This study states that Peripheral artery disease (PAD) affects >200 million patients globally. Revascularization is a mainline treatment of PAD; however, change in walking performance and quality of life (QoL) vary substantially among patients, ranging from no to marked improvement. We evaluated biochemical and histopathologic measurements of calf muscle and leg hemodynamics, before revascularization, as potential predictors of change in walking performance and QoL in response to revascularization. We measured, at baseline and 6 months after revascularization, ankle-brachial index, systolic pedal pressure at 15 seconds after postocclusive reactive hyperemia (SPP15sec), 6-minute walking distance (SMWD), initial claudication time, peak walking time, and QoL survey scores of 40 claudicating PAD patients. In addition, we determined the following: activities of mitochondrial citrate synthase, complexes 1 to 4, and manganese superoxide dismutase; myofiber morphology and oxidative damage (carbonyl adducts); and fibrosis in calf muscle. Prediction of walking performance and QoL was evaluated by Spearman rho and receiver operating characteristic curve. Baseline SPP15sec and change in SMWD were most strongly correlated. A receiver operating characteristic curve identified patients whose SMWD improved >20 m at a baseline SPP15sec cutoff of 50 mm Hg, with sensitivity of 89% and specificity of 100%. 

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