Aims
In peripheral arterial disease (PAD) patients, exercise therapy is recommended to relieve leg symptoms as noted in the 2016 AHA/ACC and 2017 ESC/ESVS guidelines. We assessed the trainability for cardiopulmonary fitness (CPF) and quality of life (QOL); three distinct patient types, including PAD, heart failure (HF), and stroke, were compared.
Methods and Results
This is a multicenter, retrospective analysis of prospectively collected data from three clinical studies. Data from 123 patients who completed 36 sessions of supervised aerobic training of moderate intensity were analyzed, including 28 PAD, 55 HF, and 40 stroke patients. Before and after training, cardiopulmonary exercise testing with noninvasive cardiac output monitoring and QOL evaluation using a 36-Item Short Form Survey (SF-36) were performed. Non-response was defined as a negative change in post-training value compared to pre-training value. The result showed improvement in CPF in all three groups. However, CRF increased lesser in the PAD group than in the HF and stroke groups; physical and mental component scores (MCS) of SF-36 exhibited similar pattern. Non-response rates of peak V̇O2, oxygen uptake efficiency slope, and MCS were higher in the PAD. In the PAD group, non-responders regarding peak V̇O2 had a higher pulse wave velocity than responders.
Conclusions
In PAD patients following exercise therapy, CRF and QOL improved less on average; their non-response rate was also higher compared to HF or stroke patients. Therefore, a higher dose of exercise might be needed to elicit adaptation in PAD patients, especially those with high pulse wave velocity.