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Peripheral vascular disease.

A C Bylund-Fellenius, P M Walker, A Elander

    The American Review of Respiratory Disease
    |February 1, 1984
    PubMed
    Summary
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    Reduced blood flow during exercise impairs skeletal muscle metabolism in patients with claudication. However, their muscles adapt to maintain energy balance, suggesting pain originates from fast-twitch fibers.

    Area of Science:

    • Physiology
    • Exercise Metabolism
    • Skeletal Muscle Biology

    Background:

    • Reduced blood flow during exercise impacts skeletal muscle energy and oxygen levels.
    • Claudicating patients exhibit altered muscle metabolism compared to healthy individuals.

    Purpose of the Study:

    • To investigate the effects of reduced blood flow on skeletal muscle metabolism during exercise.
    • To compare metabolic responses in claudicating patients and healthy subjects.
    • To examine adaptations in muscle tissue following repeated exposure to reduced blood flow.

    Main Methods:

    • Human studies involving leg exercise in claudicating patients and normal subjects.
    • Experimental studies perfusing contracting rat hindlimbs at reduced blood flow.
    • Analysis of muscle oxygen tension, energy state, and [lactate]/[pyruvate] ratio.

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  • Assessment of oxidative enzyme activities.

    • Main Results:

    • Claudicating patients showed lower muscle oxygen tension and energy state during exercise.
    • Patients maintained a lower [lactate]/[pyruvate] ratio, indicating higher oxidative capacity.
    • Rat gastrocnemius muscle (fast-twitch) was more affected by reduced flow than soleus (slow-twitch).
    • Repeated reduced blood flow induced chronic changes in oxidative enzyme activity in rat muscles.

    Conclusions:

    • Skeletal muscle metabolism is significantly affected by reduced blood flow during exercise.
    • Fast-twitch glycolytic fibers are more vulnerable to ischemia than slow-twitch oxidative fibers.
    • Chronic adaptations in oxidative enzymes occur in response to repeated exercise-induced ischemia, mirroring changes in claudicating patients.