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Wilburn D, Miserlis D, Fletcher E, Papoutsi E, Ismaeel A, Bradley C, Ring A, Wilkinson T, Smith RS, Ferrer L, Haynatzki G, Monteleone P, Banerjee S, Brisbois E, Bohannon WT, Koutakis P. Skeletal muscle desmin alterations following revascularization in peripheral artery disease claudicants. Sci Rep 2024; 14:12609. [PMID: 38824194 PMCID: PMC11144188 DOI: 10.1038/s41598-024-63626-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/30/2024] [Indexed: 06/03/2024] Open
Abstract
Peripheral artery disease (PAD) is characterized by varying severity of arterial stenosis, exercise induced claudication, malperfused tissue precluding normal healing and skeletal muscle dysfunction. Revascularization interventions improve circulation, but post-reperfusion changes within the skeletal muscle are not well characterized. This study investigates if revascularization enhanced hemodynamics increases walking performance with concurrent improvement of mitochondrial function and reverses abnormal skeletal muscle morphological features that develop with PAD. Fifty-eight patients completed walking performance testing and muscle biopsy before and 6 months after revascularization procedures. Muscle fiber morphology, desmin structure, and mitochondria respiration assessments before and after the revascularization were evaluated. Revascularization improved limb hemodynamics, walking function, and muscle morphology. Qualitatively not all participants recovered normal structural architecture of desmin in the myopathic myofibers after revascularization. Heterogenous responses in the recovery of desmin structure following revascularization may be caused by other underlying factors not reversed with hemodynamic improvements. Revascularization interventions clinically improve patient walking ability and can reverse the multiple subcellular functional and structural abnormalities in muscle cells. Further study is needed to characterize desmin structural remodeling with improvements in skeletal muscle morphology and function.
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Affiliation(s)
- Dylan Wilburn
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Dimitrios Miserlis
- Department of Surgery and Perioperative Care, University of Texas, Austin, TX, USA
- Department of Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Emma Fletcher
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Evlampia Papoutsi
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Ahmed Ismaeel
- Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Cassandra Bradley
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Andrew Ring
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Trevor Wilkinson
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA
| | - Robert S Smith
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX, USA
| | - Lucas Ferrer
- Department of Surgery and Perioperative Care, University of Texas, Austin, TX, USA
| | - Gleb Haynatzki
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter Monteleone
- Department of Internal Medicine, University of Texas, Austin, TX, USA
| | - Subhash Banerjee
- Department of Cardiology, Baylor Scott & White Medical Center, Dallas, TX, USA
| | - Elizabeth Brisbois
- School of Chemical, Materials and Biomedical Engineering, College of Engineering, University of Georgia, Athens, GA, USA
| | - William T Bohannon
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX, USA
| | - Panagiotis Koutakis
- Department of Biology, Baylor University, B.207 Baylor Science Building, One Bear Place #97388, Waco, TX, 76798-7388, USA.
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Lamberti N, Traina L, Savriè C, Tsolaki E, Rinaldo N, Straudi S, Guerzoni F, Napoli N, Manfredini R, Gasbarro V, Manfredini F. Lower All-Cause Mortality Risk in Females and Males with Peripheral Artery Disease following Pain-Free Home-Based Exercise: A 7-Year Observational Study. J Pers Med 2023; 13:jpm13040636. [PMID: 37109022 PMCID: PMC10143366 DOI: 10.3390/jpm13040636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
We evaluated the sex-specific difference in response upon participation in an exercise program with respect to the risk of adverse clinical outcomes among patients with peripheral artery disease (PAD) and claudication. The records of 400 PAD patients were assessed between 2012 and 2015. Two hundred of them were addressed to a walking program prescribed at the hospital and executed at home at symptom-free walking speed (Ex), while the remaining 200 acted as a control group (Co). The number and date of deaths, all-cause hospitalizations, and amputations for a 7-year period were collected from the regional registry. At baseline, no differences were observed (MEXn = 138; FEXn = 62; MCOn = 149; FCOn = 51). The 7-year survival rate was significantly higher in FEX (90%) than in MEX (82% hazard ratio, HR: 0.542 95% CI 0.331-0.885), FCO (45%, HR: 0.164 95% CI 0.088-0.305), and MCO (44%; HR: 0.157 95% CI 0.096-0.256). A significantly lower rate of hospitalization (p < 0.001) and amputations (p = 0.016) was observed for the Ex group compared to the Co group, without differences by sex. In conclusion, in PAD patients, active participation in a home-based pain-free exercise program was associated with a lower rate of death and better long-term clinical outcomes, particularly among women.
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Affiliation(s)
- Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Luca Traina
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Caterina Savriè
- Clinica Medica Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Elpiniki Tsolaki
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Natascia Rinaldo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Franco Guerzoni
- Health Statistics Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Nicola Napoli
- Health Statistics Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
| | - Roberto Manfredini
- Clinica Medica Unit, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
| | - Vincenzo Gasbarro
- Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
- Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Via L. Borsari 46, 44121 Ferrara, Italy
- Unit of Rehabilitation Medicine, University Hospital of Ferrara, Via Aldo Moro 8, 44124 Ferrara, Italy
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Bonaca MP, Hogan SE. Tradeoffs in Approach to PAD Revascularization: Shared Decision Making in the Spotlight. J Am Coll Cardiol 2023; 81:371-373. [PMID: 36697137 DOI: 10.1016/j.jacc.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Marc P Bonaca
- CPC Clinical Research, Aurora, Colorado, USA; University of Colorado, Aurora Colorado, USA; University of Colorado School of Medicine, Aurora, Colorado, USA.
| | - Shea E Hogan
- CPC Clinical Research, Aurora, Colorado, USA; University of Colorado School of Medicine, Aurora, Colorado, USA; Denver Health Hospital, Denver, Colorado, USA. https://twitter.com/SheaHogan7
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