Post-Exercise Ankle-Brachial Pressure Index Demonstrates Altered Endothelial Function in the Elderly

Abstract

Background:The ankle-brachial pressure index (ABI), the ratio of the systolic blood pressure of the ankle to the systolic brachial pressure, is commonly measured at rest, but ABI values post-exercise enhance the sensitivity of the test and can be used to identify atherosclerotic vascular damage. However, it has not been established whether or not enhanced post-exercise ABI is also associated with endothelial dysfunction. We hypothesized that a decrease in post-exercise ABI is related to impaired endothelial function.Purpose:To investigate alterations in post-exercise ABI values and endothelial dysfunction in the elderly.Methods:The study population comprised 35 men and women aged 51–77 years (mean age: 66 years). Patients with peripheral arterial disease or a history of heart failure were excluded. The ABI was estimated at rest and immediately after exercise. The exercise protocol comprised 2.5 min of active pedal flexion exercises at a speed of 60 times/min. Endothelial function was assessed by measuring flow-mediated vasodilation (FMD) in the brachial artery using ultrasound imaging.Results:No correlation was found between FMD and the ABI at rest. However, a weak correlation was found between FMD and post-exercise ABI (r = 0.46, P = 0.06). A strong correlation was observed between FMD and a decrease in post-exercise ABI compared to baseline readings (r = −0.52, P = 0.01). Multiple linear regression analysis was used to generate a prediction equation for FMD using the percentage decrease in post-exercise ABI. Significant correlations were observed between the ultrasound imaging-measured FMD and the predicted FMD (R2 = 0.27, P = 0.001).Conclusions:Post-exercise ABI appears to be a simple surrogate marker for endothelial function in the elderly, although larger studies are required for validation.

Smoking Counteracts the Favorable Effect of Exercise Training on Endothelial Function in Patients with Type 2 Diabetes

“…First, we used the post-exercise ABI for the assessment of endothelial function; this method is acceptable but is not perfect. 8 Second, we had no information on the dietary regimen of the patients during the study period; we cannot exclude the possibility that smokers also had poor diets, which would have confounded our results. Third, the smoking assessment was based on self-reports and was not verified.…”

“…This simple exercise test can be a useful surrogate marker of endothelial dysfunction. 8 In brief, resting ABI was measured using a Doppler flow meter (VaSera, VS-1000, Fukuda denshi, Japan), with the patient in a supine position, according to a standard protocol. ABI was also measured immediately (60 times/min) after 2.5 min of active pedal flexion exercises.…”

Influência Do Fluxo Arterial Periférico Na Capacidade Funcional Em Indivíduos Hipertensos

“…Ressalta-se que um fator importante para avaliação do ITB e correta caracterização da DAP é o momento em que este índice é avaliado, seja em repouso ou pós--exercício, pois com o exercício há um aumento do fluxo através de uma estenose fixa que leva a uma queda significativa na pressão tornozelo (Kim;Wattanakit;Gornik, 2012). Dessa forma, Sato et al (2011) avaliaram em 35 sujeitos as alterações no ITB pós-exercício e a disfunção endotelial, sendo avaliada pela medida da vasodilatação mediada pelo fluxo (FMD) na artéria braquial, em idosos. Neste estudo não houve correlação entre a FMD e o ITB em repouso, entretanto ocorreu uma fraca correlação entre a FMD e o ITB pós-exercício.…”

Comparação do efeito agudo do exercício com a eletroestimulação funcional sobre o fluxo arterial periférico de indíviduos hipertensos e diabéticos: um estudo piloto

“…13 Protocolo para exercício de planti/dorsiflexão de tornozelo O protocolo de exercício foi composto por 2,5 minutos de exercícios de planti/dorsiflexão ativa de tornozelo bilateralmente abrangendo 60 repetições/min. 14…”

“…O ITB é um método não invasivo e de boa reprodutibilidade para o diagnóstico de DAP, sendo os valores menores que 0,90; um preditor de risco para morbidade e mortalidade coronariana e vascular cerebral, pois metade dos pacientes com DAP possuem sintomas dessas doenças. 5 Dessa forma, em um estudo realizado no Japão, 14 os autores ressaltaram que o ITB é geralmente medido em repouso, mas valores pós-exercício aumentam a sensibilidade do teste e pode ser utilizado para identificar doença vascular aterosclerótica. Tais autores formularam a hipótese que a diminuição do ITB no pós-exercício esteja relacionada com a presença de disfunção endotelial.…”