Quantitative CMR markers of impaired vascular reactivity associated with age and peripheral artery disease

Journal of Cardiovascular Magnetic Resonance

Research

Thomas F Floyd¹  Emile R Mohler²  Erin K Englund³  Zachary B Rodgers³  Felix W Wehrli³  Michael C Langham³  Cheng Li³ 

[1] Department of Anesthesiology, Stony Brook University Medical Center, 11794, Stony Brook, NY, USA;Department of Medicine, University of Pennsylvania School of Medicine, 19104, Philadelphia, PA, USA;Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce Street, 19104, Philadelphia, PA, USA;

关键词: Peripheral arterial disease;    Atherosclerosis;    Microvascular function;    Pulse-wave velocity;    Blood oxygen saturation;    Phase image;    Magnetic resonance oximetry;   

DOI  :  10.1186/1532-429X-15-17

 received in 2012-11-09, accepted in 2013-01-14,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to develop and evaluate an integrated CMR method incorporating dynamic oximetry, blood flow and pulse-wave velocimetry to assess vascular reactivity in patients with peripheral artery disease (PAD) and healthy controls.Methods and resultsThe study population consisted of young healthy subjects (YH, 30 ± 7 yrs, N = 19),PAD (71 ± 9 yrs, N = 38), and older healthy controls (OHC, 68 ± 9 yrs, N = 43). Peripheral vascular reactivity was evaluated with two methods, time-resolved quantification of blood flow velocity and oxygenation level in the femoral artery and vein, respectively, performed simultaneously both at rest and hyperemia. Aortic stiffness was assessed via pulse-wave velocity. Oximetric data showed that compared to OHC, the time-course of the hemoglobin oxygen saturation in PAD patients had longer washout time (28.6 ± 1.2 vs 16.9 ± 1.1 s, p < 0.0001), reduced upslope (0.60 ± 0.1 vs 1.3 ± 0.08 HbO2/sec, p < 0.0001) and lower overshoot (8 ± 1.4 vs 14 ± 1.2 HbO2, p = 0.0064). PAD patients also had longer-lasting antegrade femoral artery flow during hyperemia (51 ± 2.1 vs 24 ± 1.8 s, p < 0.0001), and reduced peak-to-baseline flow rate (3.1 ± 0.5 vs 7.4 ± 0.4, p < 0.0001). Further, the pulsatility at rest was reduced (0.75 ± 0.32 vs 5.2 ± 0.3, p < 0.0001), and aortic PWV was elevated (10.2 ± 0.4 vs 8.1 ± 0.4 m/s, p = 0.0048).ConclusionThe proposed CMR protocol quantifies multiple aspects of vascular reactivity and represents an initial step toward development of a potential tool for evaluating interventions, extrapolating clinical outcomes and predicting functional endpoints based on quantitative parameters.

【 授权许可】

Unknown   
© Langham et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.