Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease

Amanda J. Ross, Zhaohui Gao, Jonathan Carter Luck, Cheryl A. Blaha, Aimee E. Cauffman, Faisal Aziz, John F. Radtka, David N. Proctor, Urs A. Leuenberger, Lawrence I. Sinoway, Matthew D. Muller

Research output: Contribution to journalArticle

  • 6 Citations

Abstract

Background Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD. Methods Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.

LanguageEnglish (US)
Pages260-267
Number of pages8
JournalAnnals of Vascular Surgery
Volume38
DOIs
StatePublished - Jan 1 2017

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Peripheral Arterial Disease
Hyperemia
Exercise
Blood Pressure
Doppler Echocardiography
Workload
Vascular Diseases
Myocardial Ischemia
Fatigue
Coronary Disease
Blood Vessels
Echocardiography
Leg
Healthy Volunteers
Arteries
Heart Rate
Myocardial Infarction
Pain
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Ross, A. J., Gao, Z., Luck, J. C., Blaha, C. A., Cauffman, A. E., Aziz, F., ... Muller, M. D. (2017). Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease. Annals of Vascular Surgery, 38, 260-267. DOI: 10.1016/j.avsg.2016.05.135
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abstract = "Background Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD. Methods Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40{\%} of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.",
author = "Ross, {Amanda J.} and Zhaohui Gao and Luck, {Jonathan Carter} and Blaha, {Cheryl A.} and Cauffman, {Aimee E.} and Faisal Aziz and Radtka, {John F.} and Proctor, {David N.} and Leuenberger, {Urs A.} and Sinoway, {Lawrence I.} and Muller, {Matthew D.}",
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Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease. / Ross, Amanda J.; Gao, Zhaohui; Luck, Jonathan Carter; Blaha, Cheryl A.; Cauffman, Aimee E.; Aziz, Faisal; Radtka, John F.; Proctor, David N.; Leuenberger, Urs A.; Sinoway, Lawrence I.; Muller, Matthew D.

In: Annals of Vascular Surgery, Vol. 38, 01.01.2017, p. 260-267.

Research output: Contribution to journalArticle

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AU - Ross,Amanda J.

AU - Gao,Zhaohui

AU - Luck,Jonathan Carter

AU - Blaha,Cheryl A.

AU - Cauffman,Aimee E.

AU - Aziz,Faisal

AU - Radtka,John F.

AU - Proctor,David N.

AU - Leuenberger,Urs A.

AU - Sinoway,Lawrence I.

AU - Muller,Matthew D.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD. Methods Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.

AB - Background Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD. Methods Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously. Results Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients. Conclusion These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.

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