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Relationship between leg muscle capillary density and peak hyperemic blood flow with endurance capacity in peripheral artery disease

JOURNAL OF APPLIED PHYSIOLOGY (2011)

期刊

JOURNAL OF APPLIED PHYSIOLOGY

卷 111, 期 1, 页码 81-86

出版社

AMER PHYSIOLOGICAL SOC

DOI: 10.1152/japplphysiol.00141.2011

关键词

claudication; skeletal muscle

类别

Physiology Sport Sciences

资金

National Heart, Lung, and Blood Institute [R01-HL-755752]
Office of Research on Women's Health, Office of the Director

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摘要

Robbins JL, Jones WS, Duscha BD, Allen JD, Kraus WE, Regensteiner JG, Hiatt WR, Annex BH. Relationship between leg muscle capillary density and peak hyperemic blood flow with endurance capacity in peripheral artery disease. J Appl Physiol 111: 81-86, 2011. First published April 21, 2011; doi:10.1152/japplphysiol.00141.2011.-The aim of this study was to determine if skeletal muscle capillary density is lower in patients with peripheral artery disease (PAD) and if capillary density relates to functional limitations. PAD patients with intermittent claudication (IC) have a decreased exercise tolerance due to exercise-induced muscle ischemia. Despite the apparent role diminished arterial flow has in this population, the degree of walking pain and functional limitation is not entirely explained by altered hemodynamics of the affected limbs. We hypothesized that skeletal muscle capillary density is lower in PAD and is related to the functional impairment observed in this population. Sixty-four patients with PAD and 56 controls underwent cardiopulmonary exercise testing and a gastrocnemius muscle biopsy. A subset of these patients (48 PAD and 47 controls) underwent peak hyperemic flow testing via plethysmography. Capillary density in PAD patients was lower compared with controls (P < 0.001). After adjustment for several baseline demographic imbalances the model relating capillary density to peak oxygen consumption (<(V)over dot>O-2) remained significant (P < 0.001). In PAD subjects, capillary density correlated with peak <(V)over dot>O-2, peak walking time (PWT), and claudication onset time (COT). Peak hyperemic blood flow related to peak <(V)over dot>O-2 in both PAD and control subjects. PAD is associated with lower capillary density, and capillary density is related to the functional impairment as defined by a reduced peak <(V)over dot>O-2, PWT, and COT. These findings suggest that alterations in microcirculation may contribute to functional impairment capacity in PAD.

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Toward a Better Understanding of Muscle Microvascular Perfusion During Exercise in Patients With Peripheral Artery Disease: The Effect of Lower-Limb Revascularization

Annelise Meneses, Digby Krastins, Michael Nam, Tom Bailey, Jing Quah, Vaibhav Sankhla, Jeng Lam, Pankaj Jha, Karl Schulze, Jill O'Donnell, Rebecca Magee, Jonathan Golledge, Kim Greaves, Christopher D. Askew

Summary: This study compared the exercise response in patients with peripheral artery disease (PAD) before and after lower-limb endovascular revascularization. The results showed that whole-leg blood flow and conductance increased significantly after revascularization. However, there was no change in muscle microvascular perfusion response. This suggests that patients with PAD compensate for conduit artery blood flow impairment by increasing microvascular blood volume during submaximal exercise.

JOURNAL OF ENDOVASCULAR THERAPY (2022)