Angiogenesis in skeletal muscle precede improvements in peak oxygen uptake in peripheral artery disease patients.
Angiogenesis in skeletal muscle precede improvements in peak oxygen uptake in peripheral artery disease patients.
复制标题
DOI：
10.1161/atvbaha.111.230441
复制
发表时间：
2011-11
期刊：
影响因子：
--
通讯作者：
Annex BH
中科院分区：
文献类型：
--
作者：
Duscha BD;Robbins JL;Jones WS;Kraus WE;Lye RJ;Sanders JM;Allen JD;Regensteiner JG;Hiatt WR;Annex BH
PAD的特征是下肢血流受损，导致跛行和运动不耐受。运动训练改善功能能力的机制尚不清楚。本研究验证了以下假设：在接受监督运动训练的外周动脉疾病（PAD）患者中，小腿肌肉中毛细血管密度（CD）的增加发生在峰值摄氧量（VO 2）改善之前。35名PAD患者随机接受12周的直接监督或家庭运动训练。在基线和训练后进行峰值VO 2测试和腓肠肌活检。使用免疫荧光染色测量毛细血管密度（内皮细胞/mm 2）。在3周的直接监督训练后，患者的CD增加（216±66 vs 284±77，p<0.01），但峰值VO 2没有增加。然而，12周后，峰值VO 2增加（15.3±2.8 vs 16.8±3.8，p<0.01），而肌肉CD仍高于基线水平，但氧化能力标志物无变化。在受试者中，CD与直接监督训练前后的峰值VO 2相关。缺血肌肉中毛细血管密度的变化与训练可能会调节对训练的反应，这些变化之前，VO 2的增加。
PAD is characterized by impaired blood flow to the lower extremities, causing claudication and exercise intolerance. The mechanism(s) by which exercise training improves functional capacity is not understood. This study tested the hypothesis that in peripheral artery disease (PAD) patients who undergo supervised exercise training, increases in capillary density (CD) in calf muscle take place before improvements in peak oxygen uptake (VO2). 35 PAD patients were randomized to 12 weeks of directly-supervised or home–based exercise training. Peak VO2 testing and gastrocnemius muscle biopsies were performed at baseline and after training. Capillary density (endothelial cells/mm2) was measured using immunofluorescence staining. After 3 weeks of directly-supervised training, patients had an increase in CD (216±66 vs 284±77, p<0.01) but no increase in peak VO2. However after 12 weeks, peak VO2 increased (15.3±2.8 vs 16.8±3.8, p<0.01), while in muscle CD remained increased over baseline but there were no changes in markers of oxidative capacity. Within subjects, CD was related to peak VO2 before and after directly-supervised training. Changes in capillary density in ischemic muscle with training may modulate the response to training and those changes precede the increase in VO2.