Determinants of peak Vo₂ in peripheral arterial occlusive disease patients

Peripheral arterial occlusive disease (PAOD) patients with intermittent claudication are functionally limited and deconditioned. This study examined whether peak aerobic capacity (Vo₂ peak) was associated with PAOD severity, muscle mass, and comorbidities in 109 PAOD patients (93 men and 16 women) aged 48-86 years. The Vo₂ peak (1.12 ± 0.34 L/min), percentage body fat (30.6 ± 8.3%), lean tissue mass of the total body (51.4 ± 8.4 kg), lean tissue mass of the legs (16.6 ± 3.0 kg), and appendicular skeletal mass (22.8 ± 4.2 kg) were determined. The lean tissue mass of the total body (r = .44), lean tissue of the legs (r = .43) and resting ankle/brachial systolic pressure index (ABI; r = .41) correlated with peak Vo₂ (all p < .001). None of the comorbidity variables (obesity, arthritis, coronary artery disease, hypertension, diabetes, and smoking history) were significantly associated with peak Vo₂ except smoking status. The final model for the prediction of peak Vo₂ included lean tissue mass of the legs, resting ABI, smoking status, and ABI X smoking status (r² = .37,p < .001). In older patients with intermittent claudication, lean tissue mass is an important determinant of physical performance independent of PAOD severity and smoking status. Prevention of muscle atrophy may preserve ambulatory function and peak exercise capacity in older PAOD patients.