title: Coronary Exercise Hyperemia Is Impaired in Patients with Peripheral Arterial Disease.
abstract: BACKGROUND
  Peripheral arterial disease (PAD) is an atherosclerotic vascular disease that affects over 200 million people worldwide. The hallmark of PAD is ischemic leg pain and this condition is also associated with an augmented blood pressure response to exercise, impaired vascular function, and high risk of myocardial infarction and cardiovascular mortality. In this study, we tested the hypothesis that coronary exercise hyperemia is impaired in PAD.
  
  
  METHODS
  Twelve patients with PAD and no overt coronary disease (65 ± 2 years, 7 men) and 15 healthy control subjects (64 ± 2 years, 9 men) performed supine plantar flexion exercise (30 contractions/min, increasing workload). A subset of subjects (n = 7 PAD, n = 8 healthy) also performed isometric handgrip exercise (40% of maximum voluntary contraction to fatigue). Coronary blood velocity in the left anterior descending artery was measured by transthoracic Doppler echocardiography; blood pressure and heart rate were monitored continuously.
  
  
  RESULTS
  Coronary blood velocity responses to 4 min of plantar flexion exercise (PAD: Δ2.4 ± 1.2, healthy: Δ6.0 ± 1.6 cm/sec, P = 0.039) and isometric handgrip exercise (PAD: Δ8.3 ± 4.2, healthy: Δ16.9 ± 3.6, P = 0.033) were attenuated in PAD patients.
  
  
  CONCLUSIONS
  These data indicate that coronary exercise hyperemia is impaired in PAD, which may predispose these patients to myocardial ischemia.
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Amanda J
authors: AJ
authors: Ross
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Zhaohui
authors: Z
authors: Gao
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Jonathan Carter
authors: JC
authors: Luck
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Cheryl A
authors: CA
authors: Blaha
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Aimee E
authors: AE
authors: Cauffman
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Faisal
authors: F
authors: Aziz
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: John F
authors: JF
authors: Radtka
authors: Department of Kinesiology, Noll Laboratory, The Pennsylvania State University, State College, PA.
authors: David N
authors: DN
authors: Proctor
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Urs A
authors: UA
authors: Leuenberger
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA.
authors: Lawrence I
authors: LI
authors: Sinoway
authors: Penn State Heart and Vascular Institute, Penn State University College of Medicine, Hershey, PA. Electronic address: mmuller1@hmc.psu.edu.
authors: Matthew D
authors: MD
authors: Muller
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D016022:Case-Control Studies; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D015444:Exercise; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006339:Heart Rate; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue; D056888:Patient Positioning; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology*; D011237:Predictive Value of Tests; D016683:Supine Position; D034941:Upper Extremity / Q000098:blood supply*