Koppe-Schmeißer Franziska, Schwaderlapp Melanie, Schmeißer Julian, Dopheide Jörn F, Münzel Thomas, Daiber Andreas, Espinola-Klein Christine
Center for Cardiology, Cardiology I-General and Interventional Cardiology and Intensive Care, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany.
Center for Cardiology, Cardiology III-Angiology, University Medical Center, Johannes Gutenberg-University, 55131 Mainz, Germany.
J Clin Med. 2021 Dec 13;10(24):5851. doi: 10.3390/jcm10245851.
In patients with intermittent claudication, exercise training ameliorates inflammation by reducing oxidative stress. A total of 41 patients with intermittent claudication (Rutherford 3) were included in the study (with 21 patients treated by endovascular revascularization (ER), and 20 patients without ER). All patients were referred to home-based exercise training. Absolute and initial claudication distance (ACD, ICD) and ABI (ankle-brachial index) were measured. ROS (reactive oxygen species) formation was measured using the luminol analogue L-012. Follow-up was performed after 3 months. ROS production after NOX2 (NAPDH oxidase 2) stimulation showed a significant reduction in both groups at follow-up (PTA group: = 0.002, control group: = 0.019), with a higher relative reduction in ROS in the PTA group than in the control group ( = 0.014). ABI measurements showed a significant increase in the PTA (peripheral transluminal angioplasty) group ( = 0.001), but not in the control group ( = 0.127). Comparing both groups at follow-up, ABI was higher in the PTA group ( = 0.047). Both groups showed a significant increas ACD and ICD at follow-up (PTA group: ACD: = 0.001, ICD: < 0.0001; control group: ACD: = 0.041, ICD: = 0.002). There was no significant difference between both groups at follow-up (ACD: = 0.421, ICD: = 0.839). Endovascular therapy in combination with exercise training leads to a lower leukocyte activation state with a reduced NOX2-derived ROS production paralleled by an improved ABI, ACD and ICD. Our data support the strategy to combine exercise training with preceding endovascular therapy.
在间歇性跛行患者中，运动训练通过降低氧化应激来改善炎症。本研究共纳入41例间歇性跛行患者（卢瑟福分级3级）（其中21例接受血管腔内血运重建术（ER）治疗，20例未接受ER治疗）。所有患者均接受居家运动训练。测量绝对和初始跛行距离（ACD、ICD）以及踝臂指数（ABI）。使用鲁米诺类似物L - 012测量活性氧（ROS）的形成。3个月后进行随访。随访时，两组在NOX2（烟酰胺腺嘌呤二核苷酸磷酸氧化酶2）刺激后ROS产生均显著降低（经皮腔内血管成形术（PTA）组：= 0.002，对照组：= 0.019），PTA组ROS的相对降低幅度高于对照组（= 0.014）。ABI测量显示PTA组有显著增加（= 0.001），而对照组无显著增加（= 0.127）。随访时比较两组，PTA组的ABI更高（= 0.047）。两组在随访时ACD和ICD均显著增加（PTA组：ACD：= 0.001，ICD：< 0.0001；对照组：ACD：= 0.041，ICD：= 0.002）。随访时两组之间无显著差异（ACD：= 0.421，ICD：= 0.839）。血管腔内治疗联合运动训练可导致白细胞激活状态降低，NOX2衍生的ROS产生减少，同时ABI、ACD和ICD得到改善。我们的数据支持将运动训练与先前的血管腔内治疗相结合的策略。
