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The Exercise Pressor Reflex is attenuated and Coronary Exercise Hyperemia is improved by Peripheral Revascularization in Peripheral Arterial Disease
Author(s) -
Miller Amanda Joy,
Luck J Carter,
Kim Danielle JinKwang,
Leuenberger Urs A.,
Aziz Faisal,
Radtka John F.,
Sinoway Lawrence I.,
Muller Matthew D.
Publication year - 2018
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2018.32.1_supplement.588.19
Subject(s) - medicine , revascularization , cardiology , blood pressure , heart rate , blood flow , rate pressure product , peripheral , reflex , myocardial infarction
Patients with peripheral arterial disease (PAD) have a greater blood pressure (BP) response to exercise or augmented exercise pressor reflex. Our recent work showed that PAD patients also have impaired coronary blood flow responses to exercise which may increase cardiovascular risk. We investigated the effects of leg revascularization procedures 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 for up to 6 minutes twice: 24 hr before and one month 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. 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 significantly greater at the post revascularization visit: 4 ± 1 vs. pre revascularization: −1 ± 2 cm/s ( P = 0.038). The rate pressure product response to exercise tended to be lower following revascularization but this did not reach statistical significance (pre revascularization: 2796 ± 871 vs. post revascularization: 1766 ± 378 mmHg*beats/minute, P = 0.082). These data suggest that leg revascularization improves reflex control of BP, HR, and coronary blood flow in response to exercise in patients with PAD. Support or Funding Information P01 HL134609 (Sinoway) This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .