Superficial femoral artery plaque and functional performance in peripheral arterial disease

Walking and leg circulation study (Walcs III)

Mary M. McDermott, Kiang Liu, Timothy J. Carroll, Lu Tian, Luigi Ferrucci, Debiao Li, James Carr, Jack M. Guralnik, Melina Kibbe, William H. Pearce, Chun Yuan, Walter McCarthy, Christopher M. Kramer, Huimin Tao, Yihua Liao, Elizabeth Talley Clark, Dongxiang Xu, Jarett Berry, Jennifer Orozco, Leena Sharma & 1 others Michael H. Criqui

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. Methods: A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Results: Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Conclusions: Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms.

Original languageEnglish (US)
Pages (from-to)730-739
Number of pages10
JournalJACC: Cardiovascular Imaging
Volume4
Issue number7
DOIs
StatePublished - Jul 2011

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Ankle Brachial Index
Peripheral Arterial Disease
Femoral Artery
Walking
Leg
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comorbidity
Lower Extremity
Body Mass Index
Magnetic Resonance Spectroscopy
Arteries
Smoking
Magnetic Resonance Imaging
Exercise
Walk Test

Keywords

  • atherosclerotic plaque intermittent claudication
  • peripheral arterial disease
  • physical functioning

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Superficial femoral artery plaque and functional performance in peripheral arterial disease : Walking and leg circulation study (Walcs III). / McDermott, Mary M.; Liu, Kiang; Carroll, Timothy J.; Tian, Lu; Ferrucci, Luigi; Li, Debiao; Carr, James; Guralnik, Jack M.; Kibbe, Melina; Pearce, William H.; Yuan, Chun; McCarthy, Walter; Kramer, Christopher M.; Tao, Huimin; Liao, Yihua; Clark, Elizabeth Talley; Xu, Dongxiang; Berry, Jarett; Orozco, Jennifer; Sharma, Leena; Criqui, Michael H.

In: JACC: Cardiovascular Imaging, Vol. 4, No. 7, 07.2011, p. 730-739.

Research output: Contribution to journalArticle

McDermott, MM, Liu, K, Carroll, TJ, Tian, L, Ferrucci, L, Li, D, Carr, J, Guralnik, JM, Kibbe, M, Pearce, WH, Yuan, C, McCarthy, W, Kramer, CM, Tao, H, Liao, Y, Clark, ET, Xu, D, Berry, J, Orozco, J, Sharma, L & Criqui, MH 2011, 'Superficial femoral artery plaque and functional performance in peripheral arterial disease: Walking and leg circulation study (Walcs III)', JACC: Cardiovascular Imaging, vol. 4, no. 7, pp. 730-739. https://doi.org/10.1016/j.jcmg.2011.04.009
McDermott, Mary M. ; Liu, Kiang ; Carroll, Timothy J. ; Tian, Lu ; Ferrucci, Luigi ; Li, Debiao ; Carr, James ; Guralnik, Jack M. ; Kibbe, Melina ; Pearce, William H. ; Yuan, Chun ; McCarthy, Walter ; Kramer, Christopher M. ; Tao, Huimin ; Liao, Yihua ; Clark, Elizabeth Talley ; Xu, Dongxiang ; Berry, Jarett ; Orozco, Jennifer ; Sharma, Leena ; Criqui, Michael H. / Superficial femoral artery plaque and functional performance in peripheral arterial disease : Walking and leg circulation study (Walcs III). In: JACC: Cardiovascular Imaging. 2011 ; Vol. 4, No. 7. pp. 730-739.
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T1 - Superficial femoral artery plaque and functional performance in peripheral arterial disease

T2 - Walking and leg circulation study (Walcs III)

AU - McDermott, Mary M.

AU - Liu, Kiang

AU - Carroll, Timothy J.

AU - Tian, Lu

AU - Ferrucci, Luigi

AU - Li, Debiao

AU - Carr, James

AU - Guralnik, Jack M.

AU - Kibbe, Melina

AU - Pearce, William H.

AU - Yuan, Chun

AU - McCarthy, Walter

AU - Kramer, Christopher M.

AU - Tao, Huimin

AU - Liao, Yihua

AU - Clark, Elizabeth Talley

AU - Xu, Dongxiang

AU - Berry, Jarett

AU - Orozco, Jennifer

AU - Sharma, Leena

AU - Criqui, Michael H.

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N2 - Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. Methods: A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Results: Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Conclusions: Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms.

AB - Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. Methods: A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Results: Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Conclusions: Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms.

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