Chronic changes in skeletal muscle histology and function in peripheral arterial disease
Peripheral arterial disease (PAD) is associated with an impairment in exercise performance and muscle function that is not fully explained by the reduced leg blood flow during exercise. This study characterized the effects of PAD on muscle function, histology, and metabolism. Twenty-six patients wit...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1993-02, Vol.87 (2), p.413-421 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | REGENSTEINER, J. G WOLFEL, E. E BRASS, E. P CARRY, M. R RINGEL, S. P HARGARTEN, M. E STAMM, E. R HIATT, W. R |
| description | Peripheral arterial disease (PAD) is associated with an impairment in exercise performance and muscle function that is not fully explained by the reduced leg blood flow during exercise. This study characterized the effects of PAD on muscle function, histology, and metabolism.
Twenty-six patients with PAD and six age-matched control subjects were studied. Ten of the PAD patients had unilateral disease, which permitted paired comparisons between their diseased and nonsymptomatic legs. All PAD patients had a lower peak treadmill walking time and peak oxygen consumption than controls. Vascular disease (diseased leg in unilateral patients and the most severely diseased leg in bilateral patients) was associated with decreased calf muscle strength compared with control values. In patients with unilateral disease, the diseased legs had a greater percentage of angular fibers (indicating chronic denervation) and a decreased type II fiber cross-sectional area (expressed as percent of total fiber area) compared with the nonsymptomatic, or control, legs. In diseased legs, gastrocnemius muscle strength was correlated with the total calf cross-sectional area (r = 0.78, p < 0.05) and type II fiber cross-sectional area (r = 0.63, p < 0.05). Activities of citrate synthase, phosphofructokinase, and lactate dehydrogenase in all 26 PAD patients (most diseased leg) did not differ from control values. Despite a wide range in citrate synthase activity in PAD patients, activity of this enzyme was not correlated with muscle strength or treadmill exercise performance.
In patients with PAD, gastrocnemius muscle weakness is associated with muscle fiber denervation and a decreased type II fiber cross-sectional area. In contrast, the PAD patients displayed substantial heterogeneity in muscle enzyme activities that was not associated with exercise performance. Denervation and type II fiber atrophy may contribute to the muscle dysfunction in patients with PAD and further confirm that the pathophysiology of chronic PAD extends beyond arterial obstruction. |
| doi_str_mv | 10.1161/01.cir.87.2.413 |
| format | Article |
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Twenty-six patients with PAD and six age-matched control subjects were studied. Ten of the PAD patients had unilateral disease, which permitted paired comparisons between their diseased and nonsymptomatic legs. All PAD patients had a lower peak treadmill walking time and peak oxygen consumption than controls. Vascular disease (diseased leg in unilateral patients and the most severely diseased leg in bilateral patients) was associated with decreased calf muscle strength compared with control values. In patients with unilateral disease, the diseased legs had a greater percentage of angular fibers (indicating chronic denervation) and a decreased type II fiber cross-sectional area (expressed as percent of total fiber area) compared with the nonsymptomatic, or control, legs. In diseased legs, gastrocnemius muscle strength was correlated with the total calf cross-sectional area (r = 0.78, p < 0.05) and type II fiber cross-sectional area (r = 0.63, p < 0.05). Activities of citrate synthase, phosphofructokinase, and lactate dehydrogenase in all 26 PAD patients (most diseased leg) did not differ from control values. Despite a wide range in citrate synthase activity in PAD patients, activity of this enzyme was not correlated with muscle strength or treadmill exercise performance.
In patients with PAD, gastrocnemius muscle weakness is associated with muscle fiber denervation and a decreased type II fiber cross-sectional area. In contrast, the PAD patients displayed substantial heterogeneity in muscle enzyme activities that was not associated with exercise performance. Denervation and type II fiber atrophy may contribute to the muscle dysfunction in patients with PAD and further confirm that the pathophysiology of chronic PAD extends beyond arterial obstruction.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.87.2.413</identifier><identifier>PMID: 8425290</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Arteries ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Forecasting ; Humans ; Male ; Medical sciences ; Muscles - enzymology ; Muscles - pathology ; Muscles - physiopathology ; Physical Endurance ; Physical Exertion ; Space life sciences ; Time Factors ; Vascular Diseases - enzymology ; Vascular Diseases - pathology ; Vascular Diseases - physiopathology</subject><ispartof>Circulation (New York, N.Y.), 1993-02, Vol.87 (2), p.413-421</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-344b8c37962bfb3d7b03eb58fd1494f2cc8572c06d209c3310ff9ee95eb66e423</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,3687,23930,23931,25140,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4610585$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8425290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>REGENSTEINER, J. G</creatorcontrib><creatorcontrib>WOLFEL, E. E</creatorcontrib><creatorcontrib>BRASS, E. P</creatorcontrib><creatorcontrib>CARRY, M. R</creatorcontrib><creatorcontrib>RINGEL, S. P</creatorcontrib><creatorcontrib>HARGARTEN, M. E</creatorcontrib><creatorcontrib>STAMM, E. R</creatorcontrib><creatorcontrib>HIATT, W. R</creatorcontrib><title>Chronic changes in skeletal muscle histology and function in peripheral arterial disease</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Peripheral arterial disease (PAD) is associated with an impairment in exercise performance and muscle function that is not fully explained by the reduced leg blood flow during exercise. This study characterized the effects of PAD on muscle function, histology, and metabolism.
Twenty-six patients with PAD and six age-matched control subjects were studied. Ten of the PAD patients had unilateral disease, which permitted paired comparisons between their diseased and nonsymptomatic legs. All PAD patients had a lower peak treadmill walking time and peak oxygen consumption than controls. Vascular disease (diseased leg in unilateral patients and the most severely diseased leg in bilateral patients) was associated with decreased calf muscle strength compared with control values. In patients with unilateral disease, the diseased legs had a greater percentage of angular fibers (indicating chronic denervation) and a decreased type II fiber cross-sectional area (expressed as percent of total fiber area) compared with the nonsymptomatic, or control, legs. In diseased legs, gastrocnemius muscle strength was correlated with the total calf cross-sectional area (r = 0.78, p < 0.05) and type II fiber cross-sectional area (r = 0.63, p < 0.05). Activities of citrate synthase, phosphofructokinase, and lactate dehydrogenase in all 26 PAD patients (most diseased leg) did not differ from control values. Despite a wide range in citrate synthase activity in PAD patients, activity of this enzyme was not correlated with muscle strength or treadmill exercise performance.
In patients with PAD, gastrocnemius muscle weakness is associated with muscle fiber denervation and a decreased type II fiber cross-sectional area. In contrast, the PAD patients displayed substantial heterogeneity in muscle enzyme activities that was not associated with exercise performance. Denervation and type II fiber atrophy may contribute to the muscle dysfunction in patients with PAD and further confirm that the pathophysiology of chronic PAD extends beyond arterial obstruction.</description><subject>Arteries</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Forecasting</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Muscles - enzymology</subject><subject>Muscles - pathology</subject><subject>Muscles - physiopathology</subject><subject>Physical Endurance</subject><subject>Physical Exertion</subject><subject>Space life sciences</subject><subject>Time Factors</subject><subject>Vascular Diseases - enzymology</subject><subject>Vascular Diseases - pathology</subject><subject>Vascular Diseases - physiopathology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtLw0AUhQdRaq2uXQlZiLuk88xjKcVHoSCIgrthMrnTjOblTLLov3ekoat7D-e7B-5B6JbghJCUrDFJtHVJniU04YSdoSURlMdcsOIcLTHGRZwxSi_RlfffQaYsEwu0yDkVtMBL9LWpXd9ZHeladXvwke0i_wMNjKqJ2snrBqLa-rFv-v0hUl0VmanTo-27f3IAZ4caXGCVG4MIS2U9KA_X6MKoxsPNPFfo8_npY_Ma795etpvHXawF4WPMOC9zzbIipaUpWZWVmEEpclMRXnBDtc5FRjVOK4oLzRjBxhQAhYAyTYFTtkIPx9zB9b8T-FG21mtoGtVBP3mZCZHi8HQA10dQu957B0YOzrbKHSTB8r9LiYncbN9lnkkqQ5fh4m6OnsoWqhM_lxf8-9lXXqvGONVp608YTwkWuWB_aZF9Gw</recordid><startdate>19930201</startdate><enddate>19930201</enddate><creator>REGENSTEINER, J. 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Miscellaneous</topic><topic>Forecasting</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Muscles - enzymology</topic><topic>Muscles - pathology</topic><topic>Muscles - physiopathology</topic><topic>Physical Endurance</topic><topic>Physical Exertion</topic><topic>Space life sciences</topic><topic>Time Factors</topic><topic>Vascular Diseases - enzymology</topic><topic>Vascular Diseases - pathology</topic><topic>Vascular Diseases - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>REGENSTEINER, J. G</creatorcontrib><creatorcontrib>WOLFEL, E. E</creatorcontrib><creatorcontrib>BRASS, E. P</creatorcontrib><creatorcontrib>CARRY, M. R</creatorcontrib><creatorcontrib>RINGEL, S. P</creatorcontrib><creatorcontrib>HARGARTEN, M. E</creatorcontrib><creatorcontrib>STAMM, E. R</creatorcontrib><creatorcontrib>HIATT, W. 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R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chronic changes in skeletal muscle histology and function in peripheral arterial disease</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1993-02-01</date><risdate>1993</risdate><volume>87</volume><issue>2</issue><spage>413</spage><epage>421</epage><pages>413-421</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Peripheral arterial disease (PAD) is associated with an impairment in exercise performance and muscle function that is not fully explained by the reduced leg blood flow during exercise. This study characterized the effects of PAD on muscle function, histology, and metabolism.
Twenty-six patients with PAD and six age-matched control subjects were studied. Ten of the PAD patients had unilateral disease, which permitted paired comparisons between their diseased and nonsymptomatic legs. All PAD patients had a lower peak treadmill walking time and peak oxygen consumption than controls. Vascular disease (diseased leg in unilateral patients and the most severely diseased leg in bilateral patients) was associated with decreased calf muscle strength compared with control values. In patients with unilateral disease, the diseased legs had a greater percentage of angular fibers (indicating chronic denervation) and a decreased type II fiber cross-sectional area (expressed as percent of total fiber area) compared with the nonsymptomatic, or control, legs. In diseased legs, gastrocnemius muscle strength was correlated with the total calf cross-sectional area (r = 0.78, p < 0.05) and type II fiber cross-sectional area (r = 0.63, p < 0.05). Activities of citrate synthase, phosphofructokinase, and lactate dehydrogenase in all 26 PAD patients (most diseased leg) did not differ from control values. Despite a wide range in citrate synthase activity in PAD patients, activity of this enzyme was not correlated with muscle strength or treadmill exercise performance.
In patients with PAD, gastrocnemius muscle weakness is associated with muscle fiber denervation and a decreased type II fiber cross-sectional area. In contrast, the PAD patients displayed substantial heterogeneity in muscle enzyme activities that was not associated with exercise performance. Denervation and type II fiber atrophy may contribute to the muscle dysfunction in patients with PAD and further confirm that the pathophysiology of chronic PAD extends beyond arterial obstruction.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>8425290</pmid><doi>10.1161/01.cir.87.2.413</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Arteries Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Forecasting Humans Male Medical sciences Muscles - enzymology Muscles - pathology Muscles - physiopathology Physical Endurance Physical Exertion Space life sciences Time Factors Vascular Diseases - enzymology Vascular Diseases - pathology Vascular Diseases - physiopathology |
| title | Chronic changes in skeletal muscle histology and function in peripheral arterial disease |
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