Brachial artery intima–media thickness and grayscale texture changes in patients with peripheral artery disease receiving supervised exercise training in the PROPEL randomized clinical trial

Jack Berroug, Claudia E. Korcarz, Carol K.C. Mitchell, Jo Anne M. Weber, Lu Tian, Mary M. McDermott, James H. Stein*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We performed an exploratory analysis to evaluate the effects of a treadmill exercise program on brachial artery (BA) intima–media thickness (IMT) and three BA grayscale ultrasound measures that may indicate subclinical arterial injury. Data were from a clinical trial in individuals with peripheral artery disease who were randomly assigned to treadmill exercise training or attention control. B-mode ultrasonography was performed at baseline and after 26 weeks. BA IMT, grayscale median (GSM), entropy, and gray-level difference statistic-contrast (GLDS-CON) were measured by a single reader. The 184 participants were (mean (SD)) 66.7 (8.2) years old and had an ankle–brachial index of 0.70 (0.18). Exercise training was associated with a 0.01 (0.06) mm (p = 0.025) reduction in BA IMT compared to 0.00 (0.05) mm (p = 0.807) in the control group (between-group p = 0.061). BA GSM, entropy, and GLDS-CON did not change significantly with exercise. Improvements in the 6-minute walk distance correlated with increases in resting BA blood flow (r = 0.23, p = 0.032), flow-mediated dilation (r = 0.24, p = 0.022), diameter (r = 0.29, p = 0.005), entropy (r = 0.21, p = 0.047), and GLDS-CON (r = 0.22, p = 0.041). In a post hoc analysis, BA IMT improved significantly with treadmill exercise training but did not change with attention control; however, the between-group difference did not reach statistical significance. With exercise, improvements in the 6-minute walk distance were associated with improved endothelial function, increased resting blood flow, and BA dilation, as well as higher grayscale entropy and GLDS-CON, indicating that lower extremity exercise is associated with salutary changes in upper-extremity arterial wall structure and function. ClinicalTrials.gov Identifier: NCT01408901.

Original languageEnglish (US)
Pages (from-to)12-22
Number of pages11
JournalVascular Medicine (United Kingdom)
Volume24
Issue number1
DOIs
StatePublished - Feb 1 2019

Fingerprint

Brachial Artery
Peripheral Arterial Disease
Randomized Controlled Trials
Exercise
Entropy
Dilatation
Upper Extremity
Lower Extremity
Ultrasonography
Clinical Trials
Control Groups
Wounds and Injuries

Keywords

  • brachial artery intima-media thickness
  • clinical trial
  • duplex ultrasound
  • peripheral artery disease (PAD)
  • supervised exercise therapy
  • ultrasound
  • vascular biology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{8a572ee8317145dda91e9bc039689a8c,
title = "Brachial artery intima–media thickness and grayscale texture changes in patients with peripheral artery disease receiving supervised exercise training in the PROPEL randomized clinical trial",
abstract = "We performed an exploratory analysis to evaluate the effects of a treadmill exercise program on brachial artery (BA) intima–media thickness (IMT) and three BA grayscale ultrasound measures that may indicate subclinical arterial injury. Data were from a clinical trial in individuals with peripheral artery disease who were randomly assigned to treadmill exercise training or attention control. B-mode ultrasonography was performed at baseline and after 26 weeks. BA IMT, grayscale median (GSM), entropy, and gray-level difference statistic-contrast (GLDS-CON) were measured by a single reader. The 184 participants were (mean (SD)) 66.7 (8.2) years old and had an ankle–brachial index of 0.70 (0.18). Exercise training was associated with a 0.01 (0.06) mm (p = 0.025) reduction in BA IMT compared to 0.00 (0.05) mm (p = 0.807) in the control group (between-group p = 0.061). BA GSM, entropy, and GLDS-CON did not change significantly with exercise. Improvements in the 6-minute walk distance correlated with increases in resting BA blood flow (r = 0.23, p = 0.032), flow-mediated dilation (r = 0.24, p = 0.022), diameter (r = 0.29, p = 0.005), entropy (r = 0.21, p = 0.047), and GLDS-CON (r = 0.22, p = 0.041). In a post hoc analysis, BA IMT improved significantly with treadmill exercise training but did not change with attention control; however, the between-group difference did not reach statistical significance. With exercise, improvements in the 6-minute walk distance were associated with improved endothelial function, increased resting blood flow, and BA dilation, as well as higher grayscale entropy and GLDS-CON, indicating that lower extremity exercise is associated with salutary changes in upper-extremity arterial wall structure and function. ClinicalTrials.gov Identifier: NCT01408901.",
keywords = "brachial artery intima-media thickness, clinical trial, duplex ultrasound, peripheral artery disease (PAD), supervised exercise therapy, ultrasound, vascular biology",
author = "Jack Berroug and Korcarz, {Claudia E.} and Mitchell, {Carol K.C.} and Weber, {Jo Anne M.} and Lu Tian and McDermott, {Mary M.} and Stein, {James H.}",
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Brachial artery intima–media thickness and grayscale texture changes in patients with peripheral artery disease receiving supervised exercise training in the PROPEL randomized clinical trial. / Berroug, Jack; Korcarz, Claudia E.; Mitchell, Carol K.C.; Weber, Jo Anne M.; Tian, Lu; McDermott, Mary M.; Stein, James H.

In: Vascular Medicine (United Kingdom), Vol. 24, No. 1, 01.02.2019, p. 12-22.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Brachial artery intima–media thickness and grayscale texture changes in patients with peripheral artery disease receiving supervised exercise training in the PROPEL randomized clinical trial

AU - Berroug, Jack

AU - Korcarz, Claudia E.

AU - Mitchell, Carol K.C.

AU - Weber, Jo Anne M.

AU - Tian, Lu

AU - McDermott, Mary M.

AU - Stein, James H.

PY - 2019/2/1

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N2 - We performed an exploratory analysis to evaluate the effects of a treadmill exercise program on brachial artery (BA) intima–media thickness (IMT) and three BA grayscale ultrasound measures that may indicate subclinical arterial injury. Data were from a clinical trial in individuals with peripheral artery disease who were randomly assigned to treadmill exercise training or attention control. B-mode ultrasonography was performed at baseline and after 26 weeks. BA IMT, grayscale median (GSM), entropy, and gray-level difference statistic-contrast (GLDS-CON) were measured by a single reader. The 184 participants were (mean (SD)) 66.7 (8.2) years old and had an ankle–brachial index of 0.70 (0.18). Exercise training was associated with a 0.01 (0.06) mm (p = 0.025) reduction in BA IMT compared to 0.00 (0.05) mm (p = 0.807) in the control group (between-group p = 0.061). BA GSM, entropy, and GLDS-CON did not change significantly with exercise. Improvements in the 6-minute walk distance correlated with increases in resting BA blood flow (r = 0.23, p = 0.032), flow-mediated dilation (r = 0.24, p = 0.022), diameter (r = 0.29, p = 0.005), entropy (r = 0.21, p = 0.047), and GLDS-CON (r = 0.22, p = 0.041). In a post hoc analysis, BA IMT improved significantly with treadmill exercise training but did not change with attention control; however, the between-group difference did not reach statistical significance. With exercise, improvements in the 6-minute walk distance were associated with improved endothelial function, increased resting blood flow, and BA dilation, as well as higher grayscale entropy and GLDS-CON, indicating that lower extremity exercise is associated with salutary changes in upper-extremity arterial wall structure and function. ClinicalTrials.gov Identifier: NCT01408901.

AB - We performed an exploratory analysis to evaluate the effects of a treadmill exercise program on brachial artery (BA) intima–media thickness (IMT) and three BA grayscale ultrasound measures that may indicate subclinical arterial injury. Data were from a clinical trial in individuals with peripheral artery disease who were randomly assigned to treadmill exercise training or attention control. B-mode ultrasonography was performed at baseline and after 26 weeks. BA IMT, grayscale median (GSM), entropy, and gray-level difference statistic-contrast (GLDS-CON) were measured by a single reader. The 184 participants were (mean (SD)) 66.7 (8.2) years old and had an ankle–brachial index of 0.70 (0.18). Exercise training was associated with a 0.01 (0.06) mm (p = 0.025) reduction in BA IMT compared to 0.00 (0.05) mm (p = 0.807) in the control group (between-group p = 0.061). BA GSM, entropy, and GLDS-CON did not change significantly with exercise. Improvements in the 6-minute walk distance correlated with increases in resting BA blood flow (r = 0.23, p = 0.032), flow-mediated dilation (r = 0.24, p = 0.022), diameter (r = 0.29, p = 0.005), entropy (r = 0.21, p = 0.047), and GLDS-CON (r = 0.22, p = 0.041). In a post hoc analysis, BA IMT improved significantly with treadmill exercise training but did not change with attention control; however, the between-group difference did not reach statistical significance. With exercise, improvements in the 6-minute walk distance were associated with improved endothelial function, increased resting blood flow, and BA dilation, as well as higher grayscale entropy and GLDS-CON, indicating that lower extremity exercise is associated with salutary changes in upper-extremity arterial wall structure and function. ClinicalTrials.gov Identifier: NCT01408901.

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KW - duplex ultrasound

KW - peripheral artery disease (PAD)

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KW - vascular biology

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