title: The impact of different supervised exercise regimens on endothelial function in patients with intermittent claudication.
abstract: OBJECTIVE
  The impact of supervised exercise training on endothelial function in patients with intermittent claudication is unclear. This study assesses the impact of treadmill-based supervised exercise training alone or in combination with resistance training on pain free walking distance, flow-mediated dilatation, reactive hyperaemia index, nitric oxide and asymmetric dimethylarginine.
  
  
  METHODS
  Thirty-five patients with intermittent claudication were randomised to 12 weeks of treadmill-only supervised exercise training (Group 1) or a combination of treadmill and lower-limb resistance supervised exercise training (Group 2). Pain free walking distance was assessed by six-minute walk test. Endothelial function was assessed by brachial artery flow-mediated dilatation, reactive hyperaemia index and serum analysis of asymmetric dimethylarginine and nitric oxide.
  
  
  RESULTS
  Pain free walking distance improved within Group 1 (160 m to 204 m, p = 0.03) but not Group 2 (181 m to 188 m, p = 0.82), no between group difference. No significant change in flow-mediated dilatation or reactive hyperaemia index in either group. Nitric oxide decreased in Group 1 (15.0 µmol/L to 8.3 µmol/L, p = 0.003) but not Group 2 (11.2 µmol/L to 9.1 µmol/L, p = 0.14), p = 0.07 between groups. Asymmetric dimethylarginine decreased in Group 2 (0.61 µmol/L to 0.56 µmol/L, p = 0.03) but not Group 1 (0.58 µmol/l to 0.58 µmol/L, p = 0.776), no between group difference.
  
  
  CONCLUSIONS
  Supervised exercise training does not improve endothelial function as measured by flow-mediated dilatation, reactive hyperaemia index and nitric oxide bioavailability.
authors.affiliation: Department of Vascular Surgery, Flinders University, Australia.
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Delaney
authors.affiliation: Department of Nutrition and Dietetics, Flinders University, Australia.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Miller
authors.affiliation: Department of Vascular Surgery, Flinders University, Australia.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Allan
authors.affiliation: Department of Vascular Surgery, Flinders University, Australia ian.spark@health.sa.gov.au.
authors.forename: J Ian
authors.initials: JI
authors.lastname: Spark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D015415:Biomarkers / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D007383:Intermittent Claudication / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D010147:Pain Measurement; D011788:Quality of Life; D055070:Resistance Training; D013021:South Australia; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation; D016138:Walking
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide; C018524:N,N-dimethylarginine; D001120:Arginine
keywords: Peripheral arterial disease; endothelial function; intermittent claudication; supervised exercise training