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Revascularization prevents fibrosis progression in patients with PAD
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Patients with peripheral artery disease who underwent revascularization saw a halt in progression of fibrosis, but patients who had supervised exercise therapy did not, according to results of a study presented at the American Heart Association’s Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease Scientific Sessions.
Both interventions improved walking performance.
Researchers collected gastrocnemius biopsies from 56 patients with PAD at baseline and 6 months. Twenty patients underwent surgical or endovascular revascularization, 19 underwent supervised exercise therapy and 17 had no intervention.
The primary outcome was improvement in performance of transforming growth factor-beta 1-dependent fibrosis. Transforming growth factor-beta 1 is a cytokine known to stimulate collagen deposition. Secondary outcomes included collagen abundance, 6-minute walk distance and peak walking time.
At 6 months, expression of transforming growth factor-beta 1 increased in the control group (P < .001) and the exercise therapy group (P < .001), but not in the revascularization group. Similarly, collagen density increased in the control group (P < .001) and the exercise therapy group (P < .001) but not in the revascularization group, according to the results reported.
Six-minute walk distance improved in the revascularization group (P < .05), but not in the exercise or control groups, and peak walking time improved in the revascularization (P < .05) and exercise (P < .01) groups, but not in the control group.
“Increasing blood flow to the leg with revascularization procedures halted the progression of scarring and allowed the patients to walk longer and further,” Duy Ha, a doctoral candidate in cellular and integrative physiology at the University of Nebraska Medical Center, Omaha, said in a press release. “This suggests that the long-term benefits to the health of leg muscles is better with revascularization than with exercise therapy alone.” – by Erik Swain
Reference:
Ha D, et al. Abstract 116. Presented at: Arteriosclerosis, Thrombosis and Vascular Biology/Peripheral Vascular Disease 2016 Scientific Sessions; May 5-7, 2016; Nashville, Tenn.
Disclosure: Ha reports no relevant financial disclosures.