The effects of Kaatsu training on an acute angiogenic response in post-interventional rehabilitation of peripheral arterial disease patients

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Atherosclerosis as the main cause of death in adults is one of the greatest challenges of modern medicine. Peripheral arterial disease (PAD) is a condition with worldwide increasing occurrence affecting more than 20% of Europeans and North Americans in the age group> 55 years, and in the group> 70 years of age affects as much as 60% of the population. Among many treatment forms the endovascular treatment remains the most common treatment method, however the most non-invasive, but still effective is rehabilitation by physical training. Recently, innovative solutions have been introduced concerning this form of treatment by combining anaerobic interval exercises with venous blood flow restriction (BFR) and cooling. Purpose The aim of the research is to evaluate the endothelial and angiogenic response to the aforementioned type of exercise. Methods Study was divided into 2 stages: with healthy volunteers and non-CLI patients. 35 healthy volunteers were enrolled into the 1st stage. They performed a 21-minute interval training using a cross trainer with cooling liquid pressure cuffs (arms: 40 mmHg; legs: 65 mmHg) providing vein occlusion and cooling seat. Angiogenic processes and endothelial functions were monitored by laboratory parameters - vascular endothelial growth factor (VEGF), clusters of differentiation (CD31, CD34) as well as imaging examinations – flow mediated dilatation (FMD), stiffness index (SI), reflexion index (RI), reactive hyperaemia index (RHI) and augmentation index (AI). All measurements were performed before, as well as 20 to 30 minutes after the training. Results All of the laboratory parameters were significantly elevated after the BFRT- CD34 (ΔCD34: 0.13 vs 0.01 p < 0,001), CD31 (ΔCD31: 1.11 vs 0.37 p < 0,001) and VEGFR (ΔVEGFR: 6.35 vs 2.86 p < 0.001).Only FMD and RI of all endothelial imaging parametrs significantly changed after BFRT compared to regular training (FMD: 8.9% vs 7.41 p < 0,001 ΔFMD: 2.89 vs 1.33 p < 0,01; RI: 63.43 vs 69.49 p < 0,001, ΔRI: 4.0 vs 2.0, p > 0,001). RHI and AI weren’t significantly influenced by any exercise type. Conclusions BFR training successfully stimulates acute angiogenic response and moderately influences certain endothelial functions. This 1st stage results are being now implemented into the 2nd part of project involving PAD patients.