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. 2011 Jul;111(1):81-6.
doi: 10.1152/japplphysiol.00141.2011. Epub 2011 Apr 21.

Relationship between leg muscle capillary density and peak hyperemic blood flow with endurance capacity in peripheral artery disease

Jennifer L Robbins  1 , W Schuyler Jones, Brian D Duscha, Jason D Allen, William E Kraus, Judith G Regensteiner, William R Hiatt, Brian H Annex
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Relationship between leg muscle capillary density and peak hyperemic blood flow with endurance capacity in peripheral artery disease

Jennifer L Robbins et al. J Appl Physiol (1985). 2011 Jul.

Abstract

The aim of this study was to determine if skeletal muscle capillary density is lower in patients with peripheral artery disease (PAD) and if capillary density relates to functional limitations. PAD patients with intermittent claudication (IC) have a decreased exercise tolerance due to exercise-induced muscle ischemia. Despite the apparent role diminished arterial flow has in this population, the degree of walking pain and functional limitation is not entirely explained by altered hemodynamics of the affected limbs. We hypothesized that skeletal muscle capillary density is lower in PAD and is related to the functional impairment observed in this population. Sixty-four patients with PAD and 56 controls underwent cardiopulmonary exercise testing and a gastrocnemius muscle biopsy. A subset of these patients (48 PAD and 47 controls) underwent peak hyperemic flow testing via plethysmography. Capillary density in PAD patients was lower compared with controls (P < 0.001). After adjustment for several baseline demographic imbalances the model relating capillary density to peak oxygen consumption (Vo(2)) remained significant (P < 0.001). In PAD subjects, capillary density correlated with peak Vo(2), peak walking time (PWT), and claudication onset time (COT). Peak hyperemic blood flow related to peak Vo(2) in both PAD and control subjects. PAD is associated with lower capillary density, and capillary density is related to the functional impairment as defined by a reduced peak Vo(2), PWT, and COT. These findings suggest that alterations in microcirculation may contribute to functional impairment capacity in PAD.

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Figures

Fig. 1.
Fig. 1.
The relationship of peak hyperemic blood flow (ml·100 ml tissue−1·min−1) and peak oxygen consumption (V̇o2). Both normal control (r = 0.36, P <0.05) and peripheral artery disease (PAD) subjects (r = 0.37, P < 0.05) had a positive relationship between peak hyperemic blood flow and peak V̇o2.
Fig. 2.
Fig. 2.
The relationship between capillary density (endothelial cells/mm2) and peak V̇o2, peak walking time (PWT), and claudication onset time (COT). There were positive relationships between capillary density and peak V̇o2 (r = 0.38, P < 0.05), PWT (r = 0.46, P < 0.05), and COT (r = 0.29, P < 0.05). There was no relationship between capillary density and peak V̇o2 in normal control subjects.
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