Exercise-induced brachial artery blood flow and vascular function is impaired in systemic sclerosis.
Systemic sclerosis (SSc) is a rare autoimmune disease characterized by debilitating fibrosis and vascular dysfunction; however, little is known about the circulatory response to exercise in this population. Therefore, we examined the peripheral hemodynamic and vasodilatory responses to handgrip exercise in 10 patients with SSc (61 ± 4 yr) and 15 age-matched healthy controls (56 ± 5 yr). Brachial artery diameter, blood flow, and mean arterial pressure (MAP) were determined at rest and during progressive static-intermittent handgrip exercise. Patients with SSc and controls were similar in body stature, handgrip strength, and MAP; however, brachial artery blood flow at rest was nearly twofold lower in patients with SSc compared with controls (22 ± 4 vs. 42 ± 5 ml/min, respectively; P < 0.05). Additionally, SSc patients had an ∼18% smaller brachial artery lumen diameter with an ∼28% thicker arterial wall at rest (P < 0.05). Although, during handgrip exercise, there were no differences in MAP between the groups, exercise-induced hyperemia and therefore vascular conductance were ∼35% lower at all exercise workloads in patients with SSc (P < 0.05). Brachial artery vasodilation, as assessed by the relationship between Δbrachial artery diameter and Δshear rate, was significantly attenuated in the patients with SSc (P < 0.05). Finally, vascular dysfunction in the patients with SSc was accompanied by elevated blood markers of oxidative stress and attenuated endogenous antioxidant activity (P < 0.05). Together, these findings reveal attenuated exercise-induced brachial artery blood flow and conduit arterial vasodilatory dysfunction during handgrip exercise in SSc and suggest that elevated oxidative stress may play a role.
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
Daniel R
0000-0002-2509-4686
DR
Machin
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
Heather L
HL
Clifton
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.|Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, Virginia.
Ryan S
RS
Garten
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
Jayson R
JR
Gifford
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.|Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.|Veterans Affairs Salt Lake City, GRECC, Salt Lake City, Utah; and.
Russell S
RS
Richardson
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.|Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.|Veterans Affairs Salt Lake City, GRECC, Salt Lake City, Utah; and.
D Walter
DW
Wray
Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
Tracy M
TM
Frech
Department of Internal Medicine, University of Utah, Salt Lake City, Utah; tony.donato@utah.edu.|Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah.|Department of Biochemistry, University of Utah, Salt Lake City, Utah.|Veterans Affairs Salt Lake City, GRECC, Salt Lake City, Utah; and.
Anthony J
AJ
Donato
D000975:Antioxidants / Q000378:metabolism; D001916:Brachial Artery / Q000503:physiopathology*; D016022:Case-Control Studies; D015444:Exercise; D005260:Female; D018737:Hand Strength; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D012039:Regional Blood Flow; D012595:Scleroderma, Systemic / Q000503:physiopathology*; D014664:Vasodilation / Q000502:physiology*
D000975:Antioxidants
handgrip; oxidative stress
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