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Peripheral artery disease (PAD) is a type of cardiovascular disease in which the narrowing of arteries results in reduced blood flow to a limb, which can lead to amputation of an arm or leg.

In Aus­tralia today, one per­son has an ampu­ta­tion every three hours.

New treatments for PAD are needed to protect people from amputation, so Assoc Prof Mary Kavurma, Group Leader of HRI’s Vascular Complications Group, has teamed with other HRI scientists to review the PAD research for Frontiers in Cardiovascular Medicine.

The review focuses on how endothelial cell (EC) dysfunction contributes to PAD pathophysiology, then outlines the largely untapped potential of correcting endothelial dysfunction. In addition, it focuses on current treatments and clinical trials that improve EC dysfunction and offer insights into where future research efforts could be made. Endothelial dysfunction could represent a target for PAD therapy.

“PAD is traditionally considered a large vessel disease, but the microvasculature constitutes the largest surface area of blood vessels in the limb, and the role of the microvessels in PAD is only just being realised. Given the endothelium lines the entire vascular tree, improving a dysfunctional endothelium means that we can improve functions of large and small vessels,” said Assoc Prof Kavurma.

Dysfunction of the endothelium – the thin layer of cells which line the inside of blood vessels – means it is not working as it should. When dysfunctional, the endothelium can constrict (become harder) and cause the blood vessel to narrow, as well as other complications. Endothelial dysfunction raises the risk of PAD as well as other cardiovascular diseases such as atherosclerosis, blood clots and strokes, heart attacks, heart failure and high blood pressure.

The comprehensive review brings together the expertise of Drs Christopher Stanley, Freda Passam and Siân Cartland and Prof Sanjay Patel, along with other leading cardiovascular researchers across Australia, to advise as to where research should focus next.

Image: Assoc Prof Mary Kavurma

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