» Articles » PMID: 29648515

Peripheral Revascularization Attenuates the Exercise Pressor Reflex and Increases Coronary Exercise Hyperemia in Peripheral Arterial Disease

Overview
Date 2018 Apr 13
PMID 29648515
Citations 9
Authors
Affiliations
Soon will be listed here.
Abstract

Peripheral arterial disease (PAD) is associated with augmented blood pressure (BP) and impaired coronary blood flow responses to exercise, which may increase cardiovascular risk. We investigated the effects of leg revascularization on the BP and coronary blood flow responses to exercise in PAD. Seventeen PAD patients (11 men, 66 ± 2 yr) performed single-leg plantar flexion exercise 24 h before and 1 mo following leg revascularization. BP and heart rate (HR) were measured continuously, and rate pressure product (systolic BP × HR) was calculated as an index of myocardial oxygen demand. Coronary blood velocity was obtained by transthoracic Doppler echocardiography in 8/17 subjects. The mean BP response to plantar flexion exercise was attenuated by leg revascularization (pre-revascularization: 15 ± 4 vs. post-revascularization: 7 ± 3 mmHg, P = 0.025). The HR response to plantar flexion was also attenuated following leg revascularization (pre-revascularization: 9 ± 1 vs. post-revascularization: 6 ± 1 beats/min, P = 0.006). The change in coronary blood velocity with exercise was greater at the post-revascularization visit: 4 ± 1 vs. pre-revascularization: -1 ± 2 cm/s ( P = 0.038), even though the change in rate pressure product was not greater following revascularization in these subjects (pre-revascularization: 2,796 ± 871 vs. post-revascularization: 1,766 ± 378 mmHg·beats/min, P = 0.082). These data suggest that leg revascularization alters reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. NEW & NOTEWORTHY We found that peripheral revascularization procedures lowered exercise blood pressure and improved coronary blood flow in patients with peripheral arterial disease.

Citing Articles

Effects of short-term dietary nitrate supplementation on exercise and coronary blood flow responses in patients with peripheral artery disease.

Kim D, Gao Z, Luck J, Brandt K, Miller A, Kim-Shapiro D Front Nutr. 2024; 11:1398108.

PMID: 39027664 PMC: 11257697. DOI: 10.3389/fnut.2024.1398108.


Skeletal muscle desmin alterations following revascularization in peripheral artery disease claudicants.

Wilburn D, Miserlis D, Fletcher E, Papoutsi E, Ismaeel A, Bradley C Sci Rep. 2024; 14(1):12609.

PMID: 38824194 PMC: 11144188. DOI: 10.1038/s41598-024-63626-3.


Aortic blood pressure and pulse wave indices responses to exercise in peripheral artery disease.

Kim D, Gao Z, Cui J, Leuenberger U, Brandt K, Blaha C Am J Physiol Regul Integr Comp Physiol. 2023; 325(4):R327-R336.

PMID: 37486070 PMC: 10639020. DOI: 10.1152/ajpregu.00303.2022.


Exaggerated blood pressure response to static exercise in hindlimb ischemia-reperfusion.

Qin L, Li J Front Physiol. 2023; 13:1048559.

PMID: 36589449 PMC: 9794987. DOI: 10.3389/fphys.2022.1048559.


Effects of bradykinin on voltage-gated K 4 channels in muscle dorsal root ganglion neurons of rats with experimental peripheral artery disease.

Li Q, Qin L, Li J J Physiol. 2021; 599(14):3567-3580.

PMID: 34036586 PMC: 8284427. DOI: 10.1113/JP281704.


References
1.
Norgren L, Hiatt W, Dormandy J, Nehler M, Harris K, Fowkes F . Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007; 45 Suppl S:S5-67. DOI: 10.1016/j.jvs.2006.12.037. View

2.
Muller M, Drew R, Blaha C, Mast J, Cui J, Reed A . Oxidative stress contributes to the augmented exercise pressor reflex in peripheral arterial disease patients. J Physiol. 2012; 590(23):6237-46. PMC: 3530129. DOI: 10.1113/jphysiol.2012.241281. View

3.
Pellegrino T, Storto G, Filardi P, Sorrentino A, Silvestro A, Petretta M . Relationship between brachial artery flow-mediated dilation and coronary flow reserve in patients with peripheral artery disease. J Nucl Med. 2005; 46(12):1997-2002. View

4.
Bakke E, Hisdal J, Kroese A, Jorgensen J, Stranden E . Blood pressure response to isometric exercise in patients with peripheral atherosclerotic disease. Clin Physiol Funct Imaging. 2007; 27(2):109-15. DOI: 10.1111/j.1475-097X.2007.00720.x. View

5.
Heitzer T, Rudolph V, Schwedhelm E, Karstens M, Sydow K, Ortak M . Clopidogrel improves systemic endothelial nitric oxide bioavailability in patients with coronary artery disease: evidence for antioxidant and antiinflammatory effects. Arterioscler Thromb Vasc Biol. 2006; 26(7):1648-52. DOI: 10.1161/01.ATV.0000225288.74170.dc. View