AEROBIC TRAINING WITH LIMBS INTERMITTENT ISCHEMIA IMPROVES MYOCARDIAL FUNCTION AND WALL STRETCH IN PATIENTS WITH CLAUDICATION

Background: peripheral arterial disease (PAD) is a chronic disease determining functional impairment and increased risk of cardiovascular events. Physical training improves cardiac performance and reduces NTproBNP concentration, marker of risk of cardiovascular events, in cardiac patients. Aim: we aimed to examine the effects training conducted till ischemic pain at the leg of PAD patients on myocardial function and peripheral flux.Methods: we enrolled 22 patients affected by peripheral arterial disease without cardiac disease. All patients undergone a physical training of 15 days, with treadmill test at the begin and at the end of training. Results: at the end of training patients increased walking distance (450±180 m vs 250±108 m; p<0.05). We documented at rest, at the end of physical training, an increase in flow volume of common femoral artery of the symptomatic leg (2,55±2,13 L/min vs 1,86±1,30 L/min; p<0.05); NTproBNP concentration at rest was lower al the end of training (210±130 pg/mL vs 188±108 pg/mL; p<0.005), an increase of NTproBNP concentration after maximal exercise on treadmill before treatment, with a reduced increase at the end of training period (24±21 vs 12±10 pg/mL; p<0.0005); a reduction of end-diastolic diameter of left ventricle at rest (48±4 mm vs 50±5 mm; p<0.05). The ejection fraction did not changed, while heart rate reduced after training (66±9 bpm vs 71±12 bpm; p<0.05). Conclusions: this study documented an improvement of hemodynamic and cardiac performance in response of physical training in peripheral arterial disease patients not affected by cardiac disease. Further trials will be necessary to evaluate the use of NTproBNP as a marker of good response to physical training in these patients.