Abstract 20913: Endothelial Cell Inflammation and Antioxidant Capacity Are Associated With 6-Minute Walk Performance in Patients With Symptomatic Peripheral Artery Disease

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Introduction: The aim of the study was to determine whether 6-minute walk total distance and pain-free distance were associated with circulating biomarkers of antioxidant capacity and inflammation, and with endothelial cell inflammation, oxidative stress, and apoptosis in patients with symptomatic peripheral artery disease (PAD). Methods: Exercise performance in 251 patients was assessed by pain-free distance and total distance covered during a 6-minute walk test. Patients were further characterized on clinical characteristics, on circulating biomarkers of antioxidant capacity and inflammation, and on the endothelial effects of circulating factors present in the sera using a cell culture-based bioassay on primary human arterial endothelial cells. Results: In a multivariate regression model, pain-free distance during the 6-minute walk test was negatively associated with dyslipidemia (p<0.001), chronic kidney disease (p=0.004), and NF-κB (p=0.007), and was positively associated with height (p=0.008). In multivariate analyses, total distance walked during the 6-minute walk test was negatively associated with NF-κB (p< 0.001), coronary artery disease (p=0.009), and BMI (p=0.022), and was positively associated with ABI (p<0.001), male sex (p<0.001), and hydroxyl radical antioxidant capacity (p<0.001). Conclusions: 6-minute walk performance in symptomatic patients with PAD was associated with vascular biomarkers, as walking distances were negatively associated with endothelial cell inflammation and positively associated with circulating antioxidant capacity. The clinical implication is that behavioral interventions designed to alleviate endothelial cell inflammation and increase circulating antioxidant capacity, such as exercise and antioxidant intake, may improve ambulatory ability in patients with PAD during submaximal exercise that is typically performed during daily activities.