- Background: Use of blood oxygenation level-dependent cardiovascular magnetic resonance (BOLD-CMR) to assess perfusion in the lower limb has been hampered by poor reproducibility and a failure to reliably detect post-revascularization improvements in patients with critical limb ischemia (CLI).
Objectives: This study sought to develop BOLD-CMR as an objective, reliable clinical tool for measuring calf muscle perfusion in patients with CLI.
Methods: The calf was imaged at 3-T in young healthy control subjects (n = 12), age-matched control subjects (n = 10), and patients with CLI (n = 34). Signal intensity time curves were generated for each muscle group and curve parameters, including signal reduction during ischemia (SRi) and gradient during reactive hyperemia (Grad). BOLD-CMR was used to assess changes in perfusion following revascularization in 12 CLI patients. Muscle biopsies (n = 28), obtained at the level of BOLD-CMR measurement and from healthy proximal muscle of patients undergoing lower limb amputation (n = 3), were analyzed for capillary-fiber ratio.
Results: There was good interuser and interscan reproducibility for Grad and SRi (all p < 0.0001). The ischemic limb had lower Grad and SRi compared with the contralateral asymptomatic limb, age-matched control subjects, and young control subjects (p < 0.001 for all comparisons). Successful revascularization resulted in improvement in Grad (p < 0.0001) and SRi (p < 0.0005). There was a significant correlation between capillary-fiber ratio (p < 0.01) in muscle biopsies from amputated limbs and Grad measured pre-operatively at the corresponding level.
Conclusions: BOLD-CMR showed promise as a reliable tool for assessing perfusion in the lower limb musculature and merits further investigation in a clinical trial.
MetadatenAuthor: | Adnan Bajwa, Roman Wesolowski, Ashish Patel, Prakash Saha, Francesca Ludwinski, Mohammed Ikram, Mostafa Albayati, Alberto Smith, Eike NagelORCiDGND, Bijan Modarai |
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URN: | urn:nbn:de:hebis:30:3-506087 |
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DOI: | https://doi.org/10.1016/j.jacc.2015.10.085 |
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ISSN: | 1558-3597 |
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ISSN: | 0735-1097 |
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Pubmed Id: | https://pubmed.ncbi.nlm.nih.gov/26821631 |
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Parent Title (English): | Journal of the American College of Cardiology |
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Publisher: | Elsevier ; American College of Cardiology |
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Place of publication: | New York, NY |
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Document Type: | Article |
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Language: | English |
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Year of Completion: | 2016 |
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Date of first Publication: | 2016/01/25 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Release Date: | 2019/07/01 |
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Tag: | angioplasty; cardiovascular magnetic resonance; perfusion; surgery |
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Volume: | 67 |
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Issue: | 4 |
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Page Number: | 12 |
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First Page: | 420 |
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Last Page: | 431 |
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Note: | © 2016 by the American College of Cardiology Foundation. Published by Elsevier. This is an open access article under the cc by license (http://creativecommons.org/licenses/by/4.0/) . |
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HeBIS-PPN: | 451289579 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - Namensnennung 4.0 |
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