Peripheral revascularization attenuates the exercise pressor reflex and increases coronary exercise hyperemia in peripheral arterial disease

Amanda J. Miller, J. Carter Luck, Danielle Jin-Kwang Kim, Urs A. Leuenberger, Faisal Aziz, John F. Radtka, Lawrence I. Sinoway, Matthew D. Muller

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Peripheral arterial disease (PAD) is associated with

augmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization. BP and heart rate (HR) were measured continuously, and rate pressure product (systolic BP HR) was calculated as an index of myocardial oxygen demand. Coronary blood velocity was obtained by transthoracic Doppler echocardiography in 8/17 subjects. The mean BP response to plantar flexion exercise was attenuated by leg revascularization (pre-revascularization: 15 4 vs. post-revascularization: 7 3 mmHg, P 0.025). The HR response to plantar flexion was also attenuated following leg revascularization (pre-revascularization: 9 1 vs. post-revascularization: 6 1 beats/min, P 0.006). The change in coronary blood velocity with exercise was greater at the post-revascularization visit: 4 1 vs. pre-revascularization: 1 2 cm/s (P 0.038), even though the change in rate pressure product was not greater following revascularization in these subjects (pre-revascularization: 2,796 871 vs. post-revascularization: 1,766 378 mmHg·beats/min, P 0.082). These data suggest that leg revascularization alters reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. NEW & NOTEWORTHY We found that peripheral revascularization procedures lowered exercise blood pressure and improved coronary blood flow in patients with peripheral arterial disease.

Original languageEnglish (US)
Pages (from-to)58-63
Number of pages6
JournalJournal of applied physiology
Volume125
Issue number1
DOIs
StatePublished - Jul 2018

Fingerprint

Peripheral Arterial Disease
Hyperemia
Reflex
Exercise
Blood Pressure
Leg
Heart Rate
Pressure
Doppler Echocardiography
Echocardiography
Oxygen

All Science Journal Classification (ASJC) codes

  • Physiology
  • Physiology (medical)

Cite this

@article{29185c7e28ef44e4b452a7df40b4c21c,
title = "Peripheral revascularization attenuates the exercise pressor reflex and increases coronary exercise hyperemia in peripheral arterial disease",
abstract = "Peripheral arterial disease (PAD) is associated withaugmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization. BP and heart rate (HR) were measured continuously, and rate pressure product (systolic BP HR) was calculated as an index of myocardial oxygen demand. Coronary blood velocity was obtained by transthoracic Doppler echocardiography in 8/17 subjects. The mean BP response to plantar flexion exercise was attenuated by leg revascularization (pre-revascularization: 15 4 vs. post-revascularization: 7 3 mmHg, P 0.025). The HR response to plantar flexion was also attenuated following leg revascularization (pre-revascularization: 9 1 vs. post-revascularization: 6 1 beats/min, P 0.006). The change in coronary blood velocity with exercise was greater at the post-revascularization visit: 4 1 vs. pre-revascularization: 1 2 cm/s (P 0.038), even though the change in rate pressure product was not greater following revascularization in these subjects (pre-revascularization: 2,796 871 vs. post-revascularization: 1,766 378 mmHg·beats/min, P 0.082). These data suggest that leg revascularization alters reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. NEW & NOTEWORTHY We found that peripheral revascularization procedures lowered exercise blood pressure and improved coronary blood flow in patients with peripheral arterial disease.",
author = "Miller, {Amanda J.} and Luck, {J. Carter} and {Jin-Kwang Kim}, Danielle and Leuenberger, {Urs A.} and Faisal Aziz and Radtka, {John F.} and Sinoway, {Lawrence I.} and Muller, {Matthew D.}",
year = "2018",
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volume = "125",
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Peripheral revascularization attenuates the exercise pressor reflex and increases coronary exercise hyperemia in peripheral arterial disease. / Miller, Amanda J.; Luck, J. Carter; Jin-Kwang Kim, Danielle; Leuenberger, Urs A.; Aziz, Faisal; Radtka, John F.; Sinoway, Lawrence I.; Muller, Matthew D.

In: Journal of applied physiology, Vol. 125, No. 1, 07.2018, p. 58-63.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Peripheral revascularization attenuates the exercise pressor reflex and increases coronary exercise hyperemia in peripheral arterial disease

AU - Miller, Amanda J.

AU - Luck, J. Carter

AU - Jin-Kwang Kim, Danielle

AU - Leuenberger, Urs A.

AU - Aziz, Faisal

AU - Radtka, John F.

AU - Sinoway, Lawrence I.

AU - Muller, Matthew D.

PY - 2018/7

Y1 - 2018/7

N2 - Peripheral arterial disease (PAD) is associated withaugmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization. BP and heart rate (HR) were measured continuously, and rate pressure product (systolic BP HR) was calculated as an index of myocardial oxygen demand. Coronary blood velocity was obtained by transthoracic Doppler echocardiography in 8/17 subjects. The mean BP response to plantar flexion exercise was attenuated by leg revascularization (pre-revascularization: 15 4 vs. post-revascularization: 7 3 mmHg, P 0.025). The HR response to plantar flexion was also attenuated following leg revascularization (pre-revascularization: 9 1 vs. post-revascularization: 6 1 beats/min, P 0.006). The change in coronary blood velocity with exercise was greater at the post-revascularization visit: 4 1 vs. pre-revascularization: 1 2 cm/s (P 0.038), even though the change in rate pressure product was not greater following revascularization in these subjects (pre-revascularization: 2,796 871 vs. post-revascularization: 1,766 378 mmHg·beats/min, P 0.082). These data suggest that leg revascularization alters reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. NEW & NOTEWORTHY We found that peripheral revascularization procedures lowered exercise blood pressure and improved coronary blood flow in patients with peripheral arterial disease.

AB - Peripheral arterial disease (PAD) is associated withaugmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization. BP and heart rate (HR) were measured continuously, and rate pressure product (systolic BP HR) was calculated as an index of myocardial oxygen demand. Coronary blood velocity was obtained by transthoracic Doppler echocardiography in 8/17 subjects. The mean BP response to plantar flexion exercise was attenuated by leg revascularization (pre-revascularization: 15 4 vs. post-revascularization: 7 3 mmHg, P 0.025). The HR response to plantar flexion was also attenuated following leg revascularization (pre-revascularization: 9 1 vs. post-revascularization: 6 1 beats/min, P 0.006). The change in coronary blood velocity with exercise was greater at the post-revascularization visit: 4 1 vs. pre-revascularization: 1 2 cm/s (P 0.038), even though the change in rate pressure product was not greater following revascularization in these subjects (pre-revascularization: 2,796 871 vs. post-revascularization: 1,766 378 mmHg·beats/min, P 0.082). These data suggest that leg revascularization alters reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. NEW & NOTEWORTHY We found that peripheral revascularization procedures lowered exercise blood pressure and improved coronary blood flow in patients with peripheral arterial disease.

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