TY - JOUR
T1 - Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease
AU - Ross, Amanda J.
AU - Gao, Zhaohui
AU - Luck, Jonathan Carter
AU - Blaha, Cheryl A.
AU - Cauffman, Aimee E.
AU - Aziz, Faisal
AU - Radtka, John F.
AU - Proctor, David N.
AU - Leuenberger, Urs A.
AU - Sinoway, Lawrence I.
AU - Muller, Matthew D.
N1 - Funding Information:
The authors would like to thank Dr Michael Herr for engineering support, Kris Brandt for assistance with echocardiography analysis, and Jen Stoner and Kris Gray for administrative support. This publication was supported, in part, by NIH grants UL1 TR000127 and P01 HL096570 (to L.I.S.) and KL2 TR000126 from the National Center for Advancing Translational Science and also under a grant with the Pennsylvania Department of Health using Tobacco CURE funds (to M.D.M.). The Pennsylvania Department of Health and the NIH specifically disclaim responsibility for any analyses, interpretations, or conclusions. Also contributing to this project was American Heart Association 15PRE24470033 (to A.J.R.).
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - 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). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.
AB - 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). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.
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U2 - 10.1016/j.avsg.2016.05.135
DO - 10.1016/j.avsg.2016.05.135
M3 - Article
C2 - 27575303
AN - SCOPUS:84999015147
SN - 0890-5096
VL - 38
SP - 260
EP - 267
JO - Annals of Vascular Surgery
JF - Annals of Vascular Surgery
ER -