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2015 ; 116
(9
): 1540-50
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English Wikipedia
Lower extremity manifestations of peripheral artery disease: the pathophysiologic
and functional implications of leg ischemia
#MMPMID25908727
McDermott MM
Circ Res
2015[Apr]; 116
(9
): 1540-50
PMID25908727
show ga
Lower extremity peripheral artery disease (PAD) is frequently underdiagnosed, in
part because of the wide variety of leg symptoms manifested by patients with PAD
and in part because of the high prevalence of asymptomatic PAD. In primary care
medical practices, 30% to 60% of patients with PAD report no exertional leg
symptoms and ?45% to 50% report exertional leg symptoms that are not consistent
with classic intermittent claudication. The prevalence and extent of functional
impairment and functional decline in PAD may also be underappreciated. Functional
impairment and functional decline are common in PAD, even among those who are
asymptomatic. Lower extremity ischemia is also associated with pathophysiologic
changes in calf skeletal muscle, including smaller calf muscle area, increased
calf muscle fat content, impaired leg strength, and impaired metabolic function.
People with severe PAD have poorer peroneal nerve conduction velocity compared
with people with mild PAD or no PAD. The degree of ischemia-related
pathophysiologic changes in lower extremity muscles and peripheral nerves of
people with PAD are associated with the degree of functional impairment. New
interventions are needed to improve functional performance and prevent mobility
loss in the large number of patients with PAD, including in those who are
asymptomatic or who have exertional leg symptoms other than claudication.