Effects of exercise training on common femoral artery blood flow in patients with intermittent claudication

Exercise training is a commonly used rehabilitative therapy for patients with intermittent claudication (IC). However, it is not known whether blood flow through the major conduit vessel of the leg, the common femoral artery (CFA), increases with exercise training. We tested the hypothesis that peak CFA blood flow will increase with a supervised, lengthy, and individualized exercise training program. Subjects were 10 IC patients (eight men, two women) with a mean age of 61 +/- 7 (mean +/- SD) years who had either aortoiliac (n = 7) or femoropopliteal (n = 3) stenosis. Using noninvasive Doppler flowmetry, we measured CFA blood flow and ankle pressure at rest and after a maximum symptom-limited graded treadmill test before (T1) and after 3 (T2) and 5 (T3) months of exercise training. Variables were measured in the supine and upright postures at rest and during recovery. Total walking distance and claudication distance on the treadmill were determined for T1, T2, and T3. After training, CFA blood flow and ankle pressure were not significantly higher at rest or at 1 minute after exercise compared with pretraining despite significant increases in claudication and total walking distances. The rate of CFA blood flow recovery was slower at T3, suggesting the accrual of a larger metabolic debt during exercise due to more work performed. We conclude that changes in CFA blood flow are not responsible for measured changes in performance with exercise training in IC patients.