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Longitudinal Magnetic Resonance Imaging-Based Superficial Femoral Artery Velocity Measurements in Diabetic and
Ankita Sinharoy1, Neeti Reddy2, John Kent Lin3
1Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA.
Background:
Longitudinal associations of noninvasive 2-dimensional phase-contrast magnetic resonance imaging (2D-PC-MRI) velocity markers of the superficial femoral artery (SFA) were analyzed along with the characteristics of peripheral artery disease (PAD). We hypothesized that the 2-year differences in MRI-based measures of SFA velocity were associated with longitudinal changes in markers of PAD.
Methods:
A total of 33 (11 diabetic, 22 nondiabetic) patients with PAD with baseline and 2-year follow-up MRI scans were included in this secondary analysis of the Effect of Lipid Modification on Peripheral Artery Disease after Endovascular Intervention Trial (ELIMIT). Electrocardiographically gated 2D-PC-MRI was performed at a proximal and a distal location of the distal SFA territory. SFA lumen, wall, and total vessel volumes and the normalized wall index (NWI) were analyzed.
Results:
Baseline characteristics did not differ between diabetic and nondiabetic PAD patients. Maximum proximal and distal SFA velocity measures did not differ between baseline and 2 years (41.98 interquartile range (IQR) (23.58-72.6) cm/s vs. 40.31 IQR (26.69-61.29) cm/s; P = 0.30). Pooled analysis (N = 33) showed that the 24-month change in the NWI was inversely associated with the 24-month change in the proximal maximal SFA velocity (beta = -168.36, R2 = 0.150, P value = 0.03). The 24-month change of the maximum velocity differences between the proximal and distal SFA locations was inversely associated with the 24-month changes in peak walking distance (beta = -0.003, R2 = 0.360, P value = 0.011).
Conclusion:
The 2-year change of SFA plaque burden is inversely associated with the 2-year change of proximal peak SFA blood flow velocity. 2D-PC-MRI measured SFA velocity may be of interest in assessing PAD longitudinally.
Insights
Changes in superficial femoral artery (SFA) plaque burden over two years are inversely related to changes in SFA blood flow velocity, as measured by 2D-PC-MRI. This MRI technique may help track peripheral artery disease (PAD) progression.
Area of Science:
- Cardiovascular Imaging
- Vascular Biology
- Medical Diagnostics
Background:
- Peripheral artery disease (PAD) affects blood flow in the limbs.
- Noninvasive 2-dimensional phase-contrast magnetic resonance imaging (2D-PC-MRI) measures blood flow velocity.
- Longitudinal changes in PAD markers are not fully understood.
Purpose of the Study:
- To analyze the longitudinal associations of superficial femoral artery (SFA) velocity markers from 2D-PC-MRI with peripheral artery disease (PAD) characteristics.
- To test the hypothesis that 2-year differences in MRI-based SFA velocity measures correlate with longitudinal changes in PAD markers.
Main Methods:
- A cohort of 33 patients with PAD underwent baseline and 2-year follow-up MRI scans.
- Electrocardiographically gated 2D-PC-MRI assessed SFA velocity at proximal and distal locations.
- Analysis included SFA lumen, wall, and total vessel volumes, and the normalized wall index (NWI).
Main Results:
- No significant difference in baseline characteristics between diabetic and nondiabetic PAD patients.
- Proximal and distal SFA maximum velocities did not change significantly over 2 years.
- A 2-year increase in NWI (plaque burden) was inversely associated with a 2-year increase in proximal SFA velocity (P=0.03).
- Changes in SFA velocity difference between proximal and distal sites correlated inversely with changes in peak walking distance (P=0.011).
Conclusions:
- The progression of SFA plaque burden over two years is inversely related to changes in peak SFA blood flow velocity.
- 2D-PC-MRI velocity measurements show potential for longitudinal assessment of PAD.
- MRI-derived SFA velocity may offer insights into disease progression and functional outcomes.
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