Determinants of peak Vo(2) in peripheral arterial occlusive disease patients

Peripheral arterial occlusive disease (PAOD) patients with intermittent cla udication are functionally limited and deconditioned. This study examined w hether peak aerobic capacity ((V)over doto(2) peak) was associated with PAO D severity, muscle mass, and comorbidities in 109 PAOD patients (93 men and 16 women) aged 48-86 years. The (V)over dot o(2) peak (1.12 +/- 0.34 L/min ), percentage body fat (30.6 +/- 8.3%), lean tissue mass of the total body (51.4 +/- 8.4 kg), lean tissue mass of the legs (16.6 +/- 3.0 kg), and appe ndicular skeletal mass (22.8 +/- 4.2 kg) were determined. The lean tissue m ass of the total body (r = .44), lean tissue of the legs (r = .43) and rest ing ankle/brachial systolic pressure index (ABI; r = .41) correlated with p eak (V)over doto(2) (all p < .001). None of the comorbidity variables (obes ity, arthritis, coronary artery disease, hypertension, diabetes, and smokin g history) were significantly associated with peak (V)over doto(2) except s moking status. The final model for the prediction of peak (V)over doto(2) i ncluded lean tissue mass of the legs, resting ABI, smoking status, and ABI x smoking status (r(2) = .37,p < .001). In older patients with intermittent claudication, lean tissue mass is an important determinant of physical per formance independent of PAOD severity and smoking status. Prevention of mus cle atrophy may preserve ambulatory function and peak exercise capacity in older PAOD patients.