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Erschienen in: Gefässchirurgie 8/2019

30.10.2019 | Periphere arterielle Verschlusskrankheit | Netzwerk Grundlagenforschung

Extern induzierte Blutflussrestriktion als Modell für die periphere arterielle Verschlusskrankheit in Ruhe und unter Belastung

verfasst von: J. Vogel, D. Niederer

Erschienen in: Gefässchirurgie | Ausgabe 8/2019

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Obwohl körperliche Inaktivität und zu wenig körperliche Aktivität bis zu 10 % aller weltweiten Todesfälle verursachen [27], erfüllt etwa ein Drittel der Weltbevölkerung die Mindestanforderungen der körperlichen Aktivität zur Erhaltung der Gesundheit nicht [16, 18]. Die Einführung eines körperlich aktiven Lebensstils kann die Gesamtmortalität verringern, die Lebenserwartung verlängern [40] und das Risiko der kardiovaskulären Mortalität um 42–44 % reduzieren [4, 26]. Gerade auch bei Patienten mit peripherer arterieller Verschlusskrankheit (PAVK) zeigt eine Steigerung der körperlichen Aktivität viele Vorteile [29]. …
Literatur
1.
Zurück zum Zitat Anderson JL, Halperin JL, Albert NM et al (2013) Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127(13):1425–1443PubMed Anderson JL, Halperin JL, Albert NM et al (2013) Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127(13):1425–1443PubMed
2.
Zurück zum Zitat Bagley JR, Rosengarten JJ, Galpin AJ (2015) Is blood flow restriction training beneficial for athletes? Strength Cond J 37(3):48–53 Bagley JR, Rosengarten JJ, Galpin AJ (2015) Is blood flow restriction training beneficial for athletes? Strength Cond J 37(3):48–53
3.
Zurück zum Zitat Ben Driss A, Benessiano J, Poitevin P et al (1997) Arterial expansive remodeling induced by high flow rates. Am J Physiol 272(2):H851–H858PubMed Ben Driss A, Benessiano J, Poitevin P et al (1997) Arterial expansive remodeling induced by high flow rates. Am J Physiol 272(2):H851–H858PubMed
4.
Zurück zum Zitat Blair SN, Kohl HW, Barlow CE et al (1995) Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 273(14):1093–1098PubMed Blair SN, Kohl HW, Barlow CE et al (1995) Changes in physical fitness and all-cause mortality. A prospective study of healthy and unhealthy men. JAMA 273(14):1093–1098PubMed
6.
Zurück zum Zitat Clyne CA, Mears H, Weller RO et al (1985) Calf muscle adaptation to peripheral vascular disease. Cardiovasc Res 19(8):507–512PubMed Clyne CA, Mears H, Weller RO et al (1985) Calf muscle adaptation to peripheral vascular disease. Cardiovasc Res 19(8):507–512PubMed
7.
Zurück zum Zitat Cook SB, Brown KA, Deruisseau K et al (2010) Skeletal muscle adaptations following blood flow-restricted training during 30 days of muscular unloading. J Appl Physiol 109(2):341–349PubMed Cook SB, Brown KA, Deruisseau K et al (2010) Skeletal muscle adaptations following blood flow-restricted training during 30 days of muscular unloading. J Appl Physiol 109(2):341–349PubMed
8.
Zurück zum Zitat Dopheide JF, Rubrech J, Trumpp A et al (2017) Supervised exercise training in peripheral arterial disease increases vascular shear stress and profunda femoral artery diameter. Eur J Prev Cardiol 24(2):178–191PubMed Dopheide JF, Rubrech J, Trumpp A et al (2017) Supervised exercise training in peripheral arterial disease increases vascular shear stress and profunda femoral artery diameter. Eur J Prev Cardiol 24(2):178–191PubMed
9.
Zurück zum Zitat Duvall WL, Vorchheimer DA (2004) Multi-bed vascular disease and atherothrombosis: scope of the problem. J Thromb Thrombolysis 17(1):51–61PubMed Duvall WL, Vorchheimer DA (2004) Multi-bed vascular disease and atherothrombosis: scope of the problem. J Thromb Thrombolysis 17(1):51–61PubMed
10.
Zurück zum Zitat Fowkes FGR, Rudan D, Rudan I et al (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010. Lancet 382(9901):1329–1340PubMed Fowkes FGR, Rudan D, Rudan I et al (2013) Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010. Lancet 382(9901):1329–1340PubMed
11.
Zurück zum Zitat Fujita S, Abe T, Drummond MJ et al (2007) Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. J Appl Physiol 103(3):903–910PubMed Fujita S, Abe T, Drummond MJ et al (2007) Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. J Appl Physiol 103(3):903–910PubMed
12.
Zurück zum Zitat Gerhold KA, Schwartz MA (2016) Ion channels in endothelial responses to fluid shear stress. Physiology (Bethesda) 31(5):359–369 Gerhold KA, Schwartz MA (2016) Ion channels in endothelial responses to fluid shear stress. Physiology (Bethesda) 31(5):359–369
13.
Zurück zum Zitat Green DJ, Hopman MTE, Padilla J et al (2017) Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Physiol Rev 97(2):495–528PubMedPubMedCentral Green DJ, Hopman MTE, Padilla J et al (2017) Vascular adaptation to exercise in humans: role of hemodynamic stimuli. Physiol Rev 97(2):495–528PubMedPubMedCentral
14.
Zurück zum Zitat Gualano B, Neves M, Lima FR et al (2010) Resistance training with vascular occlusion in inclusion body myositis: a case study. Med Sci Sports Exerc 42(2):250–254PubMed Gualano B, Neves M, Lima FR et al (2010) Resistance training with vascular occlusion in inclusion body myositis: a case study. Med Sci Sports Exerc 42(2):250–254PubMed
15.
Zurück zum Zitat Guerreiro LF, Rocha AM, Martins CN et al (2016) Oxidative status of the myocardium in response to different intensities of physical training. Physiol Res 65(5):737–749PubMed Guerreiro LF, Rocha AM, Martins CN et al (2016) Oxidative status of the myocardium in response to different intensities of physical training. Physiol Res 65(5):737–749PubMed
16.
Zurück zum Zitat Guthold R, Stevens GA, Riley LM et al (2018) Worldwide trends in insufficient physical activity from 2001 to 2016. Lancet Glob Health 6(10):e1077–e1086PubMed Guthold R, Stevens GA, Riley LM et al (2018) Worldwide trends in insufficient physical activity from 2001 to 2016. Lancet Glob Health 6(10):e1077–e1086PubMed
17.
Zurück zum Zitat Hackney KJ, Everett M, Scott JM et al (2012) Blood flow-restricted exercise in space. Extrem Physiol Med 1(1):12PubMedPubMedCentral Hackney KJ, Everett M, Scott JM et al (2012) Blood flow-restricted exercise in space. Extrem Physiol Med 1(1):12PubMedPubMedCentral
18.
Zurück zum Zitat Hallal PC, Andersen LB, Bull FC et al (2012) Global physical activity levels. Lancet 380(9838):247–257 Hallal PC, Andersen LB, Bull FC et al (2012) Global physical activity levels. Lancet 380(9838):247–257
19.
Zurück zum Zitat Heil M, Eitenmüller I, Schmitz-Rixen T et al (2006) Arteriogenesis versus angiogenesis: similarities and differences. J Cell Mol Med 10(1):45–55PubMed Heil M, Eitenmüller I, Schmitz-Rixen T et al (2006) Arteriogenesis versus angiogenesis: similarities and differences. J Cell Mol Med 10(1):45–55PubMed
20.
Zurück zum Zitat Hiatt WR, Regensteiner JG, Wolfel EE et al (1996) Effect of exercise training on skeletal muscle histology and metabolism in peripheral arterial disease. J Appl Physiol 81(2):780–788PubMed Hiatt WR, Regensteiner JG, Wolfel EE et al (1996) Effect of exercise training on skeletal muscle histology and metabolism in peripheral arterial disease. J Appl Physiol 81(2):780–788PubMed
21.
Zurück zum Zitat Higashi Y, Sasaki S, Kurisu S et al (1999) Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 100(11):1194–1202PubMed Higashi Y, Sasaki S, Kurisu S et al (1999) Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 100(11):1194–1202PubMed
22.
Zurück zum Zitat Hoffmann EK, Lambert IH, Pedersen SF (2009) Physiology of cell volume regulation in vertebrates. Physiol Rev 89(1):193–277PubMed Hoffmann EK, Lambert IH, Pedersen SF (2009) Physiology of cell volume regulation in vertebrates. Physiol Rev 89(1):193–277PubMed
23.
Zurück zum Zitat Iida H, Kurano M, Takano H et al (2007) Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol 100(3):275–285PubMed Iida H, Kurano M, Takano H et al (2007) Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol 100(3):275–285PubMed
24.
Zurück zum Zitat Katzel LI, Sorkin JD, Powell CC et al (2001) Comorbidities and exercise capacity in older patients with intermittent claudication. Vasc Med 6(3):157–162PubMed Katzel LI, Sorkin JD, Powell CC et al (2001) Comorbidities and exercise capacity in older patients with intermittent claudication. Vasc Med 6(3):157–162PubMed
25.
Zurück zum Zitat Lawall DH, Huppert PDP, Rümenapf PD (2015) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit. Deutsche Gesellschaft für Angiologie. AWMF-Registernummer 065-003 Lawall DH, Huppert PDP, Rümenapf PD (2015) S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit. Deutsche Gesellschaft für Angiologie. AWMF-Registernummer 065-003
26.
Zurück zum Zitat Lee D‑c, Sui X, Artero EG et al (2011) Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the Aerobics Center Longitudinal Study. Circulation 124(23):2483–2490 Lee D‑c, Sui X, Artero EG et al (2011) Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the Aerobics Center Longitudinal Study. Circulation 124(23):2483–2490
27.
Zurück zum Zitat Lee I‑M, Shiroma EJ, Lobelo F et al (2012) Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 380(9838):219–229PubMedPubMedCentral Lee I‑M, Shiroma EJ, Lobelo F et al (2012) Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 380(9838):219–229PubMedPubMedCentral
28.
Zurück zum Zitat Lejkowski PM, Pajaczkowski JA (2011) Utilization of vascular restriction training in post-surgical knee rehabilitation: a case report and introduction to an under-reported training technique. J Can Chiropr Assoc 55(4):280–287PubMedPubMedCentral Lejkowski PM, Pajaczkowski JA (2011) Utilization of vascular restriction training in post-surgical knee rehabilitation: a case report and introduction to an under-reported training technique. J Can Chiropr Assoc 55(4):280–287PubMedPubMedCentral
29.
Zurück zum Zitat Leng GC, Fowler B, Ernst E (2000) Exercise for intermittent claudication. Cochrane Database Syst Rev 2:CD990 Leng GC, Fowler B, Ernst E (2000) Exercise for intermittent claudication. Cochrane Database Syst Rev 2:CD990
30.
Zurück zum Zitat Loenneke JP, Pujol TJ (2009) The use of occlusion training to produce muscle hypertrophy. Strength Cond J 31(3):77–84 Loenneke JP, Pujol TJ (2009) The use of occlusion training to produce muscle hypertrophy. Strength Cond J 31(3):77–84
31.
Zurück zum Zitat Loenneke JP, Wilson GJ, Wilson JM (2010) A mechanistic approach to blood flow occlusion. Int J Sports Med 31(1):1–4PubMed Loenneke JP, Wilson GJ, Wilson JM (2010) A mechanistic approach to blood flow occlusion. Int J Sports Med 31(1):1–4PubMed
32.
Zurück zum Zitat Loenneke JP, Abe T, Wilson JM et al (2012) Blood flow restriction: an evidence based progressive model (Review). Acta Physiol Hung 99(3):235–250PubMed Loenneke JP, Abe T, Wilson JM et al (2012) Blood flow restriction: an evidence based progressive model (Review). Acta Physiol Hung 99(3):235–250PubMed
33.
Zurück zum Zitat Lynch GS, Ryall JG (2008) Role of beta-adrenoceptor signaling in skeletal muscle: implications for muscle wasting and disease. Physiol Rev 88(2):729–767PubMed Lynch GS, Ryall JG (2008) Role of beta-adrenoceptor signaling in skeletal muscle: implications for muscle wasting and disease. Physiol Rev 88(2):729–767PubMed
34.
Zurück zum Zitat Menêses AL, Ritti-Dias RM, Parmenter B et al (2017) Combined lower limb revascularisation and supervised exercise training for patients with peripheral arterial disease: a systematic review of randomised controlled trials. Sports Med 47(5):987–1002PubMed Menêses AL, Ritti-Dias RM, Parmenter B et al (2017) Combined lower limb revascularisation and supervised exercise training for patients with peripheral arterial disease: a systematic review of randomised controlled trials. Sports Med 47(5):987–1002PubMed
35.
Zurück zum Zitat Michishita R, Shono N, Inoue T et al (2010) Effect of exercise therapy on monocyte and neutrophil counts in overweight women. Am J Med Sci 339(2):152–156PubMed Michishita R, Shono N, Inoue T et al (2010) Effect of exercise therapy on monocyte and neutrophil counts in overweight women. Am J Med Sci 339(2):152–156PubMed
36.
Zurück zum Zitat Moritani T, Sherman WM, Shibata M et al (1992) Oxygen availability and motor unit activity in humans. Eur J Appl Physiol Occup Physiol 64(6):552–556PubMed Moritani T, Sherman WM, Shibata M et al (1992) Oxygen availability and motor unit activity in humans. Eur J Appl Physiol Occup Physiol 64(6):552–556PubMed
37.
Zurück zum Zitat Nakajima T, Iida H, Kurano M et al (2008) Hemodynamic responses to simulated weightlessness of 24‑h head-down bed rest and KAATSU blood flow restriction. Eur J Appl Physiol 104(4):727–737PubMed Nakajima T, Iida H, Kurano M et al (2008) Hemodynamic responses to simulated weightlessness of 24‑h head-down bed rest and KAATSU blood flow restriction. Eur J Appl Physiol 104(4):727–737PubMed
38.
Zurück zum Zitat Nash MS, Montalvo BM, Applegate B (1996) Lower extremity blood flow and responses to occlusion ischemia differ in exercise-trained and sedentary tetraplegic persons. Arch Phys Med Rehabil 77(12):1260–1265PubMed Nash MS, Montalvo BM, Applegate B (1996) Lower extremity blood flow and responses to occlusion ischemia differ in exercise-trained and sedentary tetraplegic persons. Arch Phys Med Rehabil 77(12):1260–1265PubMed
39.
Zurück zum Zitat Niessner A, Richter B, Penka M et al (2006) Endurance training reduces circulating inflammatory markers in persons at risk of coronary events: impact on plaque stabilization? Atherosclerosis 186(1):160–165PubMed Niessner A, Richter B, Penka M et al (2006) Endurance training reduces circulating inflammatory markers in persons at risk of coronary events: impact on plaque stabilization? Atherosclerosis 186(1):160–165PubMed
40.
Zurück zum Zitat Paffenbarger RS, Kampert JB, Lee IM et al (1994) Changes in physical activity and other lifeway patterns influencing longevity. Med Sci Sports Exerc 26(7):857–865PubMed Paffenbarger RS, Kampert JB, Lee IM et al (1994) Changes in physical activity and other lifeway patterns influencing longevity. Med Sci Sports Exerc 26(7):857–865PubMed
41.
Zurück zum Zitat Reeves GV, Kraemer RR, Hollander DB et al (2006) Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance exercise without occlusion. J Appl Physiol 101(6):1616–1622PubMed Reeves GV, Kraemer RR, Hollander DB et al (2006) Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance exercise without occlusion. J Appl Physiol 101(6):1616–1622PubMed
42.
Zurück zum Zitat Regensteiner JG, Steiner JF, Hiatt WR (1996) Exercise training improves functional status in patients with peripheral arterial disease. J Vasc Surg 23(1):104–115PubMed Regensteiner JG, Steiner JF, Hiatt WR (1996) Exercise training improves functional status in patients with peripheral arterial disease. J Vasc Surg 23(1):104–115PubMed
43.
Zurück zum Zitat Risau W (1997) Mechanisms of angiogenesis. Nature 386(6626):671–674PubMed Risau W (1997) Mechanisms of angiogenesis. Nature 386(6626):671–674PubMed
44.
Zurück zum Zitat Sayed A, Schierling W, Troidl K et al (2010) Exercise linked to transient increase in expression and activity of cation channels in newly formed hind-limb collaterals. Eur J Vasc Endovasc Surg 40(1):81–87PubMed Sayed A, Schierling W, Troidl K et al (2010) Exercise linked to transient increase in expression and activity of cation channels in newly formed hind-limb collaterals. Eur J Vasc Endovasc Surg 40(1):81–87PubMed
45.
Zurück zum Zitat Schaper W (2003) On arteriogenesis—a reply. Basic Res Cardiol 98(3):183–184PubMed Schaper W (2003) On arteriogenesis—a reply. Basic Res Cardiol 98(3):183–184PubMed
46.
Zurück zum Zitat Shi Z‑D, Tarbell JM (2011) Fluid flow mechanotransduction in vascular smooth muscle cells and fibroblasts. Ann Biomed Eng 39(6):1608–1619PubMedPubMedCentral Shi Z‑D, Tarbell JM (2011) Fluid flow mechanotransduction in vascular smooth muscle cells and fibroblasts. Ann Biomed Eng 39(6):1608–1619PubMedPubMedCentral
47.
Zurück zum Zitat Takano H, Morita T, Iida H et al (2005) Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow. Eur J Appl Physiol 95(1):65–73PubMed Takano H, Morita T, Iida H et al (2005) Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow. Eur J Appl Physiol 95(1):65–73PubMed
48.
Zurück zum Zitat Takarada Y, Takazawa H, Ishii N (2000) Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc 32(12):2035–2039PubMed Takarada Y, Takazawa H, Ishii N (2000) Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc 32(12):2035–2039PubMed
49.
Zurück zum Zitat Tendera M, Aboyans V, Bartelink M‑L et al (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 32(22):2851–2906PubMed Tendera M, Aboyans V, Bartelink M‑L et al (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J 32(22):2851–2906PubMed
50.
Zurück zum Zitat Timmerman KL, Flynn MG, Coen PM et al (2008) Exercise training-induced lowering of inflammatory (CD14+CD16+) monocytes: a role in the anti-inflammatory influence of exercise? J Leukoc Biol 84(5):1271–1278PubMed Timmerman KL, Flynn MG, Coen PM et al (2008) Exercise training-induced lowering of inflammatory (CD14+CD16+) monocytes: a role in the anti-inflammatory influence of exercise? J Leukoc Biol 84(5):1271–1278PubMed
51.
Zurück zum Zitat Tronc F, Mallat Z, Lehoux S et al (2000) Role of matrix metalloproteinases in blood flow-induced arterial enlargement: interaction with NO. Arterioscler Thromb Vasc Biol 20(12):E120–E126PubMed Tronc F, Mallat Z, Lehoux S et al (2000) Role of matrix metalloproteinases in blood flow-induced arterial enlargement: interaction with NO. Arterioscler Thromb Vasc Biol 20(12):E120–E126PubMed
53.
Zurück zum Zitat Wang G‑K, Zhu J‑Q, Zhang J‑T et al (2010) Circulating microRNA: a novel potential biomarker for early diagnosis of acute myocardial infarction in humans. Eur Heart J 31(6):659–666PubMed Wang G‑K, Zhu J‑Q, Zhang J‑T et al (2010) Circulating microRNA: a novel potential biomarker for early diagnosis of acute myocardial infarction in humans. Eur Heart J 31(6):659–666PubMed
Metadaten
Titel
Extern induzierte Blutflussrestriktion als Modell für die periphere arterielle Verschlusskrankheit in Ruhe und unter Belastung
verfasst von
J. Vogel
D. Niederer
Publikationsdatum
30.10.2019
Verlag
Springer Medizin
Erschienen in
Gefässchirurgie / Ausgabe 8/2019
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-019-00586-3

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