Positive effect of oral buflomedil on exercise-induced haemorheological damage and on claudication distance in peripheral obliterative arterial disease patients.

Abstract

Introduction In a previous study we demonstrated that isotonic exercise of the lower limbs in peripheral obliterative arterial disease patients could induce a highly significant decrease in blood filterability in venous blood taken from the femoral vein, besides a significant rise of the lactic acid level with a decrease in venous p02 and an increase in the A-V p02 difference (Guerrini et aI1982). This rheological impairment may be considered as an expression of the hyperviscosity syndrome secondary to vascular disease (Di Perri et al 1983), and as such it might be secondary and dependent to a tissue ischaemia. After isotonic exercise and a recovery period (not more than 30 minutes), the patients were treated with Buflomedil intravenously (100 mg in 2 minutes) and 10 minutes after the end of the infusion they were tested a second time in the same manner. After the second exercise, while the lactic acid level was not significantly different from the corresponding changes after the baseline exercise test, no rheological impairment was observed. These findings suggest, along with the 'in vitro' studies of other authors (Teitel & MussIer 1980, Teitel, Tietz & Vezlen 1981), that the action of the drug may be directed to the red blood cell, preventing the metabolic tissue acidosis from affecting the cell's rheological characteristics (Guerrini et al 1982). The rheological effect of Buflomedil was confirmed by other authors (Coccheri et al 1982, Oormandy & Ernst 1981) while its therapeutic action was demonstrated as well (SunderPlassman, Messmer & Becker 1981, Landgraf, Ehrly & Hildebrandt 1980). On the basis of these findings we set out to evaluate if Buflomedil could induce the same effect if administered per os and we determined to see whether a prolonged treatment could improve the 'performance' of vascular patients.