title: Supervised exercise training in peripheral arterial disease increases vascular shear stress and profunda femoral artery diameter.
abstract: Background Arteriogenesis is promoted by flow- and pressure-related forces such as tangential wall stress and laminar shear stress. Exercise training (ET) is known to promote arteriogenesis in peripheral arterial disease (PAD) patients. It remains unclear whether supervised ET (SET) promotes arteriogenesis more efficiently than non-SET (nSET). Methods and results Forty PAD patients participated in a SET or nSET training programme ( n = 20 each) and were compared to 20 healthy individuals without any history of cardiovascular events. Femoral artery diameter, flow and velocity were measured by ultrasound. Tangential wall stress and laminar shear stress were calculated for femoral arteries. Follow-up was performed after a mean of 7.65 ± 1.62 months. At follow-up, only the SET group showed a significant increase in lumen diameter of the profunda femoral artery ( p = 0.03), accompanied by an increase of tangential wall stress ( p = 0.002). Laminar shear stress decreased, but remained higher for the SET group compared to controls ( p < 0.01). Individual changes in walking distance were higher for SET patients ( p = 0.01) than nSET patients ( p = 0.07). Profunda femoral lumen diameter and tangential wall stress correlated directly with walking distance ( r = 0.446; p < 0.001), as well as with each other ( r = 0.743; p < 0.0001). Conclusions Our results indicate that SET promotes arteriogenesis more efficiently than nSET. Femoral lumen diameter and flow might help with the monitoring of ET efficiency and potential arteriogenesis.
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.|2 Division of Clinical and Interventional Angiology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Jörn F
authors.initials: JF
authors.lastname: Dopheide
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rubrech
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Amelie
authors.initials: A
authors.lastname: Trumpp
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Geissler
authors.affiliation: 3 Department of Internal Medicine I, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Geraldine C
authors.initials: GC
authors.lastname: Zeller
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Schnorbus
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Schmidt
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.affiliation: 1 Center of Cardiology I - General and Interventional Cardiology, Angiology and Intensive Care, University Medical Center, Johannes Gutenberg-University Mainz, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Espinola-Klein
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D016022:Case-Control Studies; D003097:Collateral Circulation; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D012039:Regional Blood Flow; D013314:Stress, Mechanical; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D000070857:Walk Test; D016138:Walking
keywords: Peripheral arterial disease; arteriogenesis; exercise training; laminar shear stress; profunda femoral arterial diameter; tangential wall stress