Summary
Controversy exists as to whether exercise in patients with intermittent claudication
causes a harmful biochemical effect associated with an ischaemia-reperfusion injury
of skeletal muscle. We report on exercise-induced changes in neutrophil activation,
soluble P-selectin and von Willebrand factor in 34 patients with intermittent claudication
and 12 matched controls.
Von Willebrand factor (vWF) showed a cyclical pattern of response to exercise in control
subjects (rising from 103 ± 8 to 119 ± 7 U/dl); claudicants did not show this pattern
but had higher levels of vWF throughout (p <0.03). There was no consistent pattern
of response in neutrophil hydrogen peroxide production to exercise in either claudicants
or control subjects. Soluble P-selectin levels increased after exercise, but this
only reached statistical significance after repeated exercise in claudicants (rising
from 320 ± 28 to 357 ± 28 ng/ml). This rise in soluble P-selectin after exercise may
indicate progressive platelet activation which may contribute to the excess cardiovascular
mortality that claudicants are prone to.
