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Van Schaardenburgh 2013 Abstract IOC75

From Bioblast
Van Schaardenburgh M (2013) Five Plus Study. Mitochondr Physiol Network 18.03.

Link: IOC75 Open Access

Van Schaardenburgh M (2013)

Event: IOC75

Michel Van Schaardenburgh

The aim of the Five Plus study is to investigate the mitochondrial reaction of muscle tissue on training in patients with peripheral arterial disease (PAD).

Peripheral arterial disease (PAD) is caused by atherosclerosis that leads to arterial stenosis and occlusions in the major vessels supplying the lower extremities. Vascular surgeons measure the degree of arterial insufficiency secondary to these stenosis and occlusions by dividing the blood pressure of the ankle by that of the arm (ABI). An ABI under 0.9 is a sign of PAD.

PAD is divided into 3 levels of arterial insufficiency.

  1. Asymptomatic PAD; ABI under 0.9: patients do not experience any specific symptoms.
  2. Intermittent claudication (IC); IC is characterized by repeated muscle discomfort in the lower limb reproduced by exercise and relieved by rest within 10 minutes. Patients may complain of muscle fatigue, aching or cramping. Ankle-brachial index is between 0.4 and 0.9. 1
  3. Critical limb ischemia is described as a decrease in limb perfusion that causes a potential threat to its viability. The condition includes non-healing ulcerations, ischemic rest pain or pedal gangrene. Ankle-brachial index is usually between 0 and 0.4. 1

Mitochondria in patients with peripheral arterial disease do not have the capacity to produce as much ATP as normal muscle mitochondria. Patients with PAD find themselves in double jeopardy; not only do they have a decreased supply of nutrients and oxygen, as a result of diseased arteries, but the concurrent mitochondrial respiratory defect leads to even less ATP production from the amount of O2 present in spite of the atherosclerotic disease. 2,3,4

In this study we will mainly concentrate on patients with intermittent claudication (IC).

Current evidence does not support the hypothesis that training of this patient group leads to a significant improvement in blood flow.5 Explanations of improvements are linked to metabolic changes and increased oxidative capacity of skeletal muscles. 1,2,3

Resistance training increases the efficiency of mitochondria and the oxidative energy transfer.6 The question arises whether improved mitochondrial function can partly compensate for less O2 and improve the clinical situation of our study group.


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References

  1. L. Norgren, W. R. Hiatt, J. A. Dormandy, M. R. Nehler, K. A. Harris, F. G. Fowkes, K. Bell, J. Caporusso, I. Durand-Zaleski, K. Komori, J. Lammer, C. Liapis, S. Novo, M. Razavi, J. Robbs, N. Schaper, H. Shigematsu, M. Sapoval, C. White, J. White, D. Clement, M. Creager, M. Jaff, E. Mohler, 3rd, R. B. Rutherford, P. Sheehan, H. Sillesen, and K. Rosenfield, 'Inter-Society Consensus for the Management of Peripheral Arterial Disease (Tasc Ii )', European journal of vascular and endovascular surgery, 33 Suppl 1 (2007), S1-75.
  2. Pipinos, II, A. R. Judge, J. T. Selsby, Z. Zhu, S. A. Swanson, A. A. Nella, and S. L. Dodd, 'The Myopathy of Peripheral Arterial Occlusive Disease: Part 1. Functional and Histomorphological Changes and Evidence for Mitochondrial Dysfunction', Vascular and endovascular surgery, 41 (2007), 481-9.
  3. Pipinos, II, A. R. Judge, J. T. Selsby, Z. Zhu, S. A. Swanson, A. A. Nella, and S. L. Dodd, 'The Myopathy of Peripheral Arterial Occlusive Disease: Part 2. Oxidative Stress, Neuropathy, and Shift in Muscle Fiber Type', Vascular and endovascular surgery, 42 (2008), 101-12.
  4. Pipinos, II, V. G. Sharov, A. D. Shepard, P. V. Anagnostopoulos, A. Katsamouris, A. Todor, K. A. Filis, and H. N. Sabbah, 'Abnormal Mitochondrial Respiration in Skeletal Muscle in Patients with Peripheral Arterial Disease', J Vasc Surg, 38 (2003), 827-32.
  5. K. H. Tan, L. De Cossart, and P. R. Edwards, 'Exercise Training and Peripheral Vascular Disease', The British journal of surgery, 87 (2000), 553-62.
  6. M. Tonkonogi, and K. Sahlin, 'Physical Exercise and Mitochondrial Function in Human Skeletal Muscle', Exerc Sport Sci Rev, 30 (2002), 129-37.


Figure 1

Five Plus

Five Plus

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