Response of peripheral arterial pulse wave velocity to acute exercise in patients after recent myocardial infarction and healthy controls.

Y Trachsel,L D Trachsel,T Marcin,D Herzig,N Zenger,P Eser,M Dysli,M Wilhelm,Lena Jonasson

doi:10.1371/journal.pone.0219146

Y Trachsel, L D Trachsel + Show 7 more

Open Access

https://doi.org/10.1371/journal.pone.0219146

Copy DOI

Abstract

BackgroundMany studies found increased central arterial stiffness and poor endothelial function in patients with coronary artery disease (CAD). Acute exercise has been shown to decrease peripheral pulse wave velocity (pPWV) in young healthy volunteers. We hypothesized the response to acute exercise to be diminished in CAD patients compared to healthy young (HY) and age-matched (HAM) controls.MethodsIn 21 patients after recent myocardial infarction (CAD), 11 HAM and 10 HY pPWV was measured by applanation tonometry at the proximal femoral artery and the posterior tibial artery at rest and from 5 to 15 min after cessation of exhaustive exercise. Heart rate (HR) and blood pressure (BP) were monitored continuously. Resting central PWV (cPWV) was measured between the carotid and femoral arteries. Resting values and reponses to acute exercise were compared between the three groups and predictors for pPWV response were sought.ResultsThe response in pPWV to acute exercise seen in HY (lowering in pPWV by 17%) was absent in both CAD and HAM. Resting pPWV was not statistically different between the three groups, while cPWV was comparable in CAD and HAM but 17% lower in HY. Predictors for response in pPWV to exercise were age (Spearman r = 0.48), cPWV (r = 0.34) and response in diastolic BP (r = 0.32).ConclusionThe response in pPWV to acute exercise observed in HY was absent in CAD and HAM. In dilated peripheral arteries, PWV may reflect stiffness of passive vessel structures, which are likely to increase with age in healthy persons and CAD alike.

Highlights

Exercise training in patients with coronary artery disease (CAD) has been shown to increase exercise capacity [1] and decrease cardiovascular and all-cause mortality [2]
The response in peripheral pulse wave velocity (pPWV) to acute exercise seen in healthy young (HY) was absent in both CAD and HAM
Resting pPWV was not statistically different between the three groups, while central PWV (cPWV) was comparable in CAD and HAM but 17% lower in HY

Summary

Introduction

Exercise training in patients with coronary artery disease (CAD) has been shown to increase exercise capacity [1] and decrease cardiovascular and all-cause mortality [2]. Dilation of peripheral large arteries as a response to acute exercise has been quantified by measuring artery diameter changes, flow changes or changes in pulse wave velocity (PWV). Previous studies in young healthy subjects and elderly cardiac patients have suggested that pPVW measured during hyperemia after occlusion may be a surrogate for flow-mediated dilatation (FMD, relative change in arterial diameter) following occlusion [15,16,17,18]. Two studies that have directly compared post-occlusion pPWV measurements to FMD measured by ultrasound have found only partial agreement [17,19] This implies that endothelial function is likely to play a role in post-exercise decrease of pPWV, but may not be the only important variable. Acute exercise has been shown to decrease peripheral pulse wave velocity (pPWV) in young healthy volunteers. We hypothesized the response to acute exercise to be diminished in CAD patients compared to healthy young (HY) and age-matched (HAM) controls

Methods

Discussion

Conclusion