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. 2017 Aug 30;6(9):e006604.
doi: 10.1161/JAHA.117.006604.

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index

Majd AlGhatrif  1   2   3 , Ariel Zane  2 , Matt Oberdier  1 , Marco Canepa  2   4 , Stephanie Studenski  2 , Eleanor Simonsick  2 , Richard G Spencer  5 , Kenneth Fishbein  5 , David Reiter  5 , Edward G Lakatta  1 , Mary M McDermott  6 , Luigi Ferrucci  7
Affiliations

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low-Normal Ankle-Brachial Index

Majd AlGhatrif et al. J Am Heart Assoc. .

Abstract

Background: Lower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle-brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production.

Methods and results: We examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post-exercise phosphocreatine recovery rate constant (kPCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post-exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post-exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms-1, P=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (P=0.028). Similarly, post-exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P=0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P=0.0405).

Conclusions: An ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent subsequent functional decline.

Keywords: aging; ankle‐brachial index; mitochondrial function.

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Figures

Figure 1
Figure 1
Least‐square means and standard errors of post‐exercise phosphocreatine recovery rate constant (kPCr) in patients with an ankle‐brachial index (ABI) 0.9 to 1.1 (black bar) and patients with an ABI>1.1 (white bar), adjusting for age, sex, race, diabetes mellitus, smoking, and body mass index.
Figure 2
Figure 2
Linear regression analysis showing the association between post‐exercise phosphocreatine recovery rate constant (kPCr) of the thigh muscle with ankle‐brachial index.
See this image and copyright information in PMC

References

    1. McDermott MM, Liu K, Greenland P, Guralnik JM, Criqui MH, Chan C, Pearce WH, Schneider JR, Ferrucci L, Celic L, Taylor LM, Vonesh E, Martin GJ, Clark E. Functional decline in peripheral arterial disease: associations with the ankle brachial index and leg symptoms. JAMA. 2004;292:453–461. - PubMed
    1. Pipinos II, Judge AR, Selsby JT, Zhu Z, Swanson SA, Nella AA, Dodd SL. The myopathy of peripheral arterial occlusive disease: part 1. Functional and histomorphological changes and evidence for mitochondrial dysfunction. Vasc Endovascular Surg. 2008;41:481–489. - PubMed
    1. Esterhammer R, Schocke M, Gorny O, Posch L, Messner H, Jaschke W, Fraedrich G, Greiner A. Phosphocreatine kinetics in the calf muscle of patients with bilateral symptomatic peripheral arterial disease during exhaustive incremental exercise. Mol Imaging Biol. 10:30–39. - PubMed
    1. Pipinos II, Sharov VG, Shepard AD, Anagnostopoulos PV, Katsamouris A, Todor A, Filis KA, Sabbah HN. Abnormal mitochondrial respiration in skeletal muscle in patients with peripheral arterial disease. J Vasc Surg. 2003;38:827–832. - PubMed
    1. Greiner A, Esterhammer R, Bammer D, Messner H, Kremser C, Jaschke WR, Fraedrich G, Schocke MFH. High‐energy phosphate metabolism in the calf muscle of healthy humans during incremental calf exercise with and without moderate cuff stenosis. Eur J Appl Physiol. 2007;99:519–531. - PubMed

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