Peripheral artery disease (PAD) is characterized by obstructed hemodynamics and claudication reducing quality of life and muscle function. A myopathy has been shown to develop in PAD patients and characterization of changes in skeletal muscle needs further elucidation. PURPOSE: To assess myofibrillar ultrastructural changes between control and stage IV PAD patients. METHODS: Twenty-six participants (13 control:13 stage IV) were recruited to take part in this cross-sectional study. The mean(±SD) age, mass, height, and BMI were 53(±11) years, 81(±22) kg, 165(±15) cm, and 30(±1.5) kg/m2. Muscle samples were collected from the gastrocnemius and prepared for transmission electron microscopy. Relative mitochondria area, average mitochondrial size, number of mitochondria/250μm2, relative myofibril area, average m-line length, number of z-discs/250μm2, mitochondria/z-disc, relative lipid droplet area, average lipid droplet size, and number of lipid droplets/250μm2 were measured and averaged for each participant using two-individual micrographs. All variables were statistically assessed using an independent t-test or Mann-Whitney U at a significance value of pRESULTS:Relative mitochondrial area (U=11.534, p2 (t=5.343, p2 (t=-1.902, p=.07) was observed. M-line lengths were shorter for stage IV PAD patients than controls (U=11.543, p2 (U=.037, p=.848). Average mitochondria/z-disc was significantly greater in controls than in stage IV PAD patients (t=5.737, pCONCLUSION:The largest changes seen in PAD skeletal muscle ultrastructure are in the mitochondria number and total mitochondria area. This decrease in mitochondria may explain altered muscle function not accounted for by hemodynamic obstructions.



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