EFFECTS OF FEMORAL REVASCULARIZATION ON BLOOD FLOW DURING EXERCISE IN PAD PATS

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 PAD患者由于动脉狭窄或阻塞而导致血液流动受损，从而导致氧气输送不足。据报道，PAD的治疗干预（如血运重建）可改善踝臂指数（ABI）（动脉阻塞指数），并增加最大小腿血流量。了解PAD治疗后血管功能变化的意义在于，可以制定更有效的策略来改善PAD患者固有的潜在心血管功能障碍。我们假设PAD的血运重建治疗将增加运动期间小腿肌肉的血流动力学和氧合，并且这些变化将与血管功能的变化正相关，如通过脉搏波速度（动脉硬度指数）和峰值反应性充血评估的。本研究将招募15名患有PAD的男性和女性，并在治疗前、治疗后3-7天和治疗恢复4周后访问Noll实验室。 在每次访视期间，将向参与者提供：步行障碍问卷;要求在脉搏波速度和ABI期间休息;进行总计8分钟的等长小腿肌肉锻炼，同时使用多普勒超声测量血流动力学和峰值反应性充血;进行6分钟步行试验以评估功能能力;最后，再次休息以重复脉搏波速度和ABI测量。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Individuals with PAD suffer from low oxygen delivery as a consequence of arterial narrowing or obstruction that impairs blood flow. Treatment interventions for PAD such as revascularization have been reported to improve ankle-brachial index (ABI), an index of arterial obstruction, and increase maximal calf blood flow. The significance of understanding changes in vascular function following treatment for PAD is that more effective strategies can be developed to improve the underlying cardiovascular dysfunction inherent in individuals with PAD. We hypothesize that revascularization treatment for PAD will increase calf muscle hemodynamics and oxygenation during exercise, and that these changes will be positively correlated with changes in vascular function as assessed by pulse-wave velocity (index of arterial stiffness) and peak reactive hyperemia. Fifteen men and women with PAD will be recruited for this study and visit Noll Laboratory before treatment, 3-7 days after treatment, and following 4 weeks of recovery from treatment. During each visit, participants will be given: a walking impairment questionnaire; asked to rest during pulse-wave velocity and ABI; perform a total of 8 min of isometric calf muscle exercise while hemodynamics and peak reactive hyperemia are measured using Doppler ultrasound; perform a 6 min walk test to assess functional capacity; and lastly, rest again for repeat pulse-wave velocity and ABI measurements.