Lower-limb hot-water immersion acutely induces beneficial hemodynamic and cardiovascular responses in peripheral arterial disease and healthy, elderly controls: lower-limb hot-water immersion in PAD

Research output: Contribution to journalArticle

Authors

  • Kate N Thomas
  • André M van Rij
  • Sam Lucas
  • James D Cotter

Colleges, School and Institutes

External organisations

  • Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: andre.vanrij@otago.ac.nz.
  • Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
  • School of Physical Education, Sport and Exercise Sciences, University of Otago Dunedin, New Zealand.

Abstract

Passive heat induces beneficial perfusion profiles, provides substantive cardiovascular strain and reduces blood pressure, thereby holding potential for healthy and cardiovascular disease populations. The aim of this study was to assess acute responses to passive heat via lower-limb hot-water immersion in patients with peripheral arterial disease (PAD) and healthy, elderly controls. Eleven patients with PAD (age 71±6 y, 7 male) and ten Controls (age 72±7 y, 8 male) underwent hot-water immersion (30 min waist-level immersion in 42.1±0.6°C water). Before, during and following immersion, brachial and popliteal artery diameter, blood flow and shear stress were assessed using duplex ultrasound. Lower-limb perfusion was measured also using venous occlusion plethysmography and near-infrared spectroscopy. During immersion, shear rate increased (p200%), plethysmography (>100%) and spectroscopy, while central and peripheral pulse wave velocity decreased in both groups. Mean arterial blood pressure was reduced by 22±9 mmHg (main effect p<0.0001, interaction p=0.60) during immersion, and remained 7±7 mmHg lower 3 h afterward. In PAD, popliteal shear profiles and claudication both compared favourably with those measured immediately following symptom-limited walking. A 30-min hot-water immersion is a practical means of delivering heat therapy to PAD patients and healthy, elderly individuals to induce appreciable systemic (chronotropic and blood pressure lowering) and hemodynamic (upper and lower-limb perfusion and shear rate increases) responses.

Details

Original languageEnglish
Pages (from-to)R281-R291
JournalAJP Regulatory Integrative and Comparative Physiology
Volume312
Issue number3
Publication statusPublished - 1 Mar 2017

Keywords

  • shear stress, passive heat, peripheral arterial disease, peripheral vascular disease, PVD, PAD, heat therapy, antegrade, shear rate, elderly