. Appl Physiol Nutr Metab. 2017;42(9):901-8. PMid:28460182.

16 Ramos Gonzalez M, Caldwell JT, Branch PA, et al. Impact of shear rate pattern on post-occlusive near-infrared spectroscopy microvascular reactivity. Microvasc Res. 2018;116:50-6. PMid:29080792.

17 Rosenberry R, Munson M, Chung S, et al. Age-related microvascular dysfunction: novel insight from near-infrared spectroscopy. Exp Physiol. 2018;103(2):190-200. PMid:29114952.

18 Kragelj R, Jarm T, Erjavec T, Presern-Strukelj M, Miklavcic D. Parameters of postocclusive reactive hyperemia measured by near infrared spectroscopy in patients with peripheral vascular disease and in healthy volunteers. Ann Biomed Eng. 2001;29(4):311-20. PMid:11339328.

19 Mattu AT, MacInnis MJ, Doyle-Baker PK, Murias JM. Effects of the menstrual and oral contraceptive cycle phases on microvascular reperfusion. Exp Physiol. 2020;105(1):184-91. PMid:31625647.

20 Rosenberry R, Trojacek D, Chung S, Cipher DJ, Nelson MD. Interindividual differences in the ischemic stimulus and other technical considerations when assessing reactive hyperemia. Am J Physiol Regul Integr Comp Physiol. 2019;317(4):R530-8. PMid:31314545.

21 Tremblay JC, King TJ. Near-infrared spectroscopy: can it measure endothelial function? Exp Physiol. 2016;101(11):1443-4. PMid:27620539.

22 Soares RN, Oliveira GV, Alvares TS, Murias JM. The effects of the analysis strategy on the correlation between the NIRS reperfusion measures and the FMD response. Microvasc Res. 2020;127:103922. PMid:31479661.

23 Ryan TE, Brophy P, Lin CT, Hickner RC, Neufer PD. Assessment of in vivo skeletal muscle mitochondrial respiratory capacity in humans by near-infrared spectroscopy: a comparison with in situ measurements. J Physiol. 2014;592(15):3231-41. PMid:24951618.

24 Gayda M, Juneau M, Tardif JC, Harel F, Levesque S, Nigam A. Cardiometabolic and traditional cardiovascular risk factors and their potential impact on macrovascular and microvascular function: preliminary data. Clin Hemorheol Microcirc. 2015;59(1):53-65. PMid:24518371.

25 Soares RN, Proctor DN, Oliveira GV, Alvares TS, Murias JM. Acute application of a transdermal nitroglycerin patch protects against prolonged forearm ischemia‐induced microvascular dysfunction. Microcirculation. 2020;27(3):e12599. PMid:31782855.

26 Grassi B, Quaresima V. Near-infrared spectroscopy and skeletal muscle oxidative function in vivo in health and disease: a review from an exercise physiology perspective. J Biomed Opt. 2016;21(9):091313. PMid:27443955.

27 van Beekvelt MC, Borghuis MS, van Engelen BG, Wevers RA, Colier WN. Adipose tissue thickness affects in vivo quantitative near-IR spectroscopy in human skeletal muscle. Clin Sci. 2001;101(1):21-8. PMid:11410110.

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