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Exercise AND peripheral vascular disease

Gerry Fowkes, Ian N Gillespie
BACKGROUND: Intermittent claudication is pain in the legs due to muscle ischaemia associated with arterial stenosis or occlusion. Angioplasty is a technique that involves dilatation and recanalisation of a stenosed or occluded artery. OBJECTIVES: The objective of this review was to determine the effects of angioplasty of arteries in the leg when compared with non surgical therapy, or no therapy, for people with mild to moderate intermittent claudication. SEARCH METHODS: Sources searched include the Cochrane Peripheral Vascular Diseases Group's Specialized Trials Register (August 2006), the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2006) and reference lists of relevant articles...
March 9, 2018: Cochrane Database of Systematic Reviews
Farzin Fakhry, Hugo Jp Fokkenrood, Sandra Spronk, Joep Aw Teijink, Ellen V Rouwet, M G Myriam Hunink
BACKGROUND: Intermittent claudication (IC) is the classic symptomatic form of peripheral arterial disease affecting an estimated 4.5% of the general population aged 40 years and older. Patients with IC experience limitations in their ambulatory function resulting in functional disability and impaired quality of life (QoL). Endovascular revascularisation has been proposed as an effective treatment for patients with IC and is increasingly performed. OBJECTIVES: The main objective of this systematic review is to summarise the (added) effects of endovascular revascularisation on functional performance and QoL in the management of IC...
March 8, 2018: Cochrane Database of Systematic Reviews
Lukas Streese, Arne Deiseroth, Juliane Schäfer, Arno Schmidt-Trucksäss, Henner Hanssen
Background: Age is a key determinant for the development of cardiovascular disease and higher age coincides with an increased prevalence of obesity and physical inactivity. The study examines the influence of physical activity on aging processes of physiological systems focusing on the mechanisms of vascular aging. Methods/Design: The study consists of two parts. The cross-sectional approach aims at examining the association of physical fitness and cardiovascular risk with large and small artery function in healthy older active (HOA, n = 40) and sedentary (HOS, n = 40) persons as well as older sedentary individuals with increased cardiovascular risk (OSR, n = 80) aged 50-80 years...
2018: Frontiers in Physiology
Samuel Fernández, Juan Carlos Parodi, Fabián Moscovich, Camilo Pulmari
BACKGROUND: Medical treatment of disabling intermittent claudication or critical limb threatening ischemia causing rest pain often fails or has partial response. METHODS: In this pilot study thirty-six patients (12 females) affected by disabling intermittent claudication or rest pain of the lower extremities were exposed to a daily 3 L water intake for up to six weeks. Cutaneous foot temperature, ankle/brachial index, time and distance of claudication and pain intensity were recorded before and at the completion of the hydration period...
February 23, 2018: Annals of Vascular Surgery
Viola Vaccarino, Samaah Sullivan, Muhammad Hammadah, Kobina Wilmot, Ibhar Al Mheid, Ronnie Ramadan, Lisa Elon, Pratik M Pimple, Ernest V Garcia, Jonathon Nye, Amit J Shah, Ayman Alkhoder, Oleksiy Levantsevych, Hawkins Gay, Malik Obideen, Minxuan Huang, Tené T Lewis, J Douglas Bremner, Arshed A Quyyumi, Paolo Raggi
BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is frequent in patients with coronary artery disease and is associated with worse prognosis. Young women with a previous myocardial infarction (MI), a group with unexplained higher mortality than men of comparable age, have shown elevated rates of MSIMI, but the mechanisms are unknown. METHODS: We studied 306 patients (150 women and 156 men) ≤61 years of age who were hospitalized for MI in the previous 8 months and 112 community controls (58 women and 54 men) frequency matched for sex and age to the patients with MI...
February 20, 2018: Circulation
Y J Zhang, S L Wu, H Y Li, Q H Zhao, C H Ning, R Y Zhang, J X Yu, W Li, S H Chen, J S Gao
Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension)...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
David Kovacs, Beata Csiszar, Katalin Biro, Katalin Koltai, Dora Endrei, Istvan Juricskay, Barbara Sandor, Dora Praksch, Kalman Toth, Gabor Kesmarky
BACKGROUND AND AIMS: We assumed that hand-held Doppler ultrasound (DUS) at rest was insufficient to assess the severity of peripheral artery disease (PAD). Toe pressure and transcutaneous tissue oxygen pressure were studied to prove whether these could identify more patients with severe lower limb ischemia; exercise was applied to provoke ischemia. METHODS: 120 patients with PAD and 30 volunteers without PAD were recruited. DUS, transcutaneous tissue oxygen pressure (tcpO2) and toe pressure measurements were performed at rest and after exercise...
January 16, 2018: Atherosclerosis
Pierre Abraham, Christophe Colas-Ribas, Isabelle Signolet, Myriam Ammi, Mathieu Feuilloy, Jean Picquet, Samir Henni
BACKGROUND: Exercise transcutaneous oximetry (Ex-tcPO2) is used to argue for the vascular origin of lower limb pain, especially at the proximal level, where the diagnosis of peripheral artery disease can be difficult. This study analyzed the principal indications, mean results, and limitations of Ex-tcPO2, as well as the relationship between the annual number of Ex-tcPO2 tests and internal iliac artery (IIA) revascularizations.Methods and Results:Data from our first 15 years' experience (3,631 patients, 5,080 tests) with Ex-tcPO2 were analyzed retrospectively using the minimal value of the decrease from rest of oxygen pressure (DROPmin)...
January 18, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Adam M Noyes, J Dawn Abbott, Kensey Gosch, Kim Smolderen, John A Spertus, Omar Hyder, Peter Soukas, Mehdi H Shishehbor, Herbert D Aronow
Patients with peripheral artery disease (PAD) and intermittent claudication (IC) have impaired functional status and quality of life. However, little is known about which factors are associated with poorer health status at the time of initial presentation for PAD specialty care. Characterization of such features might provide insight into disparities that impact health status in this population. A total of 1258 patients from the United States, the Netherlands and Australia with new or worsened IC were enrolled at their first PAD specialty care visit between June 2011 and December 2015...
January 1, 2018: Vascular Medicine
Robin Ramphul, Maria Fernandez, Sam Firoozi, Juan C Kaski, Rajan Sharma, Debasish Banerjee
BACKGROUND: Despite pre-kidney-transplant cardiovascular (CV) assessment being routine care to minimise perioperative risk, the utility of such assessment is not well established. The study reviewed the evaluation and outcome of a standardised CV assessment protocol. METHODS: Data were analysed for 231 patients (age 53.4 ± 12.9 years, diabetes 34.6%) referred for kidney transplantation between 1/2/2012-31/12/2014. One hundred forty-three patients were high-risk (age > 60 years, diabetes, CV disease, heart failure, peripheral vascular disease) and offered dobutamine stress echocardiography (DSE); 88 patients were low-risk and offered ECG and echocardiography with/without exercise treadmill test...
January 8, 2018: BMC Nephrology
Samir Henni, Guillaume Mahe, Christophe Lamotte, Remi Laurent, Alessandra Bura Riviere, Marion Aubourg, Gabrielle Sarlon, Damien Laneelle, Anne Long, Isabelle Signolet, Jean Picquet, Mathieu Feuilloy, Pierre Abraham
INTRODUCTION: In lower extremity peripheral artery disease (PAD), transcutaneous oximetry at exercise (Ex-TcpO2) has been largely validated in research practice, but evidence of routine practice in various vascular laboratories is missing. We hypothesized that Ex-TcPO2 would change the diagnosis hypotheses, investigations and treatments for patients referred for exertional limb pain. MATERIAL & METHODS: A multicenter prospective trial was conducted in nine different referral centers...
January 3, 2018: European Journal of Internal Medicine
Risha Lane, Amy Harwood, Lorna Watson, Gillian C Leng
BACKGROUND: Exercise programmes are a relatively inexpensive, low-risk option compared with other, more invasive therapies for treatment of leg pain on walking (intermittent claudication (IC)). This is the fourth update of a review first published in 1998. OBJECTIVES: Our goal was to determine whether an exercise programme was effective in alleviating symptoms and increasing walking treadmill distances and walking times in people with intermittent claudication. Secondary objectives were to determine whether exercise was effective in preventing deterioration of underlying disease, reducing cardiovascular events, and improving quality of life...
December 26, 2017: Cochrane Database of Systematic Reviews
Mariana Faria-Urbina, Rudolf K F Oliveira, Manyoo Agarwal, Aaron B Waxman
PURPOSE: Pulmonary hypertension (PH) in the setting of parenchymal lung disease adversely affects quality of life and survival. However, PH-specific drugs may result in ventilation/perfusion imbalance and currently, there are no approved PH treatments for this patient population. In the present retrospective study, data from 22 patients with PH associated with lung disease treated with inhaled treprostinil (iTre) and followed up clinically for at least 3 months are presented. METHODS: PH was defined by resting right heart catheterization as a mean pulmonary artery pressure (mPAP) ≥ 35 mmHg, or mPAP ≥ 25 mmHg associated with pulmonary vascular resistance ≥ 4 Woods Units...
December 23, 2017: Lung
Iléana Desormais, Victor Aboyans, Francis Pesteil, Philipe Lacroix
Medical management of peripheral arterial disease (PAD) patients is aimed at limb symptom relief and reducing systemic major adverse events risk. For the first purpose: exercise therapy is recommended in case of claudication; multidisciplinary evaluation for surgical options is mandatory in case of critical limb ischaemia. Reducing cardiac and stroke risk can be achieved through: statin prescription in most of the cases; antiplatelet agents in symptomatic PAD patients; cardio-vascular risk factors control.
December 19, 2017: La Presse Médicale
Hussein F Sakr, Amr M Abbas, Mohamed A Haidara
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with a systemic procoagulant hypofibrinolysis state that is considered as a risk factor for microangiopathy and peripheral vascular diseases. Swimming exercise ameliorates the metabolic dysfunction in type 2 diabetes. Vitamin E is a natural antioxidant that reduces the risk of endothelial dysfunction in metabolic syndrome. The aim of the present study is to investigate the effect of combined swimming exercise with vitamin E on coagulation as well as blood fibrinolysis markers in rats with NAFLD...
November 21, 2017: Journal of Basic and Clinical Physiology and Pharmacology
Nils Cornelis, Roselien Buys, Inge Fourneau, Tijl Dewit, Véronique Cornelissen
BACKGROUND: Supervised walking is a first line therapy in peripheral arterial disease (PAD) with complaints of intermittent claudication. However, uptake of supervised programmes is low. Home-based exercise seems an appealing alternative; especially since technological advances, such as tele-coaching and tele-monitoring, may facilitate the process and support patients when adopting a physically active lifestyle. To guide the development of such an intervention, it is important to identify barriers of physical activity and the needs and interests for technology-enabled exercise in this patient group...
November 16, 2017: VASA. Zeitschrift Für Gefässkrankheiten
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
December 2017: Herz
Ping-Chung Leung
Sauna has become a popular club house facility where the dweller enjoys relaxation. Some exercise groups like yoga and Qigong practitioners, are making use of the heated environment to achieve quicker and better results of trainings. Sauna therapy is producing a thermal stress through hyperthermia. The cardiovascular system readily responds by increasing the heart rate which can become double the resting stage within minutes and cardiac output may have a 70% increase. The body's surface response to heat leads to a 40% of decrease in peripheral vascular resistance, thus allowing rapid peripheral blood flow which is responsible for greater heat dispersal directly from the skin...
October 2017: Journal of Exercise Rehabilitation
Jessica L Ross, Luis F Queme, Jordan E Lamb, Kathryn J Green, Zachary K Ford, Michael P Jankowski
Issues of peripheral circulation have been increasingly suggested as an underlying cause of musculoskeletal pain in many conditions, including sickle cell anemia and peripheral vascular disease. We have previously shown in our model of transient ischemia and reperfusion (I/R) injury of the forelimb that individual group III and IV muscle afferents display altered chemosensitivity and mechanical thresholds 1 day after injury. Functional alterations corresponded to increased evoked and spontaneous pain-related behaviors and decreased muscle strength and voluntary activity-all actions that echo clinical symptoms of ischemic myalgia...
October 30, 2017: Pain
Alexander Z Copelan, Baljendra S Kapoor, Ali F AbuRahma, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Stephen P Reis, Paul J Rochon, Colette M Shaw, Jonathan M Lorenz
Iliac artery occlusive disease can present as a sudden-onset acute thrombotic or thromboembolic event or as a chronic progressive atherosclerotic process that presents as claudication progressing to rest pain. Depending on the clinical presentation, the diagnosis is usually confirmed through Doppler vascular ultrasound, CT angiography, or MR angiography; the choice of imaging is usually based on modality availability and the presence of patient comorbidities such as chronic kidney disease. The Trans-Atlantic Inter-Society Consensus II classification system is commonly used to describe the extent of the peripheral vascular disease...
November 2017: Journal of the American College of Radiology: JACR
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