scholarly journals Dynamic characteristics of T2*-weighted signal in calf muscles of peripheral artery disease during low-intensity exercise

2016 ◽  
Vol 46 (1) ◽  
pp. 40-48 ◽  
Author(s):  
Zhijun Li ◽  
Matthew D. Muller ◽  
Jianli Wang ◽  
Christopher T. Sica ◽  
Prasanna Karunanayaka ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Dynamic Characteristics ◽  
Peripheral Artery ◽  
Low Intensity ◽  
Artery Disease ◽  
Low Intensity Exercise ◽  
Calf Muscles

Effects of Low-Intensity Exercise on Patients with Peripheral Artery Disease

2009 ◽  
Vol 37 (1) ◽  
pp. 106-110 ◽  
Author(s):  
Keith Elizabeth Pena ◽  
Christine B. Stopka ◽  
Sharon Barak ◽  
Harold R. Gertner ◽  
Eli Carmeli
Keyword(s):  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Low Intensity ◽  
Artery Disease ◽  
Low Intensity Exercise

scholarly journals Restless Leg Syndrome in Peripheral Artery Disease: Prevalence among Patients with Claudication and Benefits from Low-Intensity Exercise

2019 ◽  
Vol 8 (9) ◽  
pp. 1403
Author(s):  
Lamberti ◽  
López-Soto ◽  
Rodríguez-Borrego ◽  
Straudi ◽  
Basaglia ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Near Infrared ◽  
Ankle Brachial Index ◽  
Exercise Program ◽  
Restless Leg Syndrome ◽  
Peripheral Artery ◽  
Low Intensity ◽  
Home Based ◽  
Artery Disease ◽  
Low Intensity Exercise

Restless leg syndrome (RLS) disrupts sleep, affecting the quality of life of patients with various chronic diseases. We assessed the prevalence of RLS in peripheral artery disease (PAD) patients and the effects of a pain-free exercise program. A total of 286 patients with claudication were enrolled in a home-based low-intensity exercise program prescribed at the hospital. RLS was determined through standardized questions. Hemodynamics, degree of calf deoxygenation, and mobility were assessed using the ankle-brachial-index, a treadmill test assisted by near-infrared spectroscopy and the 6-min walk test, respectively. During hospital visits, persistence of RLS, adherence to exercise, hemodynamics, and mobility were assessed. At the enrollment, 101 patients (35%) presented RLS, with higher prevalence among females (p = 0.032). Compared to RLS-free patients, they showed similar hemodynamics but more severe calf deoxygenation (p < 0.001) and lower mobility (p = 0.040). Eighty-seven RLS patients (83%) reported the disappearance of symptoms after 39 (36−70) days of exercise. This subgroup, compared to nonresponders, showed higher adherence (p < 0.001), hemodynamic (p = 0.041), and mobility improvements (p = 0.003). RLS symptoms were frequent in PAD but were reduced by a pain-free walking exercise aimed at inducing peripheral aerobic adaptations. The concomitant recovery of sleep and mobility may represent a synergistic action against the cardiovascular risk in PAD.

scholarly journals Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease

JAMA ◽  
2021 ◽  
Vol 325 (13) ◽  
pp. 1266 ◽  
Author(s):  
Mary M. McDermott ◽  
Bonnie Spring ◽  
Lu Tian ◽  
Diane Treat-Jacobson ◽  
Luigi Ferrucci ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
High Intensity ◽  
Peripheral Artery ◽  
Walk Distance ◽  
Low Intensity ◽  
Home Based ◽  
Walking Exercise ◽  
Artery Disease

A systematic review and meta-analysis of the role of statins and their intensity in peripheral artery disease

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Sagris ◽  
J Katsaros ◽  
S Giannopoulos ◽  
DG Kokkinidis
Keyword(s):  
Systematic Review ◽  
Peripheral Artery Disease ◽  
Meta Analysis ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Peripheral Artery ◽  
Free Survival ◽  
Low Intensity ◽  
All Cause Mortality ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Background Peripheral artery disease (PAD) affects more than eight million Americans. However, several studies have shown that those patients are often undertreated, and that statin utilization is suboptimal.  American Heart Association guidelines highlight statins as the first-line lipid-lowering therapy to treat patients with PAD. Our objective with this meta-analysis was to further explore the impact of statins on PAD outcomes and examine whether the actual statin (high vs low intensity) dose impacts outcomes. Methods We performed a systematic review and meta-analysis according to the PRISMA guidelines. Any study that presented a comparison of statins vs no statins for PAD patients or compared high vs low intensity statins and provided outcomes with hazard ratio was considered as potentially eligible. The Medline (PubMed) database was searched up to August 30, 2020. A random effects meta-analysis was performed. Results In total, 38 studies and 275,670 patients were included in this meta-analysis. In total, 136,025 (49.34%) were on statins vs 139,645 (50.66%) who were not on statins. Statins had an association with a reduction in all cause-mortality by 42% (HR:0.58, 95% CI: 0.49-0.67, I2= 96.26%) and cardiovascular death by 43% (HR:0.57, 95% CI: 0.40-0.74, I2= 80.39%). Statins use was associated with an increase in amputation-free survival by 56% (HR:0.44, 95% CI: 0.30-0.58, I2 = 15%). The risk of amputation and loss of patency was reduced by 35% (HR:0.65, 95% CI:0.41-0.89, I2 = 86.91%), 46% (HR:0.54, 95% CI: 0.34-0.74, Ι2 = 0%), respectively. Statins use was also associated with a reduction in the risk of major adverse cardiovascular events (MACE) by 35% (HR:0.65, 95% CI: 0.51-0.80, I2= 93.22%) and the incidence of myocardial infarction (MI) by 41% (HR:0.59, 95% CI: 0.33-0.86, I2 = 76.78%). Among patients treated with statins, high-intensity treatment group was associated with a reduction in all cause-mortality by 36% (HR:0.64, 95% CI: 0.54-0.74, I2 = 96.49%) compared to patients treated with low intensity statins. Conclusion Statin treatment among patients with PAD was associated with a statistically significant reduction in all-cause mortality, cardiovascular mortality, MI, MACE, risk for amputation or loss of patency. Statins were also associated with a higher amputation free survival.

scholarly journals Diffusion as a Natural Contrast in MR Imaging of Peripheral Artery Disease (PAD) Tissue Changes. A Case Study of the Clinical Application of DTI for a Patient with Chronic Calf Muscles Ischemia

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 92
Author(s):  
Weronika Mazur ◽  
Małgorzata Urbańczyk-Zawadzka ◽  
Robert Banyś ◽  
Rafał Obuchowicz ◽  
Mariusz Trystuła ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Diffusion Tensor ◽  
Peripheral Circulation ◽  
Significant Loss ◽  
Arterial Stenosis ◽  
Peripheral Artery ◽  
Double Blind ◽  
Distribution Method ◽  
Artery Disease ◽  
Calf Muscles

This paper reports a first application of diffusion tensor imaging with corrections by using the B-matrix spatial distribution method (BSD-DTI) for peripheral artery disease (PAD) detected in the changes of diffusion tensor parameters (DTPs). A 76-year-old male was diagnosed as having PAD, since he demonstrated in angiographic images of lower legs severe arterial stenosis and the presence of lateral and peripheral circulation and assigned to the double-blind RCT using mesenchymal stem cells (MSCs) or placebo for the regenerative treatment of implications of ischemic diseases. In order to indicate changes in diffusivity in calf muscles in comparison to a healthy control, a DTI methodology was developed. The main advantage of the applied protocol was decreased scanning time, which was achieved by reducing b-value and number of scans (to 1), while maintaining minimal number of diffusion gradient directions and high resolution. This was possible due to calibration via the BSD method, which reduced systematic errors and allowed quantitative analysis. In the course of PAD, diffusivities were elevated across the calf muscles in posterior compartment and lost their anisotropy. Different character was noticed for anterior compartment, in which diffusivities along and across muscles were decreased without a significant loss of anisotropy. After the intervention involving a series of injections, the improvement of DTPs and tractography was visible, but can be assigned neither to MSCs nor placebo before unblinding.

scholarly journals Blood pressure and calf muscle oxygen extraction during plantar flexion exercise in peripheral artery disease

2017 ◽  
Vol 123 (1) ◽  
pp. 2-10 ◽  
Author(s):  
J. Carter Luck ◽  
Amanda J. Miller ◽  
Faisal Aziz ◽  
John F. Radtka ◽  
David N. Proctor ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Artery Disease ◽  
Healthy Subjects ◽  
Near Infrared ◽  
Plantar Flexion ◽  
Peripheral Artery ◽  
Low Intensity ◽  
Skeletal Muscle Oxygenation ◽  
Artery Disease ◽  
Plantar Flexion Exercise

Peripheral artery disease (PAD) is an atherosclerotic vascular disease that affects 200 million people worldwide. Although PAD primarily affects large arteries, it is also associated with microvascular dysfunction, an exaggerated blood pressure (BP) response to exercise, and high cardiovascular mortality. We hypothesized that fatiguing plantar flexion exercise that evokes claudication elicits a greater reduction in skeletal muscle oxygenation (SmO2) and a higher rise in BP in PAD compared with age-matched healthy subjects, but low-intensity steady-state plantar flexion elicits similar responses between groups. In the first experiment, eight patients with PAD and eight healthy controls performed fatiguing plantar flexion exercise (from 0.5 to 7 kg for up to 14 min). In the second experiment, seven patients with PAD and seven healthy controls performed low-intensity plantar flexion exercise (2.0 kg for 14 min). BP, heart rate (HR), and SmO2 were measured continuously using near-infrared spectroscopy (NIRS). SmO2 is the ratio of oxygenated hemoglobin to total hemoglobin, expressed as a percent. At fatigue, patients with PAD had a greater increase in mean arterial BP (18 ± 2 vs. vs. 10 ± 2 mmHg, P = 0.029) and HR (14 ± 2 vs. 6 ± 2 beats/min, P = 0.033) and a greater reduction in SmO2 (−54 ± 10 vs. −12 ± 4%, P = 0.001). However, both groups had similar physiological responses to low-intensity, nonpainful plantar flexion exercise. These data suggest that patients with PAD have altered oxygen uptake and/or utilization during fatiguing exercise coincident with an augmented BP response. NEW & NOTEWORTHY In this laboratory study, patients with peripheral artery disease performed plantar flexion exercise in the supine posture until symptoms of claudication occurred. Relative to age- and sex-matched healthy subjects we found that patients had a higher blood pressure response, a higher heart rate response, and a greater reduction in skeletal muscle oxygenation as determined by near-infrared spectroscopy. Our data suggest that muscle ischemia contributes to the augmented exercise pressor reflex in peripheral artery disease.

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