Document Detail


Acute impairment of the endothelial function by maximal treadmill exercise in patients with intermittent claudication, and its improvement after supervised physical training.
MedLine Citation:
PMID:  17353883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The aim of this study was to determine the effects of maximal exercise and of physical training on endothelial function (EF) of patients with intermittent claudication (IC). METHODS: EF, assessed by ultrasonography of the brachial artery, has been measured in 22 male patients with IC before (pre-exercise EF) and after (postexercise EF) maximal treadmill test. Absolute claudication distance (ACD) and ankle brachial index (ABI) have been measured too. The measurements have been repeated after 18 days (3 times weekly, for 6 weeks) of supervised physical training. RESULTS: Before training, the pre-exercise EF was 7.6+/-2.94 and postexercise EF 5.28+/-3.3 (-33.2%) (P<0.01). After training, the pre-exercise EF was 10.3+/-4.04, whilst postexercise EF was 7.79+/-2.56 (-18.97%) (P<0.01). The differences between the pre-exercise value before and after training and between the postexercise value before and after training were significant (P<0.01). ACD and ABI after training increased respectively from 93.95 to 166.55 m and from 0.67 to 0.71 (P<0.001). CONCLUSIONS: Endothelial dysfunction takes a relevant part in the pathophysiology of IC, with 2/3 of the patients showing an EF lower than the pathological cut-off. Maximal exercise worsens the EF, according to the trend associated with the acute inflammatory response. All these features suggest that physical activity in IC should not utilize the maximal working load, in order to avoid the high inflammatory activation and the acute complications of atherosclerotic plaque. The supervised physical training, besides confirming itself as the most effective means to increase the walking ability, also proved to be able to improve the EF of these patients, as described about other diseases. It is probable that moderate hemodynamic stress reduces the levels of the inflammatory markers and increases the flow-mediated vasodilation through an ischemic preconditioning. The increased walking ability, associated with the improvement of EF could improve the heavy systemic outcome of claudicant patients, as it has been demonstrated in patients with coronary heart disease. Further prospective survival studies on cardiovascular outcomes of trained claudicant patients are needed.
Authors:
G M Andreozzi; A Leone; R Laudani; G Deinite; R Martini
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  26     ISSN:  0392-9590     ISO Abbreviation:  Int Angiol     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-13     Completed Date:  2007-07-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  12-7     Citation Subset:  IM    
Affiliation:
Angiology Care Unit, University Hospital of Padua, Italy. giuseppe.maria.andreozzi@sanita.padova.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Pressure
Brachial Artery / physiopathology
Endothelium, Vascular / physiopathology*
Exercise Test
Exercise Therapy / methods*
Humans
Intermittent Claudication / etiology,  physiopathology*,  rehabilitation
Lower Extremity / blood supply*
Male
Middle Aged
Peripheral Vascular Diseases / complications,  physiopathology,  rehabilitation*
Time Factors
Treatment Outcome
Ultrasonography, Doppler, Color
Walking

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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