The improvement of walking abilities and endothelial function after the supervised training treadmill program (STTP) in patients with peripheral artery disease (PAD) is not related to prostacyclin and thromboxane release.

BACKGROUND

In this prospective study we evaluated the relationship between thromboxane B2 (TXB2), prostacyclin (PGI2) and lactate concentrations, and the improvement of walking abilities and endothelial function in patients with peripheral artery disease (PAD) undergoing a supervised treadmill training program (STTP).

METHODS

A total of fifty-nine patients with stable intermittent claudication were included into a 12-week long STTP. Changes in blood pressure, biochemical parameters, ankle/brachial index (ABI), flow-mediated dilatation (FMD), maximal walking time (MWT) and pain-free walking time (PFWT) were assessed before and after STTP. Additional baseline and post-STTP measurements were taken for blood lactate, and TXB2 and PGI2 urinary derivatives before and after maximal exercise (ME).

RESULTS

The MWT improved significantly after STTP by 91% (p<0.0001) and PFWT by 97% (p<0.0001). Also, ABI values improved significantly after STTP in all patient groups and was more pronounced in those with longer MWT at baseline. FMD values increased by 45% (p<0.0001) after STTP. Urinary 11-dehydro-thromboxane B2 and 2,3-dinor-6-keto-PGF1α concentration tend to decrease after STTP and their ratio remained unchanged. Lactate levels did not change after the treadmill training program. Hs-CRP and fibrinogen concentration decreased significantly after STTP only in patients with longer MWT at baseline-fourth quartile.

CONCLUSIONS

STTP in patients with PAD showed significantly improved walking abilities and endothelial function. Lactate production, TXB2 release, and PGI2 release are not directly correlated with improvement of endothelial function and walking abilities. Patients with better-walking abilities at baseline derive greater clinical and metabolic benefits from STTP.