Abstract 17167: Effects of Arm-Ergometry Exercise Training on Vascular Function in Patients with Severe Peripheral Arterial Disease Unable to Perform Traditional Walking Exercise Training
We previously reported that endothelial dysfunction as assessed by brachial artery flow mediated vasodilatation (FMD) is predictive of reduced transcutaneous oxygen tension (TcPO2) in the feet of patients with severe peripheral arterial disease (PAD). Although, traditional walking training improves endothelial function in patients with claudication, patients with severe PAD may be unable to participate in walking training. Arm ergometry training has been demonstrated to improve cardiorespiratory function in patients with mild-moderate claudication. We therefore hypothesized that arm ergometry training would significantly improve endothelial function in patients with severe PAD, which would be associated with improved TcPO2 levels.
Methods: Participants (8m, 1f, age 74.4 yrs, 100% smoke Hx, 45% DM, ABI 0.39 ±0.06), unable to perform walking training due to severe PAD, participated in a 12 wk, 3 h/wk supervised arm ergometry training program. Endothelial function was assessed via brachial artery FMD. Arterial stiffness was assessed via carotid-femoral pulse wave velocity. Gravity dependent TcPO2 of the feet was assessed via change in TcPO2 from a seated to a supine position. Paired t-tests were used to assess changes in study variables over time. Associations between variables were determined by Pearson's partial correlations.
Results: A significant improvement was observed in all measures of endothelial function and arterial stiffness. There was a strong association between change in time to peak FMD and observed change in TcPO2 as well as, between change in peak FMD and TcPO2 levels at 12 weeks (Table 1).
Conclusions: These data suggest for the first time that it is possible to improve endothelial function via arm ergometry training in patients with severe PAD unable to perform walking training, and that this improvement is associated with changes in gravity dependent TcPO2 levels, attributed to a systemic vascular contribution of exercise training.
- © 2010 by American Heart Association, Inc.