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

Michael C. Langham, Erin K. Englund, Emile R. Mohler, Cheng Li, Zachary B. Rodgers, Thomas F. Floyd, Felix W. Wehrli

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background: The 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 results. The 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 HbO§ssub§2§esub§/sec, p < 0.0001) and lower overshoot (8 ± 1.4 vs 14 ± 1.2 HbO§ssub§2§ esub§, 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). Conclusion: The 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.

Original languageEnglish (US)
Article number17
JournalJournal of Cardiovascular Magnetic Resonance
Volume15
Issue number1
DOIs
Publication statusPublished - Mar 25 2013

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Keywords

  • Atherosclerosis
  • Blood oxygen saturation
  • Magnetic resonance oximetry
  • Microvascular function
  • Peripheral arterial disease
  • Phase image
  • Pulse-wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Family Practice

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