Clinical Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana Slovenia.
Clinical Department of Anaesthesiology and Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231176815. doi: 10.1177/10760296231176815.
Patients with intermittent claudication have significantly higher levels of inflammatory biomarkers, particularly interleukins, which is also a consequence of exercise limitation. Physical activity, which is one of the preventive measures against atherosclerosis, is associated with a decrease in inflammatory biomarkers. Therefore, in our study, we investigated the effects of revascularization of peripheral arteries in patients with intermittent claudication on functional capacity and levels of inflammatory markers. The study included 26 patients with intermittent claudication who underwent percutaneous transluminal angioplasty (PTA). Before the procedure and 2-4 months after successful revascularization, the ankle-brachial index (ABI), functional capacity using the treadmill test, and the walking impairment questionnaire (WIQ) were determined. Inflammatory biomarkers were also measured before and after procedures. Successful revascularization was associated with an increase in intermittent claudication: 120 (20-315) versus 300 (100-1000 m), < 0.001. Treadmill testing showed a significant increase in initial and maximal walking distance. After revascularization, ABI increased significantly (0.55 vs 0.82, < 0.003). Improvement in functional performance was also demonstrated by WIQ. Two to three months after revascularization, some inflammatory biomarkers decreased significantly: fibrinogen, interleukin-6 (IL-6), and interleukin-8 (IL-8). The high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-alpha (TNFα) also did not decrease significantly. The levels of some inflammatory markers: IL-6, TNFα, and fibrinogen were significantly related to the improvement in patients' functional capacity. The results of our study show that successful revascularization of the lower limb arteries not only improves the functional capacity of patients with intermittent claudication, but also reduces the systemic inflammatory response and may have a preventive effect on local and concomitant other atherosclerotic diseases.
间歇性跛行患者的炎症生物标志物水平显著升高,特别是白细胞介素,这也是运动受限的结果。作为动脉粥样硬化预防措施之一的体力活动与炎症生物标志物的降低有关。因此,在我们的研究中,我们调查了外周动脉再通对间歇性跛行患者的功能能力和炎症标志物水平的影响。该研究纳入了 26 名接受经皮腔内血管成形术(PTA)的间歇性跛行患者。在手术前和成功再通后 2-4 个月,测定踝臂指数(ABI)、跑步机测试的功能能力和步行障碍问卷(WIQ)。还在手术前后测定了炎症生物标志物。成功的再通与间歇性跛行的增加有关:120(20-315)与 300(100-1000 m),<0.001。跑步机测试显示初始和最大步行距离显著增加。再通后 ABI 显著增加(0.55 与 0.82,<0.003)。WIQ 也显示了功能表现的改善。再通后 2-3 个月,一些炎症生物标志物显著降低:纤维蛋白原、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)。高敏 C 反应蛋白(hsCRP)和肿瘤坏死因子-α(TNFα)也没有显著降低。一些炎症标志物的水平:IL-6、TNFα和纤维蛋白原与患者功能能力的改善显著相关。我们的研究结果表明,下肢动脉的成功再通不仅改善了间歇性跛行患者的功能能力,还降低了全身炎症反应,可能对局部和伴随的其他动脉粥样硬化疾病具有预防作用。