10.4 Physical Aerobic Supervised Training Improves Endothelial and Microcirculatory Resistance to Oxidative Stress in Peripheral Arterial Disease

Introduction: We aimed to investigate if aerobic controlled training in vascular claudication can prevent endothelium dysfunction acutely induced by maximum exercise (walking throughout maximal calf pain) in patients with peripheral arterial disease.

Methods: 12 patients were enrolled in the study. We performed endothelium dependent dilation (EDD) at humeral artery and microcirculatory reactivity tests (laser-Doppler flowmetry: post ischaemic test and endothelium dependent dilation elicited by jontophoretic administration of acetylcholine). These tests were performed before and after single treadmill exercise maintained to cause the maximum calf pain. The same protocol was repeated after 20 days controlled training (treadmill prolonged before pain onset).

Results: Training increased pain maximum walking distance (275±15 vs 125,8±40 m; p±0,7 vs 10,3±0,5%; p±4,2% vs −54,3±3,6%; p<0,05). Microcirculatory hyperaemic function increased after training (85,3±3,9% vs 66,2±1,5%: (see table).

figure Tab1

Conclusions: Aerobic training improves humeral EDD and increases its resistance to oxidative stress induced by maximal exercise. Furthermore training improves microcirculatory endothelium dependent dilation and microcirculatory vascular reserve in patients affected from peripheral arterial disease with claudication.