Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d11156075e191">Background</h5> <p id="P1">Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million 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. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d11156075e196">Methods</h5> <p id="P2">Twelve patients with PAD and no overt coronary disease (65 ± 2 yr, 7 men) and 15 healthy control subjects (64 ± 2 yr, 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% 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. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d11156075e201">Results</h5> <p id="P3">Coronary blood velocity responses to 4 minutes of plantar flexion exercise (PAD: Δ 2.4 ± 1.2, healthy: Δ 6.0 ± 1.6 cm/s, <i>P</i> = 0.039) and to isometric handgrip exercise (PAD: Δ 8.3 ± 4.2, healthy: Δ 16.9 ± 3.6, <i>P</i> = 0.033) were attenuated in PAD patients. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d11156075e212">Conclusions</h5> <p id="P4">These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia. </p> </div>