Journal article
Toward a Better Understanding of Muscle Microvascular Perfusion During Exercise in Patients With Peripheral Artery Disease: The Effect of Lower-Limb Revascularization
Journal of Endovascular Therapy, Vol.31(1), pp.115-125
2024
PMID: 35898156
Abstract
Purpose:
Leg muscle microvascular blood flow (perfusion) is impaired in response to maximal exercise in patients with peripheral artery disease (PAD); however, during submaximal exercise, microvascular perfusion is maintained due to a greater increase in microvascular blood volume compared with that seen in healthy adults. It is unclear whether this submaximal exercise response reflects a microvascular impairment, or whether it is a compensatory response for the limited conduit artery flow in PAD. Therefore, to clarify the role of conduit artery blood flow, we compared whole-limb blood flow and skeletal muscle microvascular perfusion responses with exercise in patients with PAD (n=9; 60±7 years) prior to, and following, lower-limb endovascular revascularization.
Materials and Methods:
Microvascular perfusion (microvascular volume × flow velocity) of the medial gastrocnemius muscle was measured before and immediately after a 5 minute bout of submaximal intermittent isometric plantar-flexion exercise using contrast-enhanced ultrasound imaging. Exercise contraction-by-contraction whole-leg blood flow and vascular conductance were measured using strain-gauge plethysmography.
Results:
With revascularization there was a significant increase in whole-leg blood flow and conductance during exercise (p<0.05). Exercise-induced muscle microvascular perfusion response did not change with revascularization (pre-revascularization: 3.19±2.32; post-revascularization: 3.89±1.67 aU.s−1; p=0.38). However, the parameters that determine microvascular perfusion changed, with a reduction in the microvascular volume response to exercise (pre-revascularization: 6.76±3.56; post-revascularization: 2.42±0.69 aU; p<0.01) and an increase in microvascular flow velocity (pre-revascularization: 0.25±0.13; post-revascularization: 0.59±0.25 s−1; p=0.02).
Conclusion:
These findings suggest that patients with PAD compensate for the conduit artery blood flow impairment with an increase in microvascular blood volume to maintain muscle perfusion during submaximal exercise.
Clinical Impact:
The findings from this study support the notion that the impairment in conduit artery blood flow in patients with PAD leads to compensatory changes in microvascular blood volume and flow velocity to maintain muscle microvascular perfusion during submaximal leg exercise. Moreover, this study demonstrates that these microvascular changes are reversed and become normalized with successful lower-limb endovascular revascularization.
Details
- Title
- Toward a Better Understanding of Muscle Microvascular Perfusion During Exercise in Patients With Peripheral Artery Disease: The Effect of Lower-Limb Revascularization
- Authors
- Annelise Meneses (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - LegacyDigby Krastins (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - LegacyMichael Nam (Author) - Sunshine Coast University HospitalTom Bailey (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - LegacyJing Quah (Author) - Sunshine Coast Hospital and Health ServiceVaibhav Sankhla (Author) - Sunshine Coast University HospitalJeng Lam (Author) - Sunshine Coast Hospital and Health ServicePankaj Jha (Author) - Sunshine Coast University HospitalKarl Schulze (Author) - Sunshine VascularJill O'Donnell (Author) - Sunshine Coast University HospitalRebecca Magee (Author) - Sunshine Coast University HospitalJonathan Golledge (Author) - James Cook UniversityKim Greaves (Author) - Sunshine Coast University HospitalChristopher Askew (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - Legacy
- Publication details
- Journal of Endovascular Therapy, Vol.31(1), pp.115-125
- Publisher
- Sage Publications Inc.
- Date published
- 2024
- DOI
- 10.1177/15266028221114722
- ISSN
- 1545-1550
- PMID
- 35898156
- Grants
- Organisation Unit
- Cancer Research Cluster; Faculty of Science, Health, Education and Engineering; School of Health and Behavioural Sciences - Legacy; School of Health and Sport Sciences - Legacy; UniSC Clinical Trials Centre; School of Health - Sports & Exercise Science; Healthy Ageing Research Cluster
- Language
- English
- Record Identifier
- 99649079102621
- Output Type
- Journal article
Metrics
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Peripheral Vascular Disease
- Surgery
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Source: InCites