Soluble endoglin as a prognostic factor of the claudication distance improvement in patients with peripheral artery disease undergoing supervised treadmill training program

Conservative therapy after complete revascularization is increasing in popularity in patients with peripheral artery disease (PAD). The aim of the present study was to find determinants of the improvement of walking abilities and endothelial function in patients with PAD undergoing supervised treadmill training program (STTP). The presented study enclosed 66 patients in the mean age 65.4 ± 7.7 years with PAD who underwent a 3-month length STTP. We assessed the effect of following factors on the change of the flow-mediated dilatation value (ΔFMD), maximal walking time (ΔMWT), and pain-free walking time (ΔPFWT). The evaluation included several biochemical and anthropometric indices with special insight into markers of angiogenesis, including soluble endoglin (sEng), platelet-derived growth factor, and angiopoietin-2. Linear regression analysis for each of the variables and multi-factorial model analysis of variances was adopted to select the most influential determinants. The levels of sEng, a biomarker of several cardiovascular pathologies, were found to significantly predict the greater improvement of maximal walking time and pain-free walking time. Moreover, the linear regression analysis demonstrated, and analysis of variance confirmed that coronary artery disease and peracted endovascular interventions of lower limbs arteries are significant determinants of the better ΔFMD improvement. On the contrary, treatment with β-blockers and older age were poor predictors of ΔFMD increase. In conclusion, the sEng level could serve as a determinant of walking abilities change after STTP in patients with PAD. The treatment with β-blockers, the coexistence of coronary artery disease, and peracted endovascular interventions of lower limbs arteries are determinants of endothelial function.