Exercise therapy for chronic symptomatic peripheral artery disease

Lucia Mazzolai; Jill Belch; Maarit Venermo; Victor Aboyans; Marianne Brodmann; Alessandra Bura-Rivière; Sebastien Debus; Christine Espinola-Klein; Amy E Harwood; John A Hawley; Stefano Lanzi; Juraj Madarič; Guillaume Mahé; Davide Malatesta; Oliver Schlager; Arno Schmidt-Trucksäss; Chris Seenan; Henrik Sillesen; Garry A Tew; Adriana Visonà

doi:10.1093/eurheartj/ehad734

Exercise therapy for chronic symptomatic peripheral artery disease

Eur Heart J. 2024 Apr 14;45(15):1303-1321. doi: 10.1093/eurheartj/ehad734.

Authors

Lucia Mazzolai¹, Jill Belch², Maarit Venermo^{3

4}, Victor Aboyans^{5

6}, Marianne Brodmann⁷, Alessandra Bura-Rivière⁸, Sebastien Debus⁹, Christine Espinola-Klein¹⁰, Amy E Harwood¹¹, John A Hawley¹², Stefano Lanzi¹, Juraj Madarič^{13

14}, Guillaume Mahé^{15

16}, Davide Malatesta¹⁷, Oliver Schlager¹⁸, Arno Schmidt-Trucksäss¹⁹, Chris Seenan²⁰, Henrik Sillesen^{21

22}, Garry A Tew²³, Adriana Visonà²⁴

Affiliations

¹ Angiology Department, Lausanne University Hospital, University of Lausanne, Ch. de Mont-Paisible 18, Lausanne 1011, Switzerland.
² Institute of Cardiovascular Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
³ Department of Vascular Surgery, Abdominal Center, Helsinki University Hospital, Helsinki, Finland.
⁴ University of Helsinki, Helsinki, Finland.
⁵ Department of Cardiology, Dupuytren-2 University Hospital, France.
⁶ EpiMaCT, INSERM 1094/IRD270, Limoges University, Limoges, France.
⁷ Division of Angiology, Department of Internal Medicine, Medical University, Graz, Austria.
⁸ Department of Vascular Medicine, Toulouse University Hospital, Toulouse, France.
⁹ Department of Vascular Medicine, Vascular Surgery-Angiology-Endovascular Therapy, University of Hamburg-Eppendorf, Hamburg, Germany.
¹⁰ Center of Cardiology, Department of Cardiology III-Angiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
¹¹ Department for Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK.
¹² Exercise and Nutrition Research Programme, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
¹³ Department of Angiology, Comenius University, Bratislava, Slovakia.
¹⁴ National Institute of Cardiovascular Diseases, Bratislava, Slovakia.
¹⁵ Vascular Medicine Unit, Centre Hospitalier Universitaire de Rennes, Rennes, France.
¹⁶ INSERM CIC 1414, Université de Rennes, Rennes, France.
¹⁷ Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
¹⁸ Division of Angiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria.
¹⁹ Division of Sport and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.
²⁰ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
²¹ Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
²² Department of Clinical Medicine, University of Copenhagen, Denmark.
²³ Institute for Health and Care Improvement, York St John University, York, UK.
²⁴ Angiology Unit, Ospedale Castelfranco Veneto, Castelfranco Veneto, Italy.

PMID: 38461405
DOI: 10.1093/eurheartj/ehad734

Abstract

All guidelines worldwide strongly recommend exercise as a pillar of the management of patients affected by lower extremity peripheral artery disease (PAD). Exercise therapy in this setting presents different modalities, and a structured programme provides optimal results. This clinical consensus paper is intended for clinicians to promote and assist for the set-up of comprehensive exercise programmes to best advice in patients with symptomatic chronic PAD. Different exercise training protocols specific for patients with PAD are presented. Data on patient assessment and outcome measures are narratively described based on the current best evidence. The document ends by highlighting disparities in access to supervised exercise programmes across Europe and the series of gaps for evidence requiring further research.

Keywords: Exercise training; Intermittent claudication; Physical activity; Quality of life; Vascular rehabilitation.

© 2024 the European Society of Cardiology, the European Society of Vascular Medicine, and the European Society for Vascular Surgery. Published by Oxford University Press on behalf of the European Society of Cardiology, by Hogrefe AG on behalf of European Society of Vascular Medicine and by Elsevier B.V on behalf of European Society for Vascular Surgery. All rights reserved. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article.

MeSH terms

Europe
Exercise
Exercise Therapy / methods
Humans
Intermittent Claudication* / therapy
Peripheral Arterial Disease* / therapy
Walking