The systemic effects of intermittent claudication are reversed by angioplasty

Introduction: exercise in patients with intermittent claudication causes sy stemic effects, the consequences of which are unknown. This study investiga tes whether successful PTA reverses the systemic effects. Patients and Methods: ten patients with IC were recruited prior to PTA. Hav ing emptied their bladders and rested for 1 h, pre-exercise blood and urine samples were collected. Patients underwent treadmill exercise to maximum w alking time and blood samples were collected at 10, 20 and 30 min. A second urine sample was collected at 60 min. Total antioxidant capacity (TAC) and von Willebrands Factor (vWF) were measured in blood and albumin/creatinine ratio (ACR) and retinol binding protein/creatinine ratio (RBP/Cr) in urine , Patients were recalled 2 weeks after successful angioplasty and the proto col repeated. Following PTA patients walked for a maximum of 5 min. Results: there was no significant change in vWF. Exercise in claudicants in duced a significant increase ill median ACR (pre/post exercise=0.85; p=0.03 ) and in median RBP/Cr (pre/post exercise=1.8; p=0.04). These changes were no longer evident after successful PTA. TAC was significantly different bef ore and after angioplasty at all time intervals. Conclusion: successful PTA reverses glomerular effects of exercise in claud icants. Future work should investigate the use of PTA in conjunction with e xercise in the treatment Of peripheral vascular disease.