The systemic effects of intermittent claudication are reversed by angioplasty.
BACKGROUND
exercise in patients with intermittent claudication causes systemic effects, the consequences of which are unknown. This study investigates whether successful PTA reverses the systemic effects.


METHODS
ten patients with IC were recruited prior to PTA. Having emptied their bladders and rested for 1 h, pre-exercise blood and urine samples were collected. Patients underwent treadmill exercise to maximum walking time and blood samples were collected at 10, 20 and 30 min. A second urine sample was collected at 60 min. Total antioxidant capacity (TAC) and von Willebrands Factor (vWF) were measured in blood and albumin/creatinine ratio (ACR) and retinol binding protein/creatinine ratio (RBP/Cr) in urine. Patients were recalled 2 weeks after successful angioplasty and the protocol repeated. Following PTA patients walked for a maximum of 5 min.


RESULTS
there was no significant change in vWF. Exercise in claudicants induced a significant increase in median ACR (pre/post exercise=0.85 p =0.03) and in median RBP/Cr (pre/post exercise=1.8 p =0.04). These changes were no longer evident after successful PTA. TAC was significantly different before and after angioplasty at all time intervals.


CONCLUSIONS
successful PTA reverses glomerular effects of exercise in claudicants. Future work should investigate the use of PTA in conjunction with exercise in the treatment of peripheral vascular disease.
Lewis
D R
DR
University Department of Surgery, Bristol Royal Infirmary, Bristol, UK.
Day
A
A
Jeremy
J Y
JY
Baird
R N
RN
Smith
F C
FC
Lamont
P M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D000975:Antioxidants / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000378:metabolism* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D005082:Physical Exertion; D012177:Retinol-Binding Proteins / Q000378:metabolism; D012709:Serum Albumin / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism
D000975:Antioxidants; D012177:Retinol-Binding Proteins; D012709:Serum Albumin; D014841:von Willebrand Factor; D003404:Creatinine