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Randomized Controlled Trial
. 2011 Nov;31(11):2742-8.
doi: 10.1161/ATVBAHA.111.230441.

Angiogenesis in skeletal muscle precede improvements in peak oxygen uptake in peripheral artery disease patients

Brian D Duscha  1 , Jennifer L Robbins, William S Jones, William E Kraus, R John Lye, John M Sanders, Jason D Allen, Judith G Regensteiner, William R Hiatt, Brian H Annex
Affiliations
Randomized Controlled Trial

Angiogenesis in skeletal muscle precede improvements in peak oxygen uptake in peripheral artery disease patients

Brian D Duscha et al. Arterioscler Thromb Vasc Biol. 2011 Nov.

Abstract

Objective: Peripheral artery disease (PAD) is characterized by impaired blood flow to the lower extremities, causing claudication and exercise intolerance. The mechanism(s) by which exercise training improves functional capacity is not understood. This study tested the hypothesis that in PAD patients who undergo supervised exercise training, increases in capillary density (CD) in calf muscle take place before improvements in peak oxygen uptake (VO(2)).

Methods and results: Thirty-five PAD patients were randomly assigned to 12 weeks of directly supervised or home-based exercise training. Peak VO(2) testing and gastrocnemius muscle biopsies were performed at baseline and after training. CD (endothelial cells/mm(2)) was measured using immunofluorescence staining. After 3 weeks of directly supervised training, patients had an increase in CD (216±66 versus 284±77, P<0.01) but no increase in peak VO(2). However, after 12 weeks, peak VO(2) increased (15.3±2.8 versus 16.8±3.8, P<0.01), whereas in muscle, CD remained increased over baseline, but there were no changes in markers of oxidative capacity. Within subjects, CD was related to peak VO(2) before and after directly supervised training.

Conclusion: Changes in CD in ischemic muscle with training may modulate the response to training, and those changes precede the increase in VO(2).

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Conflict of interest statement

Disclosures

None of the authors have any conflicts of interest relative to the intervention.

Figures

Figure 1
Figure 1
Flow Chart of Enrollment and Completion of Subjects.
Figure 2
Figure 2
Supervised exercise training concomitant time course of change for capillary density and peak VO2 (• peak VO2, ■ capillary density). * indicates significantly different versus 0 week, p<0.05.
Figure 3
Figure 3
A and 3B.The Relationship Between Capillary Density (mm2) and Peak VO2 at Baseline (all subjects) and Post-Exercise Training (Supervised Group).
Figure 3
Figure 3
A and 3B.The Relationship Between Capillary Density (mm2) and Peak VO2 at Baseline (all subjects) and Post-Exercise Training (Supervised Group).
See this image and copyright information in PMC

References

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