Skeletal Muscle Microvascular Flow in Progressive Peripheral Artery Disease. Assessment With Continuous Arterial Spin-Labeling Perfusion Magnetic Resonance Imaging
Journal
Journal of the American College of Cardiology
Journal Volume
53
Journal Issue
25
Pages
2372-2377
Date Issued
2009
Author(s)
Abstract
Objectives: We present the novel application of continuous arterial spin-labeling (CASL) magnetic resonance imaging (MRI) for the measurement of calf muscle perfusion in subjects with progressive peripheral arterial disease (PAD). Background: Peripheral arterial disease is largely considered to be a disease of conduit vessels. The impact of PAD upon microvascular flow in the end-organ, muscle, remains unknown. Continuous arterial spin-labeling is a noninvasive MRI method capable of measuring microvascular flow and might assist in our understanding of the impact of PAD upon the microvasculature. Methods: Forty subjects with varying degrees of PAD and 17 age-matched PAD-free subjects were recruited and underwent measurement of the ankle-to-brachial index (ABI) and CASL. Peak hyperemic flow (PHF) and time-to-peak (TTP) were computed and assessed as a function of ABI and calf muscle group. Results: An ABI dependence was found in both PHF (p = 0.04) and TTP (p < 10-4). Whereas TTP increased almost immediately with increasing PAD severity, PHF was, in contrast, relatively well preserved until later stages of disease. Conclusions: The CASL flow measurements correlate with disease state as measured by ABI and demonstrate preserved microvascular flow reserve in the presence of early to intermediate vascular disease. ? 2009 American College of Cardiology Foundation.
Subjects
arterial spin-labeling; magnetic resonance imaging; peripheral arterial disease; skeletal muscle
SDGs
Other Subjects
adult; age distribution; aged; ankle brachial index; artery disease; blood flowmetry; clinical article; continuous arterial spin labeling; controlled study; disease course; female; gastrocnemius muscle; human; male; microvascularization; muscle blood flow; muscle perfusion; nuclear magnetic resonance imaging; priority journal; review; skeletal muscle; spin labeling; Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Humans; Leg; Magnetic Resonance Angiography; Male; Microcirculation; Middle Aged; Muscle, Skeletal; Peripheral Vascular Diseases
Type
review