Medications for Improving Walking Performance in Peripheral Artery Disease

JAMA ◽  
2013 ◽  
Vol 309 (5) ◽  
pp. 487 ◽  
Author(s):  
Mary McGrae McDermott
Keyword(s):  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Walking Performance ◽  
Artery Disease

scholarly journals Effect of a Home-Based Exercise Intervention of Wearable Technology and Telephone Coaching on Walking Performance in Peripheral Artery Disease

JAMA ◽  
2018 ◽  
Vol 319 (16) ◽  
pp. 1665 ◽  
Author(s):  
Mary M. McDermott ◽  
Bonnie Spring ◽  
Jeffrey S. Berger ◽  
Diane Treat-Jacobson ◽  
Michael S. Conte ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Exercise Intervention ◽  
Wearable Technology ◽  
Peripheral Artery ◽  
Home Based ◽  
Walking Performance ◽  
Artery Disease ◽  
Telephone Coaching

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.

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

scholarly journals Further Clinical Validation of the Walking Impairment Questionnaire for Classification of Walking Performance in Patients with Peripheral Artery Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
S. P. Sagar ◽  
P. M. Brown ◽  
D. T. Zelt ◽  
W. L. Pickett ◽  
J. E. Tranmer
Keyword(s):  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Area Under The Curve ◽  
Subscale Score ◽  
Self Report ◽  
Walking Ability ◽  
Peripheral Artery ◽  
Clinical Tool ◽  
Walking Performance ◽  
Artery Disease

The purpose of this study was to further validate theWalking Impairment Questionnaire(WIQ) as a self-report tool to aid in the clinical identification of walking ability of patients with peripheral artery disease (PAD). 132 patients with PAD and an ankle brachial index (ABI) ≤0.90 were enrolled; 123 provided complete data for the WIQ and standardized graded treadmill test. The WIQ scores were consistent with reported scores in other studies. The absolute claudication distance (ACD) ranged from 42.3 to 1589.2 meters; the peak walking time (PWT) ranged from 68 to 1800 seconds. Adjusted WIQ scores were positively and moderately associated with the log transformed ACD and PWT (r>.53,P<.001). Based on the area under the curve analysis, an overall WIQ score of 42.5 or less identified low performers (sensitivity 0.90, specificity 0.73); the combined subscale score of distance and stair of 75.5 or more identified high performers (sensitivity 0.41, specificity 0.90). We conclude that WIQ cut-offs appropriately classify walking performance in PAD patients, making this a potentially useful clinical tool. Consideration needs to be given to incorporating a standardized WIQ version into practice guidelines and the use of innovative strategies to facilitate clinical uptake.

scholarly journals Physical Activity Impacts Walking Distances and Energy Consumption of Patients with Peripheral Artery Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 903-903
Author(s):  
Nathaniel Evans ◽  
Sara Myers ◽  
Mahdi Hassan ◽  
Danae Dinkel ◽  
Jason Johanning ◽  
...  
Keyword(s):  
Physical Activity ◽  
Energy Consumption ◽  
Peripheral Artery Disease ◽  
Active Group ◽  
Peripheral Artery ◽  
Leg Muscles ◽  
Metabolic Cart ◽  
Walking Performance ◽  
Artery Disease ◽  
Inactive Group

Abstract Lower extremity peripheral artery disease (PAD) is attributed to buildup of atherosclerotic plaques preventing adequate blood flow, leading to pain during walking, and ultimately physical inactivity. Normal day-to-day levels of physical activity may impact the distance a subject can walk before claudication pain onset, as well as their energy consumption capabilities. This study compared walking performance (initial claudication distance (ICD) and absolute claudication distance (ACD)), and energy consumption (EC) between active and inactive subjects with PAD. The distinction between groups was made using previous research that declared the average PAD patient walks 3586 steps/day. Ten subjects were classified as active (□3586 average steps/day) and sixteen participants as inactive (&lt;3586 steps/day) based on a 7-day accelerometer measurement. The Gardner progressive treadmill test was used to asses ICD, ACD, and EC. EC was measured using a metabolic cart and calculated from the second minute of walking and the last minute prior to stopping due to claudication pain. The average ICD and ACD for the active group were 130.6±106.7 meters and 306.0±184.7 meters, respectively and 143.8±119.0 meters and 248.0±156.0 meters, respectively for the inactive group. The average EC for the second minute and last minute were 9.6±1.9 mlkg-1min-1 and 11.5±2.4 mlkg-1min-1 respectively for active group and 7.0±3.1 mlkg-1min-1 and 8.1±3.8 mlkg-1min-1 respectively for inactive group. The data suggests that the active group had better walking performance and greater energy consumption indicating increased efficiency of oxygen transport and extraction capability in the leg muscles.

Abstract 116: Revascularization but Not Supervised Exercise Therapy Prevents Progression of Fibrosis in the Gastrocnemius of Patients With Peripheral Artery Disease While Improving Limb Function

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Duy Ha ◽  
George Casale ◽  
Alicia Luis ◽  
Kevin Harkins ◽  
Reagan Huber ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Transforming Growth Factor ◽  
Walking Distance ◽  
Peripheral Artery ◽  
Limb Function ◽  
Supervised Exercise ◽  
Walking Performance ◽  
Artery Disease ◽  
Tgf Β1

Introduction: Patients with peripheral artery disease (PAD) develop myofiber degeneration and fibrosis in their ischemic lower extremities, along with limb dysfunction. Walking performance improves with revascularization and exercise therapy, but effects on the myopathy are unknown. We previously showed fibrosis progresses with PAD and positively correlates with expression of vascular transforming growth factor-beta 1 (TGF-β1), a cytokine that stimulates collagen deposition. Hypothesis: We hypothesize that revascularization (RVS) and supervised exercise therapy (EXE) improve limb function in association with improved TGF-β1 dependent fibrosis. Methods: Gastrocnemius biopsies were collected from PAD patients (Fontaine Stage II; N=56) at baseline and 6 months after RVS (N=20), EXE (N=19), or no intervention (CTL; N=17). TGF-β1 expression was measured as grey scale units (gsu) by quantitative fluorescence microscopy of paraffin-embedded gastrocnemius sections. Collagen abundance was measured as optical density by quantitative multi-spectral bright-field microscopy of Masson Trichrome stained paraffin sections. Six Minute Walking Distance (SMWD), in meters, and Peak Walking Time (PWT), in seconds, were determined at baseline and 6 months. Relationships among TGF-β1, collagen, and limb function were assessed. Results: TGF-β1 expression and collagen density increased in CTL and EXE but not RVS patients. SMWD and PWT increased among RVS patients. PWT but not SMWD increased among EXE patients. SMWD and PWT were unchanged among CTL patients. The data are summarized in Table 1. Conclusions: RVS and EXE improved walking performance of patients with PAD, but only RVS prevented progression of fibrosis in the gastrocnemius of these patients. Over the same 6-month period, fibrosis increased in CTL muscle but was not sufficient to alter walking performance. The data suggest that benefits to the PAD leg may be greater with RVS compared to EXE.

Abstract 115: Microvascular Response to Ramipril in Peripheral Artery Disease

2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Constance J Mietus ◽  
Peter Karvelis ◽  
Timothy Lackner ◽  
Hernan Hernandez ◽  
Holly DeSpiegelaere ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Wall Thickness ◽  
Walking Distance ◽  
Lumen Diameter ◽  
Peripheral Artery ◽  
Vascular Walls ◽  
Organ Systems ◽  
Walking Performance ◽  
Artery Disease ◽  
And Control

Background: The myopathy of Peripheral Artery Disease (PAD), a consequence of ischemia caused by atherosclerotic plaques in arteries supplying the legs, is characterized by myofiber degeneration and fibrosis of the vascular walls and extramyofiber matrix. In association with fibrosis we have found a robust expression of the profibrotic cytokine TGFβ1 in vascular smooth muscle cells. Additionally, we have observed microvascular endothelial “swelling” in PAD muscle. Published data indicate that inhibitors of the angiotensin system reduce fibrosis in multiple organ systems and improve walking performance, in diverse patient populations. We hypothesize that “swelling” of microvasculature endothelial cells represents abnormal accumulation of basement membrane Collagen Type IV (Col-IV) and that treatment with Ramipril will improve the microvasculature. Methods and Results: Gastrocnemius biopsies of PAD patients at Fontaine Stage II (N=5) before and after six months of Ramipril intervention and control patients (N=4) were labeled with an antibody specific for Col-IV. Images were acquired with an automated wide-field microscope and then processed with Image Pro Plus® and AutoQuant® deconvolution software. We used Col IV label to measure wall thickness and lumen diameter of 230 to 360 microvessels per patient, with a custom MatLab program based on the Expectation Maximization algorithm coupled with a Gaussian Mixture Model. Microvessel wall thickness was significantly greater (p < 0.04) in PAD patients before (1.54 ± 0.04 μ) and after (1.61 ± 0.06 μ) Ramipril treatment compared to control (1.42 ± 0.02). Lumen diameter was significantly greater (p < 0.02) in Post-Ramipril (3.49 ± 0.04 μ) compared to Pre-Ramipril (3.18 ± 0.08 μ) and control (3.00 ± 0.11 μ) patients. Conclusions: The increase of microvessel lumen diameter with Ramipril treatment is expected to increase microvascular perfusion and thereby improve walking distance. Our study will be expanded to increase cohort size and evaluate the association of microvascular measurements with microperfusion determined by Contrast Enhanced Ultrasonography and with walking performance.

scholarly journals Cocoa to Improve Walking Performance in Older People With Peripheral Artery Disease

2020 ◽  
Vol 126 (5) ◽  
pp. 589-599 ◽  
Author(s):  
Mary M. McDermott ◽  
Michael H. Criqui ◽  
Kathryn Domanchuk ◽  
Luigi Ferrucci ◽  
Jack M. Guralnik ◽  
...  
Keyword(s):  
Older People ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Walking Performance ◽  
Artery Disease
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