RESTOR­ING LEG BLOOD FLOW IS BET­TER OP­TION THAN EX­ER­CISE FOR PAD PA­TIENTS

UNMC grad­u­ate stu­dent is lead au­thor of study pre­sented at AHA na­tional meet­ing

Wellness Update - - WELLNESS -

OMAHA, Neb. — A grad­u­ate stu­dent from the Uni­ver­sity of Ne­braska Med­i­cal Cen­ter was the lead au­thor of a study which found that restor­ing blood ow to the legs of pa­tients with pe­riph­eral artery dis­ease (PAD) may stop the progression of scar­ring in their leg mus­cles. PAD causes pain and fa­tigue while walk­ing due to poor blood cir­cu­la­tion in ar­ter­ies that sup­ply blood to the limbs. The de­creased blood ow can lead to sub­stan­tial scar­ring and dam­age in leg mus­cles. There are cur­rently no avail­able treat­ments once the scar­ring has oc­curred. Su­per­vised ex­er­cise ther­apy and revas­cu­lar­iza­tion pro­ce­dures (which re­open or by­pass block­ages in the blood ves­sels) may help PAD pa­tients walk fur­ther and longer, but it is not known if th­ese treat­ments af­fect the scar­ring process. Duy Ha, a doc­toral can­di­date in cel­lu­lar and in­te­gra­tive phys­i­ol­ogy, was the lead au­thor on the study. Ha, who is pur­su­ing a com­bined M.D., Ph.D. de­gree, was one of only six re­searchers who were se­lected to give a mod­er­ated poster pre­sen­ta­tion in which he gave an oral pre­sen­ta­tion on the poster in front of a crowd of re­searchers. Six months later, they com­pared changes in biopsy re­sults among 30 pa­tients who un­der­went revas­cu­lar­iza­tion, 25 who par­tic­i­pated in a su­per­vised ex­er­cise pro­gram, and 17 who had no treat­ment.

Among the find­ings

Scar­ring fac­tors - col­la­gen bers and TGF- 1 - increased in the ex­er­cise and con­trol groups, but not in the revas­cu­lar­iza­tion group;

Pa­tients in both the revas­cu­lar­iza­tion and ex­er­cise groups increased their max­i­mum walk­ing time on tread­mill, be­fore calf pain made it im­pos­si­ble to con­tinue;

Only pa­tients in the revas­cu­lar­iza­tion group im­proved the dis­tance they could walk in six min­utes. Nei­ther ex­er­cise nor revas­cu­lar­iza­tion treat­ment re­versed scar­ring that had al­ready taken place in the calf mus­cles.

“In­creas­ing blood flow to the leg with revas­cu­lar­iza­tion pro­ce­dures halted the progression of scar­ring and al­lowed the pa­tients to walk longer and fur­ther.

Ha said. “This sug­gests that the long-term ben­e­fits to the health of leg mus­cles is bet­ter with revas­cu­lar­iza­tion than with ex­er­cise ther­apy alone. Un­for­tu­nately, not all pa­tients are can­di­dates for th­ese pro­ce­dures, which carry sig­nif­i­cant risks, and the treated ves­sels may get blocked again.

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