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1 Section of Vascular Medicine, Divisions of 2 General Internal Medicine, 3 Geriatrics, and 4 Cardiology, University of Colorado Health Sciences Center, Denver, Colorado 80262; and 5 Department of Medicine, Harbor-UCLA Medical Center, Torrance, California 90509
Patients with peripheral arterial disease (PAD) have arterial
occlusions that limit peripheral blood flow. This study evaluated the
dynamic response in O2 consumption
(
O2) at the onset of constant-load exercise (
O2
kinetics) in patients with PAD. Eight patients with bilateral PAD,
seven patients with unilateral PAD, nine age-matched nonsmoking
controls, and seven smoking controls performed graded treadmill
exercise to assess peak
O2.
Subjects also performed constant-load exercise tests at 2.0 miles/h at 0 and 4% grade to determine
O2 kinetics. Peak
O2 was reduced 50% in
patients with PAD compared with both control groups
(P < 0.05). At 4% grade,
phase 2
O2 kinetics were
significantly slowed for the PAD groups compared with controls (60.1 ± 15.7 and 58.7 ± 8.3 s, unilateral and bilateral PAD groups,
respectively; compared with 28.4 ± 19.3 and 27.9 ± 8.1 s,
nonsmoking and smoking controls, respectively;
P < 0.05). No relationship was found
between
O2 kinetics and
disease severity. These data demonstrate that
O2 kinetics are markedly
slowed in patients with PAD. The impairment in
O2 kinetics is not related
to smoking status or arterial disease severity and therefore may
reflect altered control of skeletal muscle metabolism.
heart rate; oxygen consumption; muscle metabolism
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