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Vascular Medicine
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Increased levels of apoptosis in gastrocnemius skeletal muscle in patients with peripheral arterial disease

Robert G. Mitchell

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

Brian D. Duscha

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

Jennifer L. Robbins

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

Shelley I. Redfern

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

Jayer Chung

University of Colorado Heath Sciences Center, Denver, CO, USA

Daniel R. Bensimhon

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

William E. Kraus

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA

William R. Hiatt

University of Colorado Heath Sciences Center, Denver, CO, USA

Judith G. Regensteiner

University of Colorado Heath Sciences Center, Denver, CO, USA

Brian H. Annex

Division of Cardiology, Department of Medicine, Durham VA and Duke University Medical Center, Durham, NC 27710, USA, annex001{at}mc.duke.edu

Intermittent claudication (IC) is the major clinical manifestation of peripheral arterial disease (PAD). Apoptosis has been linked to skeletal muscle pathophysiology in other chronic diseases such as congestive heart failure. This study tested the hypothesis that there would be increased levels of apoptosis in the skeletal muscle of patients with PAD compared with control individuals. In total, 26 individuals with PAD and 28 age-appropriate controls underwent studies of peak oxygen consumption (peak VO2) and a gastrocnemius muscle biopsy in the most symptomatic leg. Muscle biopsies were analyzed for apoptosis and caspase-3 activity. Patients with PAD had a reduced peak VO2 compared with controls. Apoptosis was increased in those with PAD compared with age-appropriate controls (3.83% ± 2.6 vs 1.53% ± 0.96; p < 0.001). In conclusion, PAD is associated with increased levels of apoptosis in the peripheral skeletal muscle. Further study is required to ascertain whether apoptosis plays a role in decreased functional capacity.

Key Words: caspase • endothelial cells • exercise • intermittent claudication

Vascular Medicine, Vol. 12, No. 4, 285-290 (2007)
DOI: 10.1177/1358863X07084858
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