Multiparametric assessment of vascular function in peripheral artery disease: dynamic measurement of skeletal muscle perfusion, blood-oxygen-level dependent signal, and venous oxygen saturation.
Multiparametric assessment of vascular function in peripheral artery disease: dynamic measurement of skeletal muscle perfusion, blood-oxygen-level dependent signal, and venous oxygen saturation.
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DOI：
10.1161/circimaging.114.002673
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Floyd TF
中科院分区：
文献类型：
--
作者：
Englund EK;Langham MC;Ratcliffe SJ;Fanning MJ;Wehrli FW;Mohler ER 3rd;Floyd TF
Endothelial dysfunction present in patients with peripheral artery disease (PAD) may be better understood by measuring the temporal dynamics of blood flow and oxygen saturation during reactive hyperemia than by conventional static measurements. Perfusion, Intravascular Venous Oxygen saturation, and T2* (PIVOT), a recently developed MRI technique, was used to measure the response to an ischemia-reperfusion paradigm in ninety-six patients with PAD of varying severity, and ten healthy controls. Perfusion, venous oxygen saturation (SvO2), and T2* were each quantified in the calf at two second temporal resolution, yielding a dynamic time course for each variable. Compared to healthy controls, patients had a blunted and delayed hyperemic response. Moreover, patients with lower ankle-brachial index had: 1) a more delayed reactive hyperemia response time, manifesting as an increase in time to peak perfusion in the gastrocnemius, soleus, and peroneus muscles, and in the anterior compartment; 2) an increase in the time to peak T2* measured in the soleus muscle; and 3) a prolongation of the posterior tibial vein SvO2 washout time. Intra- and inter-session repeatability was also assessed. Results indicated that time to peak perfusion and time to peak T2* were the most reliable extracted time course metrics. Perfusion, dynamic SvO2, and T2* response times following induced ischemia are highly correlated with PAD disease severity. Combined imaging of peripheral microvascular blood flow and dynamics of oxygen saturation with PIVOT may be a useful tool to investigate the pathophysiology of PAD.
