Clot Strength is Negatively Associated With Ambulatory Function in Patients With Peripheral Artery Disease and Intermittent Claudication

Mauer, Karin; Gardner, Andrew W.; Dasari, Tarun W.; Stoner, Julie A.; Blevins, Steve M.; Montgomery, Polly S.; Saucedo, Jorge; Exaire, J. Emilio

doi:10.1177/0003319714532518

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…The rationale for the configuration of these filters has been previously addressed (Coleman et al., ). Although the effectiveness of the settings configuration can be checked by the visual inspection of a light when the subject is walking, no specification and no recommendation have been given in studies that used the StepWatch 3 ™ in PAD patients (Gardner et al., , , , , , , , , , , ; Hiatt et al., ; Ritti‐Dias et al., ; Gardner et al., ; Mauer et al., ). It is unknown whether different configurations can produce different results and limit the comparison of studies.…”

Section: Discussionmentioning

confidence: 99%

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

Müllenheim

Chaudru

Prioux

et al. 2015

Scandinavian Med Sci Sports

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The purpose of the present review was to provide, for the first time, a comprehensive analysis and synthesis of the available studies that highlighted the clinical interest of the ambulatory assessment of either physical activity (PA) or walking capacity in patients with lower extremity peripheral artery disease (PAD). We identified 96 related articles published up to March 2015 through a computer-assisted search of the MEDLINE, EMBASE, and Web of Science databases. Ambulatory-measured PA or related energy expenditure (EE) in PAD patients was performed in 87 of the 96 included studies. The main clinical interests of these measurements were (a) the assessment of PA/EE pattern; (b) the characterization of walking pattern; and (c) the control of training load during home-based walking programs. Ambulatory-measured walking capacity was performed in the remaining studies, using either Global Positioning System receivers or the Peripheral Arterial Disease Holter Control device. Highlighted clinical interests were (a) the assessment of community-based walking capacity; (b) the use of new outcomes to characterize walking capacity, besides the conventional absolute claudication distance; and (c) the association with the patient's self-perception of walking capacity. This review also provides for the clinicians step-by-step recommendations to specifically assess PA or walking capacity in PAD patients.

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Section: Discussionmentioning

confidence: 99%

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

Müllenheim

Chaudru

Prioux

et al. 2015

Scandinavian Med Sci Sports

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“…1,2 Supervised and home-based exercise programs are efficacious for the clinical management of claudication and improve objective ambulatory measures, such as claudication onset time (COT), peak walking time (PWT), and 6-min PAD and claudication. 8 Furthermore, acute exercise may have an impact on the coagulation system, but results have been controversial, as strenuous exercise induces clotting in some studies, [9][10][11] but not in others. [12][13][14][15][16] In contrast, it appears that chronic exercise training positively modifies exerciseinduced blood coagulation; [17][18][19] however, evidence is limited in patients with PAD and claudication.…”

Section: Introductionmentioning

confidence: 99%

Effect of exercise training on clot strength in patients with peripheral artery disease and intermittent claudication: An ancillary study

et al. 2015

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Objectives:Patients with peripheral artery disease have walking impairment, greater thrombotic risk, and are often treated with exercise training. We sought to determine the effect of a 3-month-long exercise program on clot strength among patients with peripheral artery disease and intermittent claudication.Methods:Twenty-three symptomatic peripheral artery disease patients were randomly assigned to a walking exercise program or to an attention control group who performed light resistance exercise. We investigated the effect of exercise training on clot strength and time to clot formation was assessed by thromboelastography.Results:After 3 months of exercise, clot strength (maximal amplitude) and time to clot formation (R) did not change significantly from baseline, even after improvements in claudication onset time (p < 0.01) and peak walking time (p < 0.05). Furthermore, changes in clot formation parameters were not significantly different between groups. Among the 10 individuals demonstrating a reduction in clot strength (reduced maximal amplitude), one was a smoker (10%) compared to 9 of 13 non-responders (69%) whose maximal amplitude was unchanged or increased (p = 0.0097).Conclusion:In this ancillary study, a 12-week walking program improved ambulatory function in peripheral artery disease patients with claudication, but does not modify clot strength or time to clot formation. Larger studies are needed to confirm these hypothesis generating findings and to determine whether a different amount or type of exercise may induce a change in clotting in this patient population.

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Crossroads between peripheral atherosclerosis, western-type diet and skeletal muscle pathophysiology: emphasis on apolipoprotein E deficiency and peripheral arterial disease

Sfyri

Matsakas

2017

J Biomed Sci

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Atherosclerosis is a chronic inflammatory process that, in the presence of hyperlipidaemia, promotes the formation of atheromatous plaques in large vessels of the cardiovascular system. It also affects peripheral arteries with major implications for a number of other non-vascular tissues such as the skeletal muscle, the liver and the kidney. The aim of this review is to critically discuss and assimilate current knowledge on the impact of peripheral atherosclerosis and its implications on skeletal muscle homeostasis. Accumulating data suggests that manifestations of peripheral atherosclerosis in skeletal muscle originates in a combination of increased i)-oxidative stress, ii)-inflammation, iii)-mitochondrial deficits, iv)-altered myofibre morphology and fibrosis, v)-chronic ischemia followed by impaired oxygen supply, vi)-reduced capillary density, vii)- proteolysis and viii)-apoptosis. These structural, biochemical and pathophysiological alterations impact on skeletal muscle metabolic and physiologic homeostasis and its capacity to generate force, which further affects the individual’s quality of life. Particular emphasis is given on two major areas representing basic and applied science respectively: a)-the abundant evidence from a well-recognised atherogenic model; the Apolipoprotein E deficient mouse and the role of a western-type diet and b)-on skeletal myopathy and oxidative stress-induced myofibre damage from human studies on peripheral arterial disease. A significant source of reactive oxygen species production and oxidative stress in cardiovascular disease is the family of NADPH oxidases that contribute to several pathologies. Finally, strategies targeting NADPH oxidases in skeletal muscle in an attempt to attenuate cellular oxidative stress are highlighted, providing a better understanding of the crossroads between peripheral atherosclerosis and skeletal muscle pathophysiology.

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Clot Strength is Negatively Associated With Ambulatory Function in Patients With Peripheral Artery Disease and Intermittent Claudication

Cited by 3 publications

References 26 publications

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

Clinical Interest of Ambulatory Assessment of Physical Activity and Walking Capacity in Peripheral Artery Disease

Effect of exercise training on clot strength in patients with peripheral artery disease and intermittent claudication: An ancillary study

Crossroads between peripheral atherosclerosis, western-type diet and skeletal muscle pathophysiology: emphasis on apolipoprotein E deficiency and peripheral arterial disease

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