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Free radical production in peripheral vascular disease. A risk for critical ischaemia?
G Ciuffetti1, M Mercuri, E Mannarino
12nd Department of Internal Medicine, University of Perugia, Italy.
Abstract:
Malondialdehyde (MDA) plasma concentrations (marker of lipid free radical peroxidation) and the unfractionated leucocyte and erythrocyte filterability rates (through 5 micron Nuclepore filters in a positive pressure filtration system) were determined during a partial ischaemia induced by two consecutive treadmill tests in 64 stage II peripheral vascular disease (PVD) patients and in 32 matched controls. Transcutaneous oxygen pressure (tcPO2) was monitored constantly throughout the walking tests and recovery periods. In the PVD patients impairments in the flow properties of leucocytes and erythrocytes were associated with increases in MDA plasma concentrations which correlated significantly with a lengthening of the tcPO2 half recovery times--index of the worsening of ischaemia. Patients could be divided into two sub-groups on the basis of these impairments and their half recovery times, suggesting this experimental model may provide a means to identify those stage II PVD patients most likely to develop critical limb ischaemia.
Insights
Peripheral vascular disease (PVD) patients showed impaired blood flow properties linked to increased lipid peroxidation markers. This suggests a potential method to identify PVD patients at higher risk of critical limb ischaemia.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Clinical Medicine
Background:
- Peripheral vascular disease (PVD) involves impaired blood flow, increasing the risk of critical limb ischaemia.
- Assessing blood flow properties and markers of oxidative stress is crucial for understanding PVD progression.
Purpose of the Study:
- To investigate the relationship between lipid peroxidation, blood cell filterability, and ischaemia severity in stage II PVD patients.
- To evaluate the potential of an experimental model to predict the progression to critical limb ischaemia.
Main Methods:
- Measured malondialdehyde (MDA) plasma concentrations and leucocyte/erythrocyte filterability in 64 PVD patients and 32 controls during treadmill tests.
- Monitored transcutaneous oxygen pressure (tcPO2) during exercise and recovery to assess ischaemia.
- Utilized a positive pressure filtration system with 5-micron Nuclepore filters.
Main Results:
- PVD patients exhibited impaired leucocyte and erythrocyte filterability, associated with elevated MDA levels.
- Increased MDA concentrations correlated significantly with prolonged tcPO2 half-recovery times, indicating worsened ischaemia.
- Patients were classifiable into subgroups based on flow impairments and recovery times.
Conclusions:
- Impaired blood flow properties and elevated lipid peroxidation are linked to ischaemia severity in stage II PVD.
- The experimental model, assessing cell filterability and tcPO2 recovery, may help identify PVD patients at risk of critical limb ischaemia.