Abstract | OBJECTIVE: Home-based exercise is an alternative exercise mode to a structured supervised program to improve symptoms in patients with peripheral artery disease (PAD), but little is known about whether the slow-paced and less intense home program also elicits changes in vascular and inflammatory biomarkers. In an exploratory analysis from a randomized controlled trial, we compared changes in vascular and inflammatory biomarkers in patients with symptomatic PAD (typical and atypical of claudication) after home-based exercise and supervised exercise programs and in an attention-control group. METHODS: A total of 114 patients were randomized into one of the three groups (n = 38 per group). Two groups performed exercise interventions, consisting of home-based and supervised programs of intermittent walking to mild to moderate claudication pain for 12 weeks; a third group performed light resistance training as a nonwalking attention-control group. Before and after intervention, patients were characterized on treadmill performance and endothelial effects of circulating factors present in sera by a cell culture-based bioassay on primary human arterial endothelial cells, and they were further evaluated on circulating vascular and inflammatory biomarkers. RESULTS: CONCLUSIONS: This exploratory analysis found that both home-based and supervised exercise programs are efficacious to decrease cultured endothelial cell apoptosis in patients with symptomatic PAD. Furthermore, a monitored home-based exercise program elicits additional vascular benefits by improving circulating markers of endogenous antioxidant capacity, angiogenesis, endothelium-derived inflammation, and blood glucose concentration in patients with symptomatic PAD. The novel clinical significance is that important trends were found in this exploratory analysis that a contemporary home-based exercise program and a traditional supervised exercise program may favorably improve vascular and inflammatory biomarkers in addition to the well-described ambulatory improvements in symptomatic patients with PAD.
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Authors | Andrew W Gardner, Donald E Parker, Polly S Montgomery |
Journal | Journal of vascular surgery
(J Vasc Surg)
Vol. 70
Issue 4
Pg. 1280-1290
(10 2019)
ISSN: 1097-6809 [Electronic] United States |
PMID | 30922751
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Angiogenic Proteins
- Biomarkers
- Inflammation Mediators
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Topics |
- Aged
- Angiogenic Proteins
(blood)
- Apoptosis
- Biomarkers
(blood)
- Cells, Cultured
- Endothelial Cells
(metabolism, pathology)
- Exercise Therapy
- Female
- Home Care Services
- Humans
- Inflammation Mediators
(blood)
- Intermittent Claudication
(blood, diagnosis, physiopathology, rehabilitation)
- Male
- Middle Aged
- Neovascularization, Physiologic
- Oklahoma
- Oxidative Stress
- Peripheral Arterial Disease
(blood, diagnosis, physiopathology, rehabilitation)
- Time Factors
- Treatment Outcome
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