title: Oxygen pressure measurement during grip exercise reveals exercise intolerance after radial harvest.
abstract: BACKGROUND
  Exercise intolerance of the hand after harvest of the radial artery is not well understood, although mild reductions of blood flow to the hand are reported. To ascertain its prevalence, patient symptoms implying potential exercise intolerance were evaluated by measuring transcutaneous oxygen pressure of the hand during grip exercise. For ascertaining predictive values, we verified ulnar flow reserve measured by Doppler ultrasonography before the harvest of radial artery.
  
  
  METHODS
  Forty patients whose radial artery was harvested for coronary bypass graft, were interviewed and tested 1 year after operation, and their preoperative ultrasonographic data compared.
  
  
  RESULTS
  Five patients (12.5%) had mild symptoms implying exercise intolerance. Exercise tests revealed severe decreases in tissue oxygenation in 7 patients (17.5%), but in accordance with symptoms (p = 0.0018). Tissue oxygenation in the operated hand was lower than in the nonoperated even in asymptomatic patients (p = 0.0011). Preoperative Doppler echography revealed that ulnar arteries of symptomatic patients were smaller (p = 0.0019) and carried lower blood flows during manual compression of the radial artery (p = 0.0004) compared with those of asymptomatic patients. Smaller ulnar arteries (less than 1.4 mm/m(2)) with poor flow reserves (less than 60 mL x min(-1) x m(-2) during radial compression) appear to indicate risks for exercise intolerance (p = 0.0004).
  
  
  CONCLUSIONS
  More than 10% of patients after harvest of radial arteries had mild symptoms implying exercise-intolerance, which accorded with abnormal tissue oxygenation during grip exercise. Work habits of patients should be considered in radial harvest decisions, especially if preoperative Doppler echography indicates lower flow reserves for the ulnar artery.
authors.affiliation: Department of Cardiothoracic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Manabe
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tabuchi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Toyama
authors.forename: Tomoya
authors.initials: T
authors.lastname: Yoshizaki
authors.forename: Masanori
authors.initials: M
authors.lastname: Kato
authors.forename: Haisong
authors.initials: H
authors.lastname: Wu
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Kotani
authors.forename: Makoto
authors.initials: M
authors.lastname: Sunamori
mesh_terms: D001783:Blood Flow Velocity; D001785:Blood Gas Monitoring, Transcutaneous; D001026:Coronary Artery Bypass; D017079:Exercise Tolerance; D005260:Female; D006225:Hand / Q000098:blood supply; D018737:Hand Strength; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D017534:Radial Artery / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D018608:Ultrasonography, Doppler
chemical_list: D010100:Oxygen