Abstract 19103: Revascularization Improves the Myopathy, Hemodynamics and Function of the Limbs of Patients With Peripheral Arterial Disease
Introduction: Peripheral arterial disease (PAD), is characterized by myopathy, reduced hemodynamics and dysfunction of the ischemic legs. Two key characteristics of the myopathy of PAD limbs are myofiber degeneration and oxidative damage. We hypothesize that revascularization operations improve the myopathy of PAD limbs in association with improvements of hemodynamics and function.
Methods: We recruited PAD patients undergoing open or endovascular revascularization of their ischemic legs. The gastrocnemius of these patients was biopsied, and limb hemodynamics (Ankle-Brachial Index, ABI) and function (six-minute walking distance and treadmill claudication walking times) were assessed before and six months after revascularization. Slide mounted specimens of the gastrocnemius biopsies were analyzed for biomarkers of myofiber oxidative damage (carbonyl groups and 4-hydroxy-2-nonenal adducts) and morphology (myofiber cross-sectional area, major axis, minor axis and equivalent diameter) by quantitative fluorescence microscopy.
Results: Thirty claudicating patients underwent revascularization operations (21 open and 9 endovascular operations). Revascularization reduced oxidative damage observed as decreased carbonyl groups (13.4%, p<0.001) and 4-hydroxy-2-nonenal adducts (29.6%, p<0.001). Myofiber morphology improved as determined by increased cross-sectional area (18.1%, p<0.001), major axis (5.3%, p<0.05), minor axis (4.6%, p<0.05) and equivalent diameter (6.3%, p<0.01). ABI increased from 0.50±0.03 to 0.86±0.03 (p<0.001) and limb function improved as determined by increases of six-minute walking distance (25.9%, p<0.05), onset of claudication time (101.4%, p=0.001) and maximum walking time (236.3%, p=0.01).
Conclusions: Revascularization operations improved the myopathy of PAD limbs in association with improvements in both hemodynamics and function.
- © 2013 by American Heart Association, Inc.