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Results for “CLAUDICATION”

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PubMed2006

Objective evaluation of upper limb claudication: use of isokinetic dynamometry.

OBJECTIVE: The objective of this work is to present an objective, practical, and reproducible method for evaluating the functional limitation caused by occlusive arterial disease in upper limbs: a stress test using an isokinetic dynamometer. METHODS: Twenty-three patients with unilateral subclavian artery occlusive disease were included in the study, forming group 1. Seven patients of similar age, with atherosclerotic or Takayasu's disease in the aorto-iliac segment, without subclavian artery occlusive disease, were included as a control group (group 2). For all tests, we utilized the CYBEX 6000 isokinetic dynamometer. The elbow was tested using a series of 30 repetitions of extension and flexion of the arm, performed up to a maximum of 270 repetitions (9 series) or until the limit of the tested limb was reached. RESULTS: We initially compared all the limbs without arterial disease of both groups to analyze whether they presented similar functional performance. No significant difference was found for any of the parameters studied. Considering that upper limbs without arterial disease have a similar response to exercise in these analyzed parameters, we compared the upper limbs in group 1 (with and without subclavian artery occlusive disease). For all parameters, the limbs with subclavian artery occlusive disease presented significantly lower values than the control limbs (P < 0.05), which can be objectively attributed to the ischemia (there were different responses in different individuals, which allows the quantification of the limitation caused by subclavian artery occlusive disease). CONCLUSION: In this study, we present a new stress test for impairment in patients with subclavian artery occlusive disease that might facilitate the classification of patients according to their functional impairment, and thus result in a better choice of therapeutic approach for each case as well as reporting of objective parameters that allow comparisons of the results of different treatments, including for long-term follow-up.

Adult↗
PubMedDate not supplied

Statins and biomarkers in claudicants with peripheral arterial disease: cross-sectional study.

This exploratory substudy of The Iron (Fe) and Atherosclerosis Study (FeAST) compared baseline inflammatory markers, including cytokines, C-reactive protein (CRP), and ferritin, in subjects with peripheral arterial disease (PAD) taking statins with subjects with PAD who were not taking statins. Inflammatory markers in the serum of 47 subjects with PAD not taking statins and a healthy cohort of 21 medication-free men were compared with 53 PAD subjects taking statins at entry to the FeAST. Healthy subjects demonstrated lower levels of tumor necrosis factor (TNF)-R1, interleukin-6 (IL-6), and CRP. TNF-alpha R1 averaged 2.28 ng/mL versus 3.52 ng/mL, p = .0025; IL-6 averaged 4.24 pg/mL versus 16.61 pg/mL, p = .0008; and CRP averaged 0.58 mg/dL versus 0.92 mg/dL, p = .0192. A higher level of IL-6 was observed in PAD statin takers versus PAD subjects not taking statins: 19.47 pg/mL versus 13.24 pg/mL, p = .0455. As expected, total cholesterol and low-density lipoprotein levels were lower in the statin-treated group, p = .0006 and p = .0001, respectively. No significant differences in inflammatory cytokines were detected for varying doses of simvastatin. Additionally, no significant differences in inflammatory biomedical markers were found in subjects with PAD alone compared with those with concomitant coronary artery disease (CAD). Unexpectedly, serum inflammatory cytokine IL-6 levels were significantly higher in PAD subjects receiving statins. There was no difference in measured inflammatory markers in PAD subjects with concomitant CAD.

Aged↗
PubMed1978

Lower leg blood flow in intermittent claudication.

Lower leg blood flow was measured at rest and both during and after graduated bicycle exercise in five healthy men and in seventeen patients suffering from various degrees of obliterating arteriosclerosis of the lower limbs. A thermodilution technique was used for flow determinations. The subject exercised in the sitting position and the work load was increased stepwise from a starting load of 100 kpm/min (100 kpm/min load increment every second minute until exhaustion). Three flow phases were depicted during and after the exercise: the aerobic phase, the phase of relative ischaemia and a postexercise phase. During exercise, lower leg blood flow increased approximately twenty times in healthy subjects, while in the arteriosclerotic subjects there was a two-fold to ten-fold increase in flow. In patients with serious distal and proximal stenoses a proximal steal phenomenon was demonstrated during submaximal and maximal exercise. A close correlation was found between maximum individual work load capacity and maximum lower leg blood flow (r = 0.71, P less than 0.001). In the patient group lower leg blood flow at a certain work load was 45% (P less than 0.001) higher in the sitting than in the supine position.

Adult↗