scholarly journals Heat therapy improves soleus muscle force in a model of ischemia-induced muscle damage

2019 ◽  
Vol 127 (1) ◽  
pp. 215-228 ◽  
Author(s):  
Kyoungrae Kim ◽  
Blake A. Reid ◽  
Bohyun Ro ◽  
Caitlin A. Casey ◽  
Qifan Song ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Damage ◽  
Muscle Mass ◽  
Peripheral Artery Disease ◽  
Soleus Muscle ◽  
Peripheral Artery ◽  
Muscle Morphology ◽  
Heat Therapy ◽  
Artery Disease ◽  
The Impact

Leg muscle ischemia in patients with peripheral artery disease (PAD) leads to alterations in skeletal muscle morphology and reduced leg strength. We tested the hypothesis that exposure to heat therapy (HT) would improve skeletal muscle function in a mouse model of ischemia-induced muscle damage. Male 42-wk-old C57Bl/6 mice underwent ligation of the femoral artery and were randomly assigned to receive HT (immersion in a water bath at 37°C, 39°C, or 41°C for 30 min) or a control intervention for 3 wk. At the end of the treatment, the animals were anesthetized and the soleus and extensor digitorum longus (EDL) muscles were harvested for the assessment of contractile function and examination of muscle morphology. A subset of animals was used to examine the impact of a single HT session on the expression of genes involved in myogenesis and the regulation of muscle mass. Relative soleus muscle mass was significantly higher in animals exposed to HT at 39°C compared with the control group (control: 0.36 ± 0.01 mg/g versus 39°C: 0.40 ± 0.01 mg/g, P = 0.024). Maximal absolute force of the soleus was also significantly higher in animals treated with HT at 37°C and 39°C (control: 274.7 ± 6.6 mN; 37°C: 300.1 ± 7.7 mN; 39°C: 299.5 ± 10 mN, P < 0.05). In the soleus, but not the EDL muscle, a single session of HT enhanced the mRNA expression of myogenic factors as well as of both positive and negative regulators of muscle mass. These findings suggest that the beneficial effects of HT are muscle specific and dependent on the treatment temperature in a model of PAD. NEW & NOTEWORTHY This is the first study to comprehensively examine the impact of temperature and muscle fiber type composition on the adaptations to repeated heat stress in a model of ischemia-induced muscle damage. Exposure to heat therapy (HT) at 37°C and 39°C, but not at 41°C, improved force development of the isolated soleus muscle. These results suggest that HT may be a practical therapeutic tool to restore muscle mass and strength in patients with peripheral artery disease.

Abstract 282: Biomarkers of Muscle Damage in Patients with Peripheral Artery Disease

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Kim Cluff ◽  
Hootan Mehraein ◽  
Kaitlyn Howard ◽  
Panagiotis Koutakis ◽  
George P Casale ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Ftir Spectroscopy ◽  
Muscle Damage ◽  
Clinical Diagnosis ◽  
Peripheral Artery Disease ◽  
The United States ◽  
Least Squares Regression ◽  
Peripheral Artery ◽  
Spectral Peaks ◽  
Artery Disease

Introduction: Peripheral artery disease (PAD), a manifestation of systemic atherosclerosis (fat, plaque deposition and hardening of arterial walls), characterized by blockages of the arteries supplying the legs affects approximately 8 million lives in the United States. The classic symptom of PAD is intermittent claudication (IC), de[[Unable to Display Character: &#64257;]]ned as walking-induced calf pain and gait dysfunction relieved by rest. At the level of the skeletal muscle ischemic injury is manifested as a gradual and characteristic degradation of muscle histology. This injury includes altered metabolic processes, damaged organelles, and compromised bioenergetics in the affected muscle. In this study, we evaluated the hypothesis that Fourier Transform Infrared (FTIR) spectroscopy of human biopsy samples (gastrocnemius muscle) can be used to identify biochemical alterations in PAD muscle and characterize severity of muscle damage. Method: FTIR spectral profiles were collected from muscle biopsies of the gastrocnemius from 13 patients consisting of 4 controls, 5 claudicating patients, and 4 critical limb ischemia (CLI) patients. Statistical analysis of the data included an analysis of variance, and partial least squares regression (PLRS) to identify significant differences in spectral peaks and correlate them with clinical diagnosis. Results: When comparing spectral peaks between controls, claudicants, and CLI patients, significant differences (p<.05) were found in the fingerprint region at spectral peaks between wavenumbers 1200-1250 cm-1. These spectral peaks have been attributed to alterations in protein content, lipids, and DNA or phospholipid groups. FTIR spectral biomarkers, of the muscle, also correlated (r=0.91) with clinical diagnosis of PAD. Conclusion: FTIR spectroscopy was able to characterize the secondary effects of PAD on the gastrocnemius by identifying unique biochemical signatures of diseased PAD skeletal muscle. These signatures can discriminate control from PAD muscle and correlate with the clinical presentation of the PAD patient. FTIR spectroscopy provides novel spectral biomarkers that may complement existing diagnosis and treatment monitoring methods for PAD.

Abstract 17075: Impact of Peripheral Artery Disease on Outcomes Following Admission for Cardiogenic Shock

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nino Mihatov ◽  
Robert W Yeh ◽  
Eunhee Choi ◽  
Changyu Shen ◽  
Sahil A Parikh ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Peripheral Artery Disease ◽  
Circulatory Support ◽  
Complication Rates ◽  
Medicare Beneficiaries ◽  
Peripheral Artery ◽  
Adjusted Risk ◽  
Artery Disease ◽  
The Impact

Introduction: Contemporary in-hospital mortality rates for patients presenting with acute myocardial infarction (AMI) and cardiogenic shock (CS) remain as high as 50%. The impact of comorbid lower extremity peripheral artery disease (LE-PAD) is unknown. Hypothesis: LE-PAD is associated with higher morbidity and mortality in patients presenting with CS and AMI. Methods: Medicare beneficiaries hospitalized with CS related to AMI from 10/2015-6/2017 were identified. PAD status was defined by the inpatient billing codes present in the year prior to presentation. Outcomes included in-hospital mortality, amputation, peripheral revascularization, and 6-month mortality. Adjusted regression models were used to evaluate outcomes. A subgroup analysis included patients requiring mechanical circulatory support (MCS). Results: Among 45,144 patients, 5.9% (N=2,651) had LE-PAD. The average age was 77.8±7.9, 59.8% were male and 83.0% were white. Cumulative in-hospital mortality was 46.8%, with greater risk among LE-PAD patients (55.2% vs 46.3%; adjusted OR 1.52, 95% CI 1.39-1.65). LE-PAD patients also had greater adjusted risk of in-hospital amputation (1.5% vs 0.2%; OR 3.23, 95% CI: 2.16-4.83), peripheral revascularization rates (1.4% vs 0.4%; OR 1.54, 95% CI: 1.06-2.23), and 6-month mortality (43.2% vs 23.7%; HR 2.06, 95% CI: 1.80-2.35). MCS was less frequently utilized in LE-PAD (20.1% vs. 38.1%, p<0.01). Adjusted in-hospital mortality, amputation and peripheral revascularization rates were comparable between LE-PAD and non-LE-PAD patients who received MCS. Non-MCS LE-PAD patients had a 2.28 fold higher adjusted 6-month mortality compared with MCS LE-PAD patients (95% CI 1.60-3.11; Figure). Conclusions: Comorbid PAD is associated with worse limb outcomes and mortality among patients with AMI and CS. Although MCS was less likely to be used in LE-PAD patients, in-hospital mortality and limb complication rates were comparable to non-LE-PAD MCS patients.

461Modulation of ischemic and bleeding risk by peripheral artery disease after an acute coronary syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Cespon Fernandez ◽  
S Raposeiras Roubin ◽  
E Abu-Assi ◽  
S Manzano-Fernandez ◽  
F Dascenzo ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Peripheral Artery Disease ◽  
Cumulative Incidence ◽  
Bleeding Risk ◽  
Peripheral Artery ◽  
Data Set ◽  
Coronary Syndrome ◽  
Artery Disease ◽  
The Impact

Abstract Introduction Peripheral artery disease (PAD) is associated with heightened ischemic and bleeding risk in patients with acute coronary syndrome (ACS). With this study from real-life patients, we try to analyze the balance between ischemic and bleeding risk during treatment with dual antiplatelet therapy (DAPT) after an ACS according to the presence or not of PAD. Methods The data analyzed in this study were obtained from the fusion of 3 clinical registries of ACS patients: BleeMACS (2004–2013), CardioCHUVI/ARRITXACA (2010–2016) and RENAMI (2013–2016). All 3 registries include consecutive patients discharged after an ACS with DAPT and undergoing PCI. The merged data set contain 26,076 patients. A propensity-matched analysis was performed to match the baseline characteristics of patients with and without PAD. The impact of prior PAD in the ischemic and bleeding risk was assessed by a competitive risk analysis, using a Fine and Gray regression model, with death being the competitive event. For ischemic risk we have considered a new acute myocardial infarction (AMI), whereas for bleeding risk we have considered major bleeding (MB) defined as bleeding requiring hospital admission. Follow-up time was censored by DAPT suspension/withdrawal. Results From the 26,076 ACS patients, 1,600 have PAD (6.1%). Patients with PAD were older, and with more cardiovascular risk factors. DAPT with prasugrel/ticagrelor was less frequently prescribed in patients with PAD in comparison with the rest of the population (8.2% vs 22.8%, p<0.001). During a mean follow-up of 12.2±4.8 months, 964 patients died (3.7%), and 640 AMI (2.5%) and 685 MB (2.6%) were reported. After propensity-score matching, we obtained two matched groups of 1,591 patients. Patients with PAD showed a significant higher risk of both AMI (sHR 2.17, 95% CI 1.51–3.10, p<0.001) and MB (sHR 1.51, 95% CI 1.07–2.12, p=0.018), in comparison with those without PAD. The cumulative incidence of AMI was 63.9 and 29.8 per 1,000 patients/year in patients with and without PAD, respectively. The cumulative incidence of MB was 55.9 and 37.6 per 1,000 patients/year in patients with and without PAD, respectively. The rate difference per 1,000 patient-years for AMI between patients with and without PAD was +34.1 (95% CI 30.1–38.1), and for MB +18.3 (16.1–20.4). The net balance between ischemic and bleeding events comparing patients with and without PAD was positive (+15.8 per 1,000 patients/year, 95% CI 9.7–22.0). Conclusions PAD was associated with higher ischemic and bleeding risk after hospital discharge for ACS treated with DAPT. However, the balance between ischemic and bleeding risk was positive for patients with PAD in comparison with patients without PAD. As summary, ACS patients with PAD had an ischemic risk greater than the bleeding risk.

scholarly journals Leg heat therapy improves perceived physical function but does not enhance walking capacity or vascular function in patients with peripheral artery disease

2020 ◽  
Vol 129 (6) ◽  
pp. 1279-1289
Author(s):  
Jacob C. Monroe ◽  
Chen Lin ◽  
Susan M. Perkins ◽  
Yan Han ◽  
Brett J. Wong ◽  
...  
Keyword(s):  
Physical Function ◽  
Peripheral Artery Disease ◽  
Vascular Function ◽  
Controlled Study ◽  
Peripheral Artery ◽  
Walking Capacity ◽  
Heat Therapy ◽  
Walking Performance ◽  
Artery Disease ◽  
Potent Vasoconstrictor

This is the first sham-controlled study to investigate the effects of leg heat therapy (HT) on walking performance, vascular function, and quality of life in patients with peripheral artery disease (PAD). Adherence to HT was high, and the treatment was well tolerated. Our findings revealed that HT applied with water-circulating trousers evokes a clinically meaningful increase in perceived physical function and reduces the serum concentration of the potent vasoconstrictor endothelin-1 in patients with PAD.

scholarly journals Skeletal muscle capillary density is related to anaerobic threshold and claudication in peripheral artery disease

2020 ◽  
Vol 25 (5) ◽  
pp. 411-418
Author(s):  
Brian D Duscha ◽  
William E Kraus ◽  
William S Jones ◽  
Jennifer L Robbins ◽  
Lucy W Piner ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Peripheral Artery Disease ◽  
Anaerobic Threshold ◽  
Cardiopulmonary Exercise Testing ◽  
Capillary Density ◽  
Exercise Intolerance ◽  
Peripheral Artery ◽  
Cross Sectional ◽  
Control Subjects ◽  
Artery Disease

Peripheral artery disease (PAD) is characterized by impaired blood flow to the lower extremities, causing claudication and exercise intolerance. Exercise intolerance may result from reduced skeletal muscle capillary density and impaired muscle oxygen delivery. This cross-sectional study tested the hypothesis that capillary density is related to claudication times and anaerobic threshold (AT) in patients with PAD. A total of 37 patients with PAD and 29 control subjects performed cardiopulmonary exercise testing on a treadmill for AT and gastrocnemius muscle biopsies. Skeletal muscle capillary density was measured using immunofluorescence staining. PAD had decreased capillary density (278 ± 87 vs 331 ± 86 endothelial cells/mm2, p = 0.05), peak VO2 (15.7 ± 3.9 vs 24.3 ± 5.2 mL/kg/min, p ⩽ 0.001), and VO2 at AT (11.5 ± 2.6 vs 16.1 ± 2.8 mL/kg/min, p ⩽ 0.001) compared to control subjects. In patients with PAD, but not control subjects, capillary density was related to VO2 at AT ( r = 0.343; p = 0.038), time to AT ( r = 0.381; p = 0.020), and time after AT to test termination ( r = 0.610; p ⩽ 0.001). Capillary density was also related to time to claudication ( r = 0.332; p = 0.038) and time after claudication to test termination ( r = 0.584; p ⩽ 0.001). In conclusion, relationships between capillary density, AT, and claudication symptoms indicate that, in PAD, exercise limitations are likely partially dependent on limited skeletal muscle capillary density and oxidative metabolism.

Mitochondrial DNA damage in calf skeletal muscle and walking performance in people with peripheral artery disease

2020 ◽  
Vol 160 ◽  
pp. 680-689 ◽  
Author(s):  
Sunil K. Saini ◽  
Mary M. McDermott ◽  
Anna Picca ◽  
Lingyu Li ◽  
Stephanie E. Wohlgemuth ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Dna Damage ◽  
Mitochondrial Dna ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Mitochondrial Dna Damage ◽  
Walking Performance ◽  
Artery Disease
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