Vascular Inflammation, Calf Muscle Oxygen Saturation, and Blood Glucose are Associated With Exercise Pressor Response in Symptomatic Peripheral Artery Disease

Angiology ◽  
2019 ◽  
Vol 70 (8) ◽  
pp. 747-755 ◽  
Author(s):  
Andrew W. Gardner ◽  
Polly S. Montgomery ◽  
Ming Wang ◽  
Chixiang Chen ◽  
Marcos Kuroki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Oxygen Saturation ◽  
Peripheral Artery Disease ◽  
Pressor Response ◽  
Calf Muscle ◽  
Peripheral Artery ◽  
Muscle Oxygen ◽  
Artery Disease ◽  
Vascular Biomarkers

We determined whether calf muscle oxygen saturation (StO2) and vascular biomarkers of inflammation and oxidative stress were associated with an exercise pressor response during treadmill walking in 179 patients with symptomatic peripheral artery disease (PAD). The exercise pressor response was measured as the change in blood pressure from rest to the end of the first 2-minute treadmill stage (2 mph, 0% grade). There was a wide range in the change in systolic blood pressure (−46 to 50 mm Hg) and in diastolic blood pressure (−23 to 38 mm Hg), with mean increases of 4.3 and 1.4 mm Hg, respectively. In multiple regression analyses, significant predictors of systolic pressure included glucose ( P < .001) and insulin ( P = .039). Significant predictors of diastolic pressure included cultured endothelial cell apoptosis ( P = .019), the percentage drop in exercise calf muscle (StO2; P = .023), high-sensitivity C-reactive protein ( P = .032), and glucose ( P = .033). Higher levels in pro-inflammatory vascular biomarkers, impaired calf muscle StO2 during exercise, and elevated blood glucose were independently associated with greater exercise pressor response in patients with symptomatic PAD. The clinical implication is that exercise and nutritional interventions designed to improve inflammation, microcirculation, and glucose metabolism may also lower blood pressure during exercise in patients with symptomatic PAD.

Inflammation and Muscle Oxygen Saturation are Associated with Exercise Pressor Response in Peripheral Artery Disease

2019 ◽  
Vol 51 (Supplement) ◽  
pp. 582-583
Author(s):  
Polly Montgomery ◽  
Marcos Kuroki ◽  
Ming Wang ◽  
Danielle Jin-Kwang Kim ◽  
Andrew Gardner
Keyword(s):  
Oxygen Saturation ◽  
Peripheral Artery Disease ◽  
Pressor Response ◽  
Peripheral Artery ◽  
Muscle Oxygen ◽  
Artery Disease

Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease

2018 ◽  
Vol 52 ◽  
pp. 147-152 ◽  
Author(s):  
Aluísio Andrade-Lima ◽  
Gabriel G. Cucato ◽  
Wagner J.R. Domingues ◽  
Antônio H. Germano-Soares ◽  
Bruno R. Cavalcante ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Peripheral Artery Disease ◽  
Calf Muscle ◽  
Walk Test ◽  
Peripheral Artery ◽  
Muscle Oxygen ◽  
Artery Disease ◽  
6 Minute Walk Test ◽  
Minute Walk

scholarly journals Clinical Significance of Ankle Systolic Blood Pressure Following Exercise in Assessing Calf Muscle Tissue Ischemia in Peripheral Artery Disease

Angiology ◽  
2012 ◽  
Vol 64 (5) ◽  
pp. 364-370 ◽  
Author(s):  
Aman Khurana ◽  
Julie A. Stoner ◽  
Thomas L. Whitsett ◽  
Suman Rathbun ◽  
Polly S. Montgomery ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Clinical Significance ◽  
Peripheral Artery Disease ◽  
Muscle Tissue ◽  
Calf Muscle ◽  
Peripheral Artery ◽  
Tissue Ischemia ◽  
Artery Disease

scholarly journals Exercise Training Increases Resting Calf Muscle Oxygen Metabolism in Patients with Peripheral Artery Disease

Metabolites ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 814
Author(s):  
Zhe Li ◽  
Erin K. Englund ◽  
Michael C. Langham ◽  
Jinchao Feng ◽  
Kebin Jia ◽  
...  
Keyword(s):  
Exercise Training ◽  
Peripheral Artery Disease ◽  
Oxygen Metabolism ◽  
Calf Muscle ◽  
Optical Measurements ◽  
Oxygen Extraction Fraction ◽  
Peripheral Artery ◽  
Muscle Oxygen ◽  
Supervised Exercise ◽  
Artery Disease

Exercise training can mitigate symptoms of claudication (walking-induced muscle pain) in patients with peripheral artery disease (PAD). One adaptive response enabling this improvement is enhanced muscle oxygen metabolism. To explore this issue, we used arterial-occlusion diffuse optical spectroscopy (AO-DOS) to measure the effects of exercise training on the metabolic rate of oxygen (MRO2) in resting calf muscle. Additionally, venous-occlusion DOS (VO-DOS) and frequency-domain DOS (FD-DOS) were used to measure muscle blood flow (F) and tissue oxygen saturation (StO2), and resting calf muscle oxygen extraction fraction (OEF) was calculated from MRO2, F, and blood hemoglobin. Lastly, the venous/arterial ratio (γ) of blood monitored by FD-DOS was calculated from OEF and StO2. PAD patients who experience claudication (n = 28) were randomly assigned to exercise and control groups. Patients in the exercise group received 3 months of supervised exercise training. Optical measurements were obtained at baseline and at 3 months in both groups. Resting MRO2, OEF, and F, respectively, increased by 30% (12%, 44%) (p < 0.001), 17% (6%, 45%) (p = 0.003), and 7% (0%, 16%) (p = 0.11), after exercise training (median (interquartile range)). The pre-exercise γ was 0.76 (0.61, 0.89); it decreased by 12% (35%, 6%) after exercise training (p = 0.011). Improvement in exercise performance was associated with a correlative increase in resting OEF (R = 0.45, p = 0.02).

scholarly journals Peripheral Revascularization Reverses The Decline In Active Muscle Oxygen Saturation In Peripheral Artery Disease

2020 ◽  
Vol 52 (7S) ◽  
pp. 222-222
Author(s):  
J. Carter Luck ◽  
Danielle JK Kim ◽  
Cheryl A. Blaha ◽  
Samuel Pai ◽  
Faisal Aziz ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Active Muscle ◽  
Muscle Oxygen ◽  
Artery Disease

scholarly journals Calf muscle hemoglobin oxygen saturation in patients with peripheral artery disease who have different types of exertional leg pain

2012 ◽  
Vol 55 (6) ◽  
pp. 1654-1661 ◽  
Author(s):  
Andrew W. Gardner ◽  
Donald E. Parker ◽  
Polly S. Montgomery ◽  
Aman Khurana ◽  
Raphael M. Ritti-Dias ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Peripheral Artery Disease ◽  
Calf Muscle ◽  
Leg Pain ◽  
Peripheral Artery ◽  
Hemoglobin Oxygen Saturation ◽  
Different Types ◽  
Artery Disease

scholarly journals Chronic femoral artery ligation exaggerates the pressor and sympathetic nerve responses during dynamic skeletal muscle stretch in decerebrate rats

2018 ◽  
Vol 314 (2) ◽  
pp. H246-H254 ◽  
Author(s):  
Evan A. Kempf ◽  
Korynne S. Rollins ◽  
Tyler D. Hopkins ◽  
Alec L. Butenas ◽  
Joseph M. Santin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Artery Disease ◽  
Sympathetic Nerve ◽  
Sympathetic Nerve Activity ◽  
Peripheral Artery ◽  
Nerve Activity ◽  
Exercise Pressor Reflex ◽  
Pressor Reflex ◽  
Artery Disease ◽  
Dynamic Stretch

Mechanical and metabolic signals arising during skeletal muscle contraction reflexly increase sympathetic nerve activity and blood pressure (i.e., the exercise pressor reflex). In a rat model of simulated peripheral artery disease in which a femoral artery is chronically (~72 h) ligated, the mechanically sensitive component of the exercise pressor reflex during 1-Hz dynamic contraction is exaggerated compared with that found in normal rats. Whether this is due to an enhanced acute sensitization of mechanoreceptors by metabolites produced during contraction or involves a chronic sensitization of mechanoreceptors is unknown. To investigate this issue, in decerebrate, unanesthetized rats, we tested the hypothesis that the increases in mean arterial blood pressure and renal sympathetic nerve activity during 1-Hz dynamic stretch are larger when evoked from a previously “ligated” hindlimb compared with those evoked from the contralateral “freely perfused” hindlimb. Dynamic stretch provided a mechanical stimulus in the absence of contraction-induced metabolite production that closely replicated the pattern of the mechanical stimulus present during dynamic contraction. We found that the increases in mean arterial blood pressure (freely perfused: 14 ± 1 and ligated: 23 ± 3 mmHg, P = 0.02) and renal sympathetic nerve activity were significantly greater during dynamic stretch of the ligated hindlimb compared with the increases during dynamic stretch of the freely perfused hindlimb. These findings suggest that the exaggerated mechanically sensitive component of the exercise pressor reflex found during dynamic muscle contraction in this rat model of simulated peripheral artery disease involves a chronic sensitizing effect of ligation on muscle mechanoreceptors and cannot be attributed solely to acute contraction-induced metabolite sensitization. NEW & NOTEWORTHY We found that the pressor and sympathetic nerve responses during dynamic stretch were exaggerated in rats with a ligated femoral artery (a model of peripheral artery disease). Our findings provide mechanistic insights into the exaggerated exercise pressor reflex in this model and may have important implications for peripheral artery disease patients.

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