scholarly journals Intermittent pneumatic leg compressions enhance muscle performance and blood flow in a model of peripheral arterial insufficiency

2012 ◽  
Vol 112 (9) ◽  
pp. 1556-1563 ◽  
Author(s):  
Bruno T. Roseguini ◽  
Arturo A. Arce-Esquivel ◽  
Sean C. Newcomer ◽  
Hsiao T. Yang ◽  
Ronald Terjung ◽  
...  
Keyword(s):  
Blood Flow ◽  
Exercise Tolerance ◽  
Citrate Synthase ◽  
Arterial Disease ◽  
Muscle Performance ◽  
Sprague Dawley ◽  
Arterial Insufficiency ◽  
Mechanistic Basis ◽  
Peripheral Arterial

Despite the escalating prevalence in the aging population, few therapeutic options exist to treat patients with peripheral arterial disease. Application of intermittent pneumatic leg compressions (IPC) is regarded as a promising noninvasive approach to treat this condition, but the clinical efficacy, as well the mechanistic basis of action of this therapy, remain poorly defined. We tested the hypothesis that 2 wk of daily application of IPC enhances exercise tolerance by improving blood flow and promoting angiogenesis in skeletal muscle in a model of peripheral arterial insufficiency. Male Sprague-Dawley rats were subjected to bilateral ligation of the femoral artery and randomly allocated to treatment or sham groups. Animals were anesthetized daily and exposed to 1-h sessions of bilateral IPC or sham treatment for 14–16 consecutive days. A third group of nonligated rats was also studied. Marked increases in treadmill exercise tolerance (∼33%, P < 0.05) and improved muscle performance in situ (∼10%, P < 0.05) were observed in IPC-treated animals. Compared with sham-treated controls, blood flow measured with isotope-labeled microspheres during in situ contractions tended to be higher in IPC-treated animals in muscles composed of predominantly fast-twitch white fibers, such as the plantaris (∼93%, P = 0.02). Capillary contacts per fiber and citrate synthase activity were not significantly altered by IPC treatment. Collectively, these data indicate that IPC improves exercise tolerance in a model of peripheral arterial insufficiency in part by enhancing blood flow to collateral-dependent tissues.

Muscle adaptations in trained rats with peripheral arterial insufficiency

1991 ◽  
Vol 260 (2) ◽  
pp. H445-H452 ◽  
Author(s):  
T. P. Erney ◽  
G. M. Mathien ◽  
R. L. Terjung
Keyword(s):  
Citrate Synthase ◽  
Muscle Performance ◽  
O2 Consumption ◽  
Trained Group ◽  
Blood Flows ◽  
Training Adaptations ◽  
Muscle Adaptations ◽  
O2 Extraction ◽  
Arterial Insufficiency ◽  
Peripheral Arterial

The influence of training adaptations, induced within the active muscles of rats with peripheral arterial insufficiency, was assessed with an isolated hindlimb preparation. Femoral artery-stenosed rats, showing symptoms of intermittent claudication, were trained for 14-20 wk by running at 20-35 m/min up a 15% grade for up to approximately 1 h/day, 5 days/wk. Similar total hindlimb blood flows (12.6 ml/min) at a similar arterial O2 content (20.7 vol/100 ml) yielded similar blood flows (95-117 ml.min-1.100 g-1) and O2 deliveries (9-11 mumol.min-1.g-1) to the contracting muscle of sedentary (n = 10) and trained (n = 10) rats. Ten-minute periods of tetanic contractions (100 ms at 100 Hz each) at 4, 8, 13, 45, 60, and 90 tetani/min were used. Muscle force development was better maintained (P less than 0.001) by the trained group. Higher peak O2 consumption (P less than 0.01) of the trained (5.69 +/- 0.53 mumol.min-1.g-1) compared with the sedentary group (3.66 +/- 0.26 mumol.min-1.g-1) involved a greater O2 extraction, since delivery of O2 was not different between groups. Thus adaptations occurred within trained muscle to enhance performance and peak O2 consumption. Muscle citrate synthase activity, an index of mitochondrial content, was greater (P less than 0.005) in the trained group, with the low-oxidative white muscle section exhibiting the greatest change (approximately threefold sedentary). Adaptations in this section were probably realized functionally, since improvements in muscle performance were evident early in the contraction sequence.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of training following bilateral stenosis of the femoral artery in rats

1986 ◽  
Vol 250 (6) ◽  
pp. H1050-H1059 ◽  
Author(s):  
G. M. Mathien ◽  
R. L. Terjung
Keyword(s):  
Blood Flow ◽  
Exercise Tolerance ◽  
Fiber Type ◽  
Muscle Blood Flow ◽  
Muscle Tension ◽  
Muscle Performance ◽  
Dramatic Improvement ◽  
Hindlimb Muscle

The influence of training on muscle performance in situ, exercise tolerance in vivo, and muscle blood flow, was assessed in rats in which femoral arteries were previously surgically constricted to severely limit active hyperemia but not to restrict normal resting blood flow (BF). Muscle BF to the different fiber type sections of the gastrocnemius plantaris soleus muscle group was determined during in situ stimulation (15 and 30 tetani/min) using 15-microns microspheres after 0, 1, 2, 3, and 5 wk (n = 5-6/wk) of daily treadmill training. Surgical stenosis was performed 48 h prior to the initiation of training. The ability of the hindlimb muscle of sedentary stenosed animals to maintain tension in situ improved from an extensive deficit to normal at 3 wk during relatively mild contractions (15 tetani/min) but not at 5 wk during 30 tetani/min. Although BF improved to normal at 15 tetani/min, a large BF deficit remained at 30 tetani/min. Exercise tolerance during running increased approximately twofold in duration. In contrast, trained stenosed animals demonstrated normal muscle tension in situ by 2 wk during 15 tetani/min and at 5 wk during 30 tetani/min. Exercise tolerance during running increased in duration (approximately fivefold) and intensity (approximately twofold). Although BF to the entire contracting muscle mass was not different between trained and sedentary stenosed animals, its distribution within the gastrocnemius was more homogenous (P less than 0.001). This was probably due to adaptations within the fast-twitch white muscle section and could have contributed to the dramatic improvement in muscle function and exercise tolerance exhibited by the trained stenosed animals.

scholarly journals Hallucal thenar index: A new index to detect peripheral arterial disease using laser speckle flowgraphy

Vascular ◽  
2020 ◽  
pp. 170853812093893
Author(s):  
Kazuhiro Tsunekawa ◽  
Fumio Nagai ◽  
Tamon Kato ◽  
Ikkei Takashimizu ◽  
Daisuke Yanagisawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Operating Characteristic ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Laser Speckle ◽  
Laser Speckle Flowgraphy ◽  
Skin Perfusion ◽  
Peripheral Arterial ◽  
Cutaneous Blood

Objectives Laser speckle flowgraphy is a technology using reflected scattered light for visualization of blood distribution, which can be used to measure relative velocity of blood flow easily without contact with the skin within a short time. It was hypothesized that laser speckle flowgraphy may be able to identify foot ischemia. This study was performed to determine whether laser speckle flowgraphy could distinguish between subjects with and without peripheral arterial disease. Materials and methods All subjects were classified based on clinical observations using the Rutherford classification: non-peripheral arterial disease, class 0; peripheral arterial disease group, class 2–5. Rutherford class 6 was one of the exclusion criteria. Laser speckle flowgraphy measured the beat strength of skin perfusion as an indicator of average dynamic cutaneous blood flow change synchronized with the heartbeat. The beat strength of skin perfusion indicates the strength of the heartbeat on the skin, and the heartbeat strength calculator in laser speckle flowgraphy uses the blood flow data to perform a Fourier transform to convert the temporal changes in blood flow to a power spectrum. A total of 33 subjects with peripheral arterial disease and 40 subjects without peripheral arterial disease at a single center were prospectively examined. Laser speckle flowgraphy was used to measure hallucal and thenar cutaneous blood flow, and the measurements were repeated three times. The hallucal and thenar index was defined as the ratio of beat strength of skin perfusion value on hallux/beat strength of skin perfusion value on ipsilateral thenar eminence. The Mann–Whitney U-test was used to compare the median values of hallucal and thenar index and ankle brachial index between the two groups. A receiver operating characteristic curve for hallucal and thenar index of beat strength of skin perfusion was plotted, and a cutoff point was set. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index was explored in all subjects, the hemodialysis group, and the non-hemodialysis (non-hemodialysis) group. Results The median value of the hallucal and thenar index of beat strength of skin perfusion was significantly different between subjects with and without peripheral arterial disease (0.27 vs. 0.87, respectively; P <  0.001). The median value of ankle brachial index was significantly different between subjects with and without peripheral arterial disease (0.8 vs. 1.1, respectively; P <  0.001). Based on the receiver operating characteristic of hallucal and thenar index, the cutoff was 0.4416 and the sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 95%, 91.7%, and 77.6%, respectively. The correlation coefficients of all subjects, the hemodialysis group, and the non-hemodialysis group were 0.486, 0.102, and 0.743, respectively. Conclusions Laser speckle flowgraphy is a noninvasive, rapid, and widely applicable method. Laser speckle flowgraphy using hallucal and thenar index would be helpful to determine the differences between subjects with and without peripheral arterial disease. The correlation between hallucal and thenar index of beat strength of skin perfusion and ankle brachial index indicated that this index was especially useful in the non-hemodialysis group.

Training increases muscle blood flow in rats with peripheral arterial insufficiency

1990 ◽  
Vol 69 (4) ◽  
pp. 1353-1359 ◽  
Author(s):  
H. T. Yang ◽  
R. F. Dinn ◽  
R. L. Terjung
Keyword(s):  
Blood Flow ◽  
Muscle Blood Flow ◽  
Treadmill Running ◽  
Distal Limb ◽  
Adult Rats ◽  
Cage Activity ◽  
Exercise Hyperemia ◽  
Two Factors ◽  
Arterial Insufficiency ◽  
Peripheral Arterial

This study investigated the effect of physical training on muscle blood flow (BF) in rats with peripheral arterial insufficiency during treadmill running. Bilateral stenosis of the femoral artery of adult rats (300-350 g) was performed to reduce exercise hyperemia in the hindlimb but not limit resting muscle BF. Rats were divided into normal sedentary, acute stenosed (stenosed 3 days before the experiment), stenosed sedentary (limited to cage activity), and stenosed trained (run on a treadmill by a progressively intense program, up to 50-60 min/day, 5 days/wk for 6-8 wk). Hindlimb BF was determined with 85Sr- and 141Ce-labeled microspheres at a low (20 m/min) and high treadmill speed (30-40 m/min depending on ability). Maximal hindlimb BF was reduced to approximately 50% normal in the acute stenosed group. Total hindlimb BF (81 +/- 5 ml.min-1.100 g-1) did not change in stenosed sedentary animals with 6-8 wk of cage activity, but a redistribution of BF occurred within the hindlimb. Two factors contributed to a higher BF to the distal limb muscle of the trained animals. A redistribution BF within the hindlimb occurred in stenosed trained animals; distal limb BF increased to approximately 80% (P less than 0.001) of the proximal tissue. In addition, an increase in total hindlimb BF with training indicates that collateral BF has been enhanced (P less than 0.025). The associated increase in oxygen delivery to the relatively ischemic muscle probably contributed to the markedly improved exercise tolerance evident in the trained animals.

scholarly journals Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Takeo Ishii ◽  
Shizuka Takabe ◽  
Yuki Yanagawa ◽  
Yuko Ohshima ◽  
Yasuhiro Kagawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Peripheral Arterial Disease ◽  
Early Stage ◽  
Arterial Disease ◽  
Hemodialysis Patients ◽  
Laser Doppler ◽  
Doppler Flowmetry ◽  
Skin Perfusion ◽  
Dorsal Area ◽  
Peripheral Arterial

Abstract Background A simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We performed LDF for hemodialysis patients to determine the correlations between blood flow in the lower limbs and peripheral arterial disease (PAD). Methods This retrospective study included 128 hemodialysis patients. Patients were categorized into the non-PAD group (n = 106) and PAD group (n = 22), 14 early stage PAD patients were included in the PAD group. We conducted LDF for the plantar area and dorsal area of the foot and examined skin perfusion pressure (SPP) during dialysis. Results SPP-Dorsal Area values were 82.1 ± 22.0 mmHg in the non-PAD, and 59.1 ± 20.3 mmHg in PAD group, respectively (p < 0.05). The LDF-Plantar blood flow (Qb) values were 32.7 ± 15.5 mL/min in non-PAD group and 21.5 ± 11.3 mL/min in PAD group (p < 0.001). A total of 21 non-PAD patients underwent LDF before and during dialysis. The LDF-Plantar-Qb values were 36.5 ± 17.6 mL/min before dialysis and 29.6 ± 17.7 mL/min after dialysis (p < 0.05). We adjusted SPP and LDF for PAD using logistic regression, SPP-Dorsal-Area and LDF-P were significantly correlated with PAD (p < 0.05). The receiver-operating characteristic curve analysis indicated cut-off values of 20.0 mL/min for LDF-Plantar-Qb during dialysis. Conclusion LDF is a simple technique for sensitive detection of early-stage PAD. This assessment will help physicians identify early-stage PAD, including Fontaine stage II in clinical practice, thereby allowing prompt treatment.

scholarly journals Case Report: ENDOVASCULAR STENTING IN PERIPHERAL ARTERIAL DISEASE OF LOWER EXTREMITY

2017 ◽  
Vol 52 (2) ◽  
pp. 140
Author(s):  
Yudi Her Oktaviono
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Transluminal Angioplasty ◽  
Focal Lesions ◽  
First Choice ◽  
History Of ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is usually caused by multilevel atherosclerotic disease, typically in patients with a history of cigarette smoking, diabetes mellitus, or both. Intermittent claudication (IC), an early manifestation of PAD, commonly leads to reduced quality of life for patients who are limited in their ambulation. Percutaneous intervention for peripheral artery disease has evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency. Especially for high-grade stenoses or short arterial occlusions, percutaneous transluminal angioplasty (PTA) should be the method of first choice followed by the best surgical procedure later on. To achieve good long-term efficacy, a close follow-up including objective tests of both the arterial lesion and hemodynamic status, surveillance of secondary preventive measures and risk factor control is mandatory.

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