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Exercise AND peripheral vascular disease

T A Sigterman, L J J Bolt, A G Krasznai, M G Snoeijs, R Heijboer, G W H Schurink, L H Bouwman
BACKGROUND: Administration of radiocontrast during endovascular procedures for peripheral arterial disease may cause acute kidney injury, which generally recovers with supportive treatment. Long-term effects of endovascular procedures on renal function remain to be investigated. METHOD: This retrospective observational cohort study includes all patients who newly presented to the vascular surgery outpatient clinic with rutherford class II or III peripheral arterial disease and who were treated with either supervised exercise therapy or endovascular interventions...
November 26, 2016: Annals of Vascular Surgery
Holger Lawall, Peter Huppert, Christine Espinola-Klein, Gerhard Rümenapf
BACKGROUND: In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS: This guideline was prepared by a collaboration of 22 medical specialty societies and two patient self-help organizations on the basis of pertinent publications that were retrieved by a systematic search in PubMed for articles that appeared from 2008 to April 2014, with a subsequent update to May 2015...
October 28, 2016: Deutsches Ärzteblatt International
Andreas Zietzer, Eva Elina Buschmann, Doreen Janke, Lulu Li, Michèle Brix, Heike Meyborg, Philipp Stawowy, Constantin Jungk, Ivo Buschmann, Philipp Hillmeister
AIM: Physical activity is a potent way to impede vascular aging. However, patients who suffer from peripheral artery disease (PAD) are often unable to exercise adequately. For those patients, we have developed individual shear rate therapy (ISRT), which is an adaptation of external counterpulsation and enhances endovascular fluid shear stress to increase collateral growth (arteriogenesis). To evaluate the effects of physical exercise and ISRT on the telomere biology of peripheral blood mononuclear cells (PBMCs), we conducted two clinical trials...
October 22, 2016: Acta Physiologica
Michel van Schaardenburgh, Martin Wohlwend, Øivind Rognmo, Erney J R Mattsson
PURPOSE: Mitochondria are essential for energy production in the muscle cell and for this they are dependent upon a sufficient supply of oxygen by the circulation. Exercise training has shown to be a potent stimulus for physiological adaptations and mitochondria play a central role. Whether changes in mitochondrial respiration are seen after exercise in patients with a reduced circulation is unknown. The aim of the study was to evaluate the time course and whether one session of calf raise exercise stimulates mitochondrial respiration in the calf muscle of patients with peripheral vascular disease...
2016: PloS One
Rhian M Touyz
Pathophysiological mechanisms contributing to hypertension include injury to small arteries, characterised by endothelial dysfunction, vascular remodeling, fibrosis and inflammation, (so called hypertensive vascular phenotype). These changes are initially adaptive but in the long term become maladaptive leading to vascular damage and loss of function, particularly important in small resistance arteries, critically involved in the regulation of peripheral vascular resistance and consequently in blood pressure control...
September 2016: Journal of Hypertension
Christophe Colas-Ribas, Isabelle Signolet, Samir Henni, Mathieu Feuillloy, Frédéric Gagnadoux, Pierre Abraham
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease...
October 2016: Medicine (Baltimore)
A Vahl, B Elsman, A van Enst
- Revision of the 2005 guideline 'Diagnostics and treatment of lower extremity peripheral arterial disease' and the development of an audit have instigated a degree of efficiency and transparency for the treatment of patients with peripheral arterial disease (PAD). - The key recommendations are that first-line treatment of patients, who - preferably by means of a consultation in a vascular laboratory - are diagnosed with intermittent claudication, is supervised exercise therapy and secondary prevention. Referral for second-line treatment only needs to occur when invasive therapy is considered, for example when there is insufficient improvement in symptoms or in patients who have or are developing critical ischemia...
2016: Nederlands Tijdschrift Voor Geneeskunde
Daniel R Machin, Heather L Clifton, Ryan S Garten, Jayson R Gifford, Russell S Richardson, D Walter Wray, Tracy M Frech, Anthony J Donato
Systemic sclerosis (SSc) is a rare autoimmune disease characterized by debilitating fibrosis and vascular dysfunction; however, little is known about the circulatory response to exercise in this population. Therefore, we examined the peripheral hemodynamic and vasodilatory responses to handgrip exercise in 10 patients with SSc (61 ± 4 yr) and 15 age-matched healthy controls (56 ± 5 yr). Brachial artery diameter, blood flow, and mean arterial pressure (MAP) were determined at rest and during progressive static-intermittent handgrip exercise...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Rhian M Touyz
Pathophysiological mechanisms contributing to hypertension include injury to small arteries, characterised by endothelial dysfunction, vascular remodeling, fibrosis and inflammation, (so called hypertensive vascular phenotype). These changes are initially adaptive but in the long term become maladaptive leading to vascular damage and loss of function, particularly important in small resistance arteries, critically involved in the regulation of peripheral vascular resistance and consequently in blood pressure control...
September 2016: Journal of Hypertension
Hassan Albadawi, A Aria Tzika, Christian Rask-Madsen, Lindsey M Crowley, Michael W Koulopoulos, Hyung-Jin Yoo, Michael T Watkins
BACKGROUND: Obesity and type 2 diabetes are major risk factors for peripheral arterial disease in humans, which can result in lower limb demand ischemia and exercise intolerance. Exercise triggers skeletal muscle adaptation including increased vasculogenesis. The goal of this study was to determine whether demand ischemia modulates revascularization, fiber size, and signaling pathways in the ischemic hind limb muscles of mice with diet-induced obesity (DIO). MATERIALS AND METHODS: DIO mice (n = 7) underwent unilateral femoral artery ligation and recovered for 2 wks followed by 4 wks with daily treadmill exercise to induce demand ischemia...
September 2016: Journal of Surgical Research
Caroline Koch, Emmanuel Chauve, Ségolène Chaudru, Alexis Le Faucheur, Vincent Jaquinandi, Guillaume Mahé
Peripheral artery disease (PAD) is a highly prevalent disease diagnosed by the use of ankle-brachial index (ABI) at rest. In some clinical conditions (diabetes, renal insufficiency, advanced age), ABI can be falsely normal and other tests are required for the PAD diagnosis (American Heart Association statement). This study was conducted to determine the accuracy of exercise transcutaneous oxygen pressure measurement (exercise-TcPo2) in detection of arterial stenosis ≥50% using computed tomography angiography (CTA) as the gold standard...
September 2016: Medicine (Baltimore)
Amanda J Ross, Zhaohui Gao, Jonathan Carter Luck, Cheryl A Blaha, Aimee E Cauffman, Faisal Aziz, John F Radtka, David N Proctor, Urs A Leuenberger, Lawrence I Sinoway, Matthew D Muller
BACKGROUND: Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD. METHODS: Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload)...
August 27, 2016: Annals of Vascular Surgery
Jörn F Dopheide, Jennifer Rubrech, Amelie Trumpp, Philipp Geissler, Geraldine C Zeller, Boris Schnorbus, Frank Schmidt, Tommaso Gori, Thomas Münzel, Christine Espinola-Klein
BACKGROUND: Arteriogenesis is promoted by flow- and pressure-related forces such as tangential wall stress and laminar shear stress. Exercise training (ET) is known to promote arteriogenesis in peripheral arterial disease (PAD) patients. It remains unclear whether supervised ET (SET) promotes arteriogenesis more efficiently than non-SET (nSET). METHODS AND RESULTS: Forty PAD patients participated in a SET or nSET training programme (n = 20 each) and were compared to 20 healthy individuals without any history of cardiovascular events...
August 22, 2016: European Journal of Preventive Cardiology
K Dipla, A Triantafyllou, N Koletsos, V Sachpekidis, P Poulios, E Gkaliagkousi, A Zafeiridis, S Douma
OBJECTIVE: Masked hypertensives (MH) are at increased cardiovascular risk and target organ damage. Despite a growing number of studies suggesting that early identification of these patients is crucial, a 24 h ambulatory blood pressure (BP) or proper home BP monitoring are not always feasible. An exaggerated BP response during dynamic exercise testing (duration ∼9-15 min) has been used as an additional screening tool to identify suspected systolic MH. However, MH especially in young people, is often characterized by an elevated diastolic BP...
September 2016: Journal of Hypertension
Aluísio H R A Lima, Marilia A Correia, Antônio H G Soares, Breno Q Farah, Cláudia L M Forjaz, Alexandre S Silva, Maria S Brasileiro-Santos, Amilton C Santos, Raphael M Ritti-Dias
The aim of this study was to compare the effects of a single session of walking and combined exercise on oxidative stress and vascular function in peripheral arterial disease patients. Thirteen patients with peripheral arterial disease underwent two experimental sessions in random order: walking (ten sets of 2-min walking at the speed corresponding to the onset of claudication pain with 2-min interval between sets) and combined exercise (1 × 10 reps in eight resistance exercises plus five-two-minute sets of walking)...
August 5, 2016: Clinical Physiology and Functional Imaging
Bin Ma, James R Whiteford, Sussan Nourshargh, Abigail Woodfin
Chronically inflamed tissues exhibit altered characteristics that include persistent populations of inflammatory leukocytes and remodelling of the vascular network. As the majority of studies of leukocyte recruitment have been carried out in normal healthy tissues the impact of underlying chronic inflammation on ongoing leukocyte recruitment is largely unknown. Here we investigate the profile and mechanisms of acute inflammatory responses in chronically inflamed and angiogenic tissues, and consider the implications for chronic inflammatory disorders...
August 1, 2016: Journal of Pathology
Thomas F Whayne, Debabrata Mukherjee
Exercise therapy, especially when supervised on-site in a clinical facility or directed off-site for a home-based program, is an essential component of the management of coronary artery disease (CAD) and peripheral arterial disease (PAD). In the case of both atherosclerotic diseases, it can decrease adverse cardiovascular (CV) events. There has been a recent push toward invasive management of both CAD and PAD but accumulating clinical experience has shown the limitation of invasive management and emphasized the importance of medications, CV risk reduction, conditioning, and exercise, especially when supervised...
July 22, 2016: Current Vascular Pharmacology
Yoo-Been Ahn, Myung-Seop Shin, Dong-Hun Han, Munkhzaya Sukhbaatar, Mi-Sun Kim, Hye-Sun Shin, Hyun-Duck Kim
BACKGROUND AND AIMS: We aimed to evaluate the association of periodontitis with the development of early atherosclerotic vascular disease in Korean adults. METHODS: In this cross-sectional study, a total of 1343 adults aged over 40 years were recruited from a community-based cohort of Yangpyeong county, Korea, during the period 2010-2014. Only dentate individuals were included in the study. Subclinical atherosclerosis (SA) was defined as carotid intima-media thickness (cIMT)≥0...
August 2016: Atherosclerosis
Joanna Kapusta, Anna Kapusta, Jan Kowalski, Robert Irzmański
UNLABELLED: The observed with age, atherosclerotic changes in vessels and increasing damage to the vascular endothelium, causing an increase in the occurrence of cardiovascular events. An important element in the rehabilitation of patients with coronary artery disease is a physical activity, to complement the pharmacological treatment. AIM: The aim of the study was to evaluate the influence of a controlled exercise training on changes in central and peripheral circulatory system in patients after acute coronary syndrome...
June 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
D Walter Wray, Markus Amann, Russell S Richardson
The aging process appears to be a precursor to many age-related diseases, perhaps the most impactful of which is cardiovascular disease (CVD). Heart disease, a manifestation of CVD, is the leading cause of death in the USA, and heart failure (HF), a syndrome that develops as a consequence of heart disease, now affects almost six million American. Importantly, as this is an age-related disease, this number is likely to grow along with the ever-increasing elderly population. Hallmarks of the aging process and HF patients with a reduced ejection fraction (HFrEF) include exercise intolerance, premature fatigue, and limited oxygen delivery and utilization, perhaps as a consequence of diminished peripheral vascular function...
July 8, 2016: Heart Failure Reviews
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