Effects Of Peripheral Revascularization On Blood Pressure And Calf Muscle Oxygen Saturation In Peripheral Artery Disease

Peripheral artery disease (PAD) reduces oxygen supply to skeletal muscle that causes an exaggerated blood pressure response to exercise. Revascularization procedures have been important for treating impaired limb perfusion caused by PAD. However, to what extent these procedures improve tissue perfusion during exercise or normalize the exercise pressor reflex in PAD remains unknown. The purpose of the study was to examine whether revascularization reduces the exercise pressor reflex and improves skeletal muscle oxygen saturation (SmO2) measured using near-infrared spectroscopy (NIRS). Six PAD patients performed incremental supine plantar flexion exercise, starting at 0.5 kg and increased by 0.5 kg every minute for up to 14 minutes, pre- and one-month post peripheral revascularization procedure. SmO2 was measured continuously from the gastrocnemius muscle, while heart rate and blood pressure were measured beat-by-beat. Reductions in SmO2 from baseline to 1.5 kg were attenuated post-revascularization when compared to pre-intervention (-6.5 ± 6.2% vs. -39.8 ± 22.5%, P < .05). The change in mean arterial blood pressure was reduced post-revascularization (4 ± 4 mmHg vs. 16 ± 12 mmHg P < .05). These data suggest that revascularization reverses the rapid decline in SmO2 and attenuates the blood pressure response during exercise in patients with PAD.