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The effect of training on the response of plasma vascular endothelial growth factor to exercise in patients with peripheral arterial disease
Abstract   Peer reviewed

The effect of training on the response of plasma vascular endothelial growth factor to exercise in patients with peripheral arterial disease

R E Wood, I Stewart, B Sanderson, Christopher D Askew, P J Walker and S Green
Proceedings of the 11th Annual Congress of the European College of Sport Science, pp.302-302
Annual Congress of the European College of Sport Science (ECSS), 11th (Lausanne, Switzerland, 05-Jul-2006–08-Jul-2006)
2006
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Abstract

Human Movement and Sports Science intermittent claudication exercise intolerance growth factors
Peripheral arterial disease (PAD) is a manifestation of atherosclerosis resulting in stenosis of one or more major arteries that supply blood to the lower extremity. During exercise, some patients with PAD experience intermittent claudication (IC), which is pain associated with inadequate blood flow. Exercise training can delay the onset of IC, and improve maximum walking time (MWT) and peak oxygen consumption (VO2peak). This has been shown to occur in the absence of an improvement in blood flow, indicating other factors at the level of the muscle may be involved. Angiogenesis, or expansion of the capillary network with exercise training is well-documented and serves to optimise oxygen transport from the blood to active skeletal muscle fibres. Vascular endothelial growth factor (VEGF), an endothelium-specific mitogen, appears to be necessary for this process. Purposes. The aims of this study were to examine the plasma VEGF response to acute exercise (Part A), and to establish whether exercise training altered this response (Part B) in patients with IC. Plasma VEGF was determined using high-sensitivity ELISA on blood collected from patients (Part A, n=18) before and after an incremental maximum walking test (+20 and +60 minutes post-exercise). VEGF was present in the plasma of patients but was unchanged in response to acute exercise (rest: 41.39 (28.03-53.22), +20 minutes: 41.94 (29.34-53.94), +60 minutes: 37.22 (28.52-52.79) pg.mL-1, p=0.674, data are median and interquartile range). For Part B, patients were randomly assigned to a treatment group (TMT, n=7) or to a control group (CON, n=6). Three times per week, for six weeks, the TMT group completed intermittent high intensity (80-100% VO2peak) treadmill training. Each session comprised ten, two-minute bouts of exercise with two minutes of rest between each bout. All patients completed an incremental maximum walking test before and after the intervention, with blood samples drawn as for Part A. Training had no effect on plasma VEGF at rest (Week 0: 39.27 (20.57-45.27), Week 6: 27.68 (16.67-47.08) pg.mL-1, p=0.949). The response to acute exercise was also unchanged (p=0.199) despite a significant increase in MWT in the TMT group (15:15+/-8:53 to 20:06+/-8:20 minutes, p=0.009). The major findings of this study were that in patients with IC: 1) acute exercise had no effect on plasma VEGF, and 2) plasma VEGF at rest, and in response to acute exercise, was unaltered by training despite an approximate 45% increase in MWT.

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