Acute exercise and markers of endothelial injury in peripheral arterial disease.

Abstract

To determine the acute effects of exercise on plasma levels of markers of endothelial damage in patients with symptomatic peripheral arterial occlusive disease (PAOD). Prospective observational study of patients with angiographically proven PAOD undergoing treadmill exercise testing prior to surgical or radiological intervention. Ante-cubital venous blood sampling was performed in 20 patients with symptomatic PAOD prior to, and 2 min after, treadmill exercise testing. Samples were then assayed for von Willebrand factor (vWf), tissue-type plasminogen activator (tPa), and plasminogen activator inhibitor (PAI) levels. Despite a significant fall in median ankle-brachial pressure indices from 0.96 pre-exercise to 0.59 post-exercise on the right, and from 0.92 to 0.40 on the left (both p < 0.005), there were no significant changes in plasma levels of vWf, tPa, or PAI following claudication-inducing exercise. Claudication-inducing exercise does not produce acute alterations in plasma markers of endothelial damage, and the results of this study do not support the belief that claudication-inducing exercise in PAOD is damaging to vascular endothelium.