Improvement of peripheral and cardiopulmonary performance after a short-term exercise program with additive...

In patients with intermittent claudication, the walking distance can be increased, both by means of several months of intensive training and administration of IV prostaglandin E1 (PGE1) for 4 weeks. The aim of this study was, therefore, to investigate whether the combination of intensive training and PGE1 infusions during pedalergometry can increase peripheral and cardiopulmonary performance after 2 weeks. Ten patients with intermittent claudication received a once-daily intravenous infusion of 60 microg PGE1 over 2 hours during pedalergometry. In addition, a physical training program was carried out mornings and afternoons, as well as progressive treadmill training. Walking distance (3 km/h, 12%) and cardiopulmonary performance were determined at the beginning and end of the 2-week treatment. Results were compared with those of a historical control group having received a similar training program without PGE1. The initial walking distance increased from 71 to 166 m (134%). At the same time, peak work load increased by 108%, and the physical work capacity by 100%. Cardiopulmonary function improvement was reflected in all the parameters investigated (peak VO2; peak VO2/peak work load ratio; slope of deltaVO2/deltat; RER). Compared with the historical control group, the difference between the two groups with regard to the increase in walking distance was significant in favor of the combined training program with PGE1. The combination of short-term intensive training and PGE1 infusions during pedal ergometry significantly improves both the peripheral as well as the highly restricted functional capacity in patients with intermittent claudication.