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Pharmacological preconditioning of ischaemia
F Laghi Pasini1, P L Capecchi, A Acciavatti
1Institute of Clinical Medicine, University of Siena, School of Medicine, Italy.
Clinical Hemorheology and Microcirculation
|January 1, 1997
Summary
Repeated exercise and buflomedil treatment improve walking in peripheral obliterative arterial disease (POAD) patients. Both interventions increase adenosine levels, suggesting a preconditioning effect that enhances lower limb circulation and exercise capacity.
Area of Science:
- Cardiology
- Vascular Medicine
- Exercise Physiology
Background:
- Peripheral obliterative arterial disease (POAD) significantly impairs walking ability due to lower limb ischaemia.
- Haemorheological derangements are common in POAD patients, exacerbating circulatory issues.
- Adenosine plasma levels may indicate tissue response to ischaemia and exercise.
Purpose of the Study:
- To investigate the effects of repeated submaximal exercise on walking distance and haemodynamics in POAD patients.
- To explore the impact of buflomedil administration on adenosine levels and its potential role in pharmacological preconditioning.
- To assess the relationship between adenosine increases and improved exercise tolerance in POAD.
Main Methods:
- Patients with POAD underwent maximal treadmill tests interspersed with repeated submaximal exercise sessions.
- Adenosine plasma levels were measured during maximal exercise tests and after buflomedil administration (intravenous and oral).
- Buflomedil's effects were evaluated at various dosages and intervals over a one-week period.
Main Results:
- Repeated submaximal exercise prolonged walking distance and reduced haemorheological derangement in a subsequent maximal test.
- Maximal exercise tests showed increased plasma adenosine levels, suggesting ischaemic preconditioning.
- Buflomedil administration (IV and oral) also elevated plasma adenosine levels.
- A specific buflomedil regimen (600 mg orally every 12 hours) increased adenosine without drug accumulation, indicating potential pharmacological preconditioning.
Conclusions:
- Repeated exercise offers a beneficial preconditioning effect for patients with peripheral obliterative arterial disease.
- Buflomedil may induce pharmacological preconditioning by increasing adenosine levels, potentially improving lower limb ischaemia.
- Both exercise and buflomedil present therapeutic avenues for enhancing circulation and exercise capacity in POAD.