Doppler ultrasound-based leg blood flow assessments during single-leg knee-extensor exercise in patients with chronic obstructive pulmonary disease vs. healthy controls: a test-retest reliability study

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Physiology in Focus 2024 (Northumbria University, UK) (2024) Proc Physiol Soc 59, PCB013

Poster Communications: Doppler ultrasound-based leg blood flow assessments during single-leg knee-extensor exercise in patients with chronic obstructive pulmonary disease vs. healthy controls: a test-retest reliability study

Milan Mohammad1, Jacob Hartmann1, Amalie Andersen1, Helene Hartmeyer1, Ulrik Iepsen1,

1Centre for Physical Activity Research, Copenhagen University Hospital – Rigshospitalet. Copenhagen Denmark, 2Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen. Copenhagen Denmark, 3Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital – Rigshospitalet. Copenhagen Denmark, 4Centre for Physical Activity Research, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark Copenhagen Denmark, 5Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital, Hvidovre Hospital Copenhagen Denmark,

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Introduction: Patients with chronic obstructive pulmonary disease (COPD) exhibit markedly diminished exercise capacity. Studies have shown that skeletal muscle leg blood flow (Q̇leg) plays an important role as a peripheral determinant of exercise capacity (1, 2). Doppler ultrasound may be used to assess Q̇leg both at rest and during exercise. However, the reliability of this method remains unknown when applied to patients with chronic obstructive pulmonary disease (COPD).

Objectives: This study aimed to investigate the within-day and between-day reliability of Doppler ultrasound in quantifying Q̇leg during single-leg knee-extensor exercise in COPD patients and compare these measurements with those obtained from healthy matched controls.

Methods: In this case-control study, 16 participants with COPD were matched based on sex and age with 16 healthy controls. All participants underwent measurement of Q̇leg using Doppler ultrasound in a single-leg knee-extensor setup at various intensities on two separate visits (Figure 1). Influential factors on Q̇leg were controlled for, and the ultrasound scans were consistently performed by the same sonographer. The study was approved by the Regional Ethical Committee of the Capital Region of Denmark (file no. H-23049997) and performed according to the most recent guidelines of the Declaration of Helsinki. All participants provided oral and written informed consent prior to enrolment. The study was registered on ClinicalTrials.gov (ID: NCT06135701).

Results: Results indicated a high within-day and acceptable to high between-day reliability for Doppler ultrasound measurements in both COPD patients and controls. Coefficient of variance ranged from 2.9 % to 10 % for within-day and 7.9 % to 20.4 % for between-day with small between-group differences in reliability estimates favouring the healthy control group. Q̇leg was similar between group at rest, but significantly lower in COPD during single-leg knee-extensor exercise.

Conclusion: Doppler ultrasound is a reliable tool for evaluating Q̇leg in both COPD patients and healthy individuals. Furthermore, the findings of this study offer novel insights into the peripheral circulatory constraints experienced by COPD patients during exercise, as evidenced by consistently diminished leg blood flow when compared to their healthy control.

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Where applicable, experiments conform with Society ethical requirements.

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