Are Vascular Parameters Associated with Walking Impairment in Patients with Claudication? Vascular Parameters and Walking Impairment in PAD

Gustavo Oliveira da Silva, Marilia de Almeida Correia, Paulo Longano Mesquita de Oliveira, Breno Quintella Farah, Lauro C. Vianna, Pedro Puech-Leão, Nelson Wolosker, Gabriel Grizzo Cucato, Raphael Mendes Ritti-Dias*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background
The mechanisms underlying functional impairments in symptomatic PAD patients are controversial and poorly understood. Endothelial dysfunction and arterial stiffness have been proposed as potential mechanisms related to functional impairment in symptomatic PAD patients, however, more studies are needed to confirm these associations.

Objective
To analyze the association between vascular function and walking impairment in patients with peripheral arterial disease (PAD) and symptoms of claudication.

Methods
This was a cross-sectional study that included 68 patients with symptomatic PAD. All patients underwent an objective (Six-minute walk test [6MWT], 4-meter walk test) and a subjective (Walking Impairment Questionnaire [WIQ]) measurement of walking impairment. Vascular parameters measured were pulse-wave velocity (PWV) and flow-mediated dilation (FMD). Multiple linear regression was performed to investigate the association among walking impairment variables with vascular function parameters.

Results
No significant associations between the claudication onset distance (PWV: b=.060, p=.842; FMD: b=-.192, p=.456), 6MWT (PWV: b=.007, p=.975; FMD: b=.090, p=.725), WIQ distance (PWV: b=.337, p=.117; FMD: b=-.025, p=.895) WIQ speed (PWV: b=.320, p=.181; FMD: b=-.028, p=.497), WIQ stairs (PWV: b=.256, p=.204; FMD: b=-.228, p=.230), 4-meter usual walk (PWV: b=-.421, p=.107; FMD: b=-.338, p=.112), 4-meter fast walk (PWV: b=-.496, p=.063; FMD: b=-.371, p=.086) and vascular function were found.

Conclusions
In symptomatic PAD patients, vascular function is not associated to walking impairment, even when adjusting for comorbid conditions and diabetes.
Original languageEnglish
JournalAnnals of Vascular Surgery
Early online date26 Aug 2021
DOIs
Publication statusE-pub ahead of print - 26 Aug 2021

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