ACUTE EXERCISE AND MARKERS OF ENDOTHELIAL INJURY IN PERIPHERAL ARTERIAL-DISEASE

Objectives: To determine the acute effects of exercise on plasma level s of markers of endothelial damage in patients with symptomatic periph eral arterial occlusive disease (PAOD). Design: Prospective observatio nal study of patients with angiographically proven PAOD undergoing tre admill exercise testing prior to surgical or radiological intervention . Materials and methods: Ante-cubital venous blood sampling was perfor med in 20 patients with symptomatic PAOD prior to, and 2 min after, tr eadmill exercise testing. Samples were then assayed for von Willebrand factor (vWf), tissue-type plasminogen activator (tPa), and plasminoge n activator inhibitor (PAI) levels. Results: Despite a significant fal l in median ankle-brachial pressure indices form 0.96 pre-exercise to 0.59 post-exercise on the right, and from 0.92 to 0.40 on the left (bo th p<0.005), there were no significant changes in plasma levels of vWf , tPa, or PAI following claudication-inducing exercise. Conclusions: C laudication-inducing exercise does not produce acute alterations in pl asma markers of endothelial damage, and the results of this study do n ot support the belief that claudication-inducing exercise in PAOD is d amaging to vascular endothelium.