Key result
Moderate-intensity walking upregulates circulating miR-142-5p and miR-424-5p in PAD, unlike vigorous training.
Why the study?
Circulating micro-RNA may mediate walking-induced collateral vessel formation in peripheral arterial disease, but the acute effects of moderate- versus vigorous-intensity walking on these miRNAs were unknown.
Does moderate-intensity walking compared to vigorous-intensity walking improve circulating miRNA parameters related to vascular collateral formation in patients with peripheral arterial disease?
RCT (n=10)
Open-label
Randomized-balanced sequence
No
Does moderate-intensity walking compared to vigorous-intensity walking improve circulating miRNA parameters related to vascular collateral formation in patients with peripheral arterial disease?
Moderate-intensity walking, rather than vigorous-intensity exercise to exhaustion, effectively up-regulates endurance training-related miRNAs associated with arteriogenesis in patients with peripheral arterial disease.
Moderate-intensity walking may favor miRNA-mediated arteriogenesis in PAD; extends intensity-specific exercise data to randomized settings.
BACKGROUND: Walking is the preferred therapy for peripheral arterial disease in early stage. An effect of walking exercise is the increase of blood flow and fluid shear stress, leading, triggered by arteriogenesis, to the formation of collateral blood vessels. Circulating micro-RNA may act as an important information transmitter in this process. We investigated the acute effects of a single bout of 1) aerobic walking with moderate intensity; and 2) anaerobic walking with vigorous intensity on miRNA parameters related to vascular collateral formation. METHODS: Ten (10) patients with peripheral arterial disease with claudication (age 72 ± 7 years) participated in this two-armed, randomized-balanced cross-over study. The intervention arms were single bouts of supervised walking training at (1) vigorous intensity on a treadmill up to volitional exhaustion and (2) moderate intensity with individual selected speed for a duration of 20 min. One week of washout was maintained between the arms. During each intervention, heart rate was continuously monitored. Acute effects on circulating miRNAs and lactate concentration were determined using pre- and post-intervention measurement comparisons. RESULTS: Vigorous-intensity walking resulted in a higher heart rate (125 ± 21 bpm) than the moderate-intensity intervention (88 ± 9 bpm) (p < 0.05). Lactate concentration was increased after vigorous-intensity walking (p = 0.005; 3.3 ± 1.2 mmol/l), but not after moderate exercising (p > 0.05; 1.7 ± 0.6 mmol/l). The circulating levels of miR-142-5p and miR-424-5p were up-regulated after moderate-intensity (p < 0.05), but not after vigorous-intensity training (p > 0.05). CONCLUSION: Moderate-intensity walking seems to be more feasible than vigorous exercises to induce changes of blood flow and endurance training-related miRNAs in patients with peripheral arterial disease. Our data thus indicates that effect mechanisms might follow an optimal rather than a maximal dose response relation. Steady state walking without the necessity to reach exhaustion seems to be better suited as stimulus.
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Sieland et al. (2022) conducted an RCT in Peripheral arterial disease with claudication (n=10). Moderate-intensity walking vs. Vigorous-intensity walking (treadmill up to volitional exhaustion) was evaluated on Lactate accumulation (mmol/l) (p=0.010). Moderate-intensity walking significantly upregulated circulating levels of miR-142-5p and miR-424-5p in patients with peripheral arterial disease, whereas vigorous-intensity training did not.
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