末梢動脈疾患患者における腕漕ぎ運動の心血管機能への急性反応：無作為化クロスオーバー試験

To analyze the acute cardiovascular responses to arm-cranking (AC) exercise in patients with peripheral artery disease (PAD), comparing it to walking and a nonexercise control condition.

This study is a randomized crossover trial with single-blind data collection in which 17 patients with PAD and claudication (53% men, 66 ± 7 years old, 26.7 ± 4.4 kg/m 2 body mass index, 0.63 ± 0.12 ankle-brachial index) were included. They performed 3 experimental conditions (walking, AC, and control) in random order. The exercise conditions were composed of 15 bouts of 2 minutes (15 × 2) with an intensity equivalent to 4 to 6 on a modified (1-10) Borg Rating of Perceived Exertion scale. We measured blood pressure (BP), cerebral blood flow, heart rate variability, and brachial and femoral artery flow-mediated dilation before and after the conditions. Generalized estimated equations were used to analyze the acute response among experimental conditions, with P < .05 considered significant.

We observed post-exercise hypotension in both AC and walking, with a greater net effect in the AC condition compared with walking (systolic BP: AC = -14 ± 14 mm Hg; walking = -6.7 ± 8.9 mm Hg, P < .001; diastolic BP: AC = -5.8 ± 8.4 mm Hg; walking = -1.2 ± 4.1 mm Hg, P = .011). Brachial and femoral artery flow-mediated dilation, cerebral blood flow, and heart rate variability did not change after any of the conditions.

Vascular function, cerebral blood flow, and heart rate variability remained unchanged after AC and walking. However, both walking and AC induced post-exercise hypotension in patients with PAD, with a greater magnitude in the AC condition.