Exercise Training and Peripheral Arterial Disease

被引:90
作者
Haas, Tara L. [1 ]
Lloyd, Pamela G. [2 ]
Yang, Hsiao-Tung [3 ]
Terjung, Ronald L. [4 ,5 ]
机构
[1] York Univ, Angiogenesis Res Grp, Muscle Hlth Res Ctr, Fac Hlth, Toronto, ON M3J 2R7, Canada
[2] Oklahoma State Univ, Dept Physiol Sci, Stillwater, OK 74078 USA
[3] Univ Missouri, Dept Biomed Sci, Columbia, MO USA
[4] Univ Missouri, Dept Biomed Sci, Dalton Cardiovasc Res Ctr, Columbia, MO 65211 USA
[5] Univ Missouri, Dept Med Pharmacol & Physiol, Dalton Cardiovasc Res Ctr, Columbia, MO USA
关键词
ENDOTHELIAL GROWTH-FACTOR; NITRIC-OXIDE SYNTHASE; HUMAN SKELETAL-MUSCLE; COLLATERAL BLOOD-FLOW; ANKLE-BRACHIAL INDEX; ACTIVATED PROTEIN-KINASE; FACTOR MESSENGER-RNA; INDUCED MITOCHONDRIAL BIOGENESIS; ISCHEMIA-INDUCED ANGIOGENESIS; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY;
D O I
10.1002/cphy.c110065
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Peripheral arterial disease (PAD) is a common vascular disease that reduces blood flow capacity to the legs of patients. PAD leads to exercise intolerance that can progress in severity to greatly limit mobility, and in advanced cases leads to frank ischemia with pain at rest. It is estimated that 12 to 15 million people in the United States are diagnosed with PAD, with a much larger population that is undiagnosed. The presence of PAD predicts a 50% to 1500% increase in morbidity and mortality, depending on severity. Treatment of patients with PAD is limited to modification of cardiovascular disease risk factors, pharmacological intervention, surgery, and exercise therapy. Extended exercise programs that involve walking approximately five times per week, at a significant intensity that requires frequent rest periods, are most significant. Preclinical studies and virtually all clinical trials demonstrate the benefits of exercise therapy, including improved walking tolerance, modified inflammatory/hemostatic markers, enhanced vasoresponsiveness, adaptations within the limb (angiogenesis, arteriogenesis, and mitochondrial synthesis) that enhance oxygen delivery and metabolic responses, potentially delayed progression of the disease, enhanced quality of life indices, and extended longevity. A synthesis is provided as to how these adaptations can develop in the context of our current state of knowledge and events known to be orchestrated by exercise. The benefits are so compelling that exercise prescription should be an essential option presented to patients with PAD in the absence of contraindications. Obviously, selecting for a lifestyle pattern that includes enhanced physical activity prior to the advance of PAD limitations is the most desirable and beneficial. (C) 2012 American Physiological Society. Compr Physiol 2:2933-3017, 2012.
引用
收藏
页码:2933 / 3017
页数:85
相关论文
共 1059 条
[1]   Effect of diabetes mellitus on formation of coronary collateral vessels [J].
Abaci, A ;
Oguzhan, A ;
Kahraman, S ;
Eryol, NK ;
Ünal, S ;
Arinç, H ;
Ergin, A .
CIRCULATION, 1999, 99 (17) :2239-2242
[2]   Autocrine and Paracrine Angiopoietin 1/Tie-2 Signaling Promotes Muscle Satellite Cell Self-Renewal [J].
Abou-Khalil, Rana ;
Le Grand, Fabien ;
Pallafacchina, Giorgia ;
Valable, Samuel ;
Authier, Francois-Jerome ;
Rudnicki, Michael A. ;
Gherardi, Romain K. ;
Germain, Stephane ;
Chretien, Fabrice ;
Sotiropoulos, Athanassia ;
Lafuste, Peggy ;
Montarras, Didier ;
Chazaud, Benedicte .
CELL STEM CELL, 2009, 5 (03) :298-309
[3]   Scatter factor/hepatocyte growth factor in brain tumor growth and angiogenesis [J].
Abounader, R ;
Laterra, J .
NEURO-ONCOLOGY, 2005, 7 (04) :436-451
[4]   Shear stress induces expression of vascular endothelial growth factor receptor Flk-1/KDR through the CT-rich Sp1 binding site [J].
Abumiya, T ;
Sasaguri, T ;
Taba, Y ;
Miwa, Y ;
Miyagi, M .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2002, 22 (06) :907-913
[5]   Akt1/protein kinase Bα is critical for ischemic and VEGF-mediated angiogenesis [J].
Ackah, E ;
Yu, J ;
Zoellner, S ;
Iwakiri, Y ;
Skurk, C ;
Shibata, R ;
Ouchi, N ;
Easton, RM ;
Galasso, G ;
Birnbaum, MJ ;
Walsh, K ;
Sessa, WC .
JOURNAL OF CLINICAL INVESTIGATION, 2005, 115 (08) :2119-2127
[6]   Growth regulation of the vascular system: an emerging role for adenosine [J].
Adair, TH .
AMERICAN JOURNAL OF PHYSIOLOGY-REGULATORY INTEGRATIVE AND COMPARATIVE PHYSIOLOGY, 2005, 289 (02) :R283-R296
[7]   Axon Guidance Molecules in Vascular Patterning [J].
Adams, Ralf H. ;
Eichmann, Anne .
COLD SPRING HARBOR PERSPECTIVES IN BIOLOGY, 2010, 2 (05) :a001875
[8]   CAPILLARY INCREASE IN THE SKELETAL-MUSCLE OF TRAINED YOUNG AND ADULT-RATS [J].
ADOLFSSON, J ;
LJUNGQVIST, A ;
TORNLING, G ;
UNGE, G .
JOURNAL OF PHYSIOLOGY-LONDON, 1981, 310 (JAN) :529-532
[9]   The effect of current cigarette smoking on calf muscle hemoglobin oxygen saturation in patients with intermittent claudication [J].
Afaq, Azhar ;
Montgomery, Polly S. ;
Scott, Kristy J. ;
Blevins, Steve M. ;
Whitsett, Thomas L. ;
Gardner, Andrew W. .
VASCULAR MEDICINE, 2007, 12 (03) :167-173
[10]  
Agency for Healthcare Research and Quality, 2012, EFF HLTH CAR PROGR