title: Exercise after heparin administration: new therapeutic program for patients with-option arteriosclerosis oblitrans.
abstract: BACKGROUND
  A prospective study examined whether a combination of an exercise program and heparin administration improves the clinical symptoms of patients with arteriosclerosis obliterans (ASO) without an indication for surgical revascularization because of the lack of distal target vessels or other reasons such as high surgical risk or lack of a vein conduit from previous coronary artery bypass surgery.
  
  
  RESULTS
  A total of 19 consecutive patients with symptomatic non-option ASO diagnosed by angiography were randomly assigned to 3 groups: heparin + exercise (walking for 60 min after heparin injection [3,000 units/day IV for 14 days], n = 6), heparin administration only (n = 6), and exercise only (n = 7). Plasma levels of hepatocyte growth factor (HGF) were serially measured before and after intravenous administration of heparin. Ankle brachial pressure index was measured and treadmill exercise test (2.5 km/h, 12% slope) was performed before the 2-week treatment, just after finishing treatment, and 12 weeks after beginning the treatment. Ophthalmic examinations, including visual acuity test, ocular fundoscopy and fluorescein angiographic fundus photography, were performed before and 12 weeks after the treatment program. In all patients, HGF levels increased more than 4-fold of the basal level at 30 min after heparin injection. Maximum walking time was significantly higher in the heparin + exercise group than in the other 2 groups (p < 0.05). There were no patients who showed pathological retinal angiogenesis.
  
  
  CONCLUSIONS
  The combination of an exercise program and heparin administration improves the clinical symptoms of patients with non-option ASO.
authors.affiliation: First Department of Integrated Medicine, Omiya Medical Center, Jichi Medical School, Saitama, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Maejima
authors.forename: Takanori
authors.initials: T
authors.lastname: Yasu
authors.forename: Hiroto
authors.initials: H
authors.lastname: Ueba
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kakehashi
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000925:Anticoagulants; C066855:HGF protein, human; D017228:Hepatocyte Growth Factor; D006493:Heparin