1. Dynamic magnetic resonance measurements of calf muscle oxygenation and energy metabolism in peripheral artery disease
- Author
-
Kang H. Zheng, Adrianus J. Bakermans, Erik S.G. Stroes, Aart J. Nederveen, Paul F. C. Groot, Chang Ho Wessel, ANS - Brain Imaging, Vascular Medicine, ACS - Atherosclerosis & ischemic syndromes, Radiology and Nuclear Medicine, ACS - Diabetes & metabolism, and AMS - Restoration & Development
- Subjects
Muscle tissue ,Male ,medicine.medical_specialty ,interleaved scanning ,Magnetic Resonance Spectroscopy ,Vasodilation ,Severity of Illness Index ,030218 nuclear medicine & medical imaging ,Phosphocreatine ,03 medical and health sciences ,chemistry.chemical_compound ,Gastrocnemius muscle ,Peripheral Arterial Disease ,0302 clinical medicine ,Internal medicine ,Vascular ,exercise stress ,mitochondrial dysfunction ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Ankle Brachial Index ,Muscle, Skeletal ,Original Research ,Soleus muscle ,Leg ,business.industry ,Oxygenation ,intermittent claudication ,Middle Aged ,Intermittent claudication ,Oxygen ,medicine.anatomical_structure ,chemistry ,Case-Control Studies ,Cardiology ,Female ,medicine.symptom ,atherosclerosis ,business ,Energy Metabolism ,Artery ,metabolic hyperemia - Abstract
Background: Clinical assessments of peripheral artery disease (PAD) severity are insensitive to pathophysiological changes in muscle tissue oxygenation and energy metabolism distal to the affected artery. Purpose: To quantify the blood oxygenation level-dependent (BOLD) response and phosphocreatine (PCr) recovery kinetics on a clinical MR system during a single exercise-recovery session in PAD patients. Study Type: Case–control study. Subjects: Fifteen Fontaine stage II patients, and 18 healthy control subjects. Field Strength/Sequence: Interleaved dynamic multiecho gradient-echo 1H T 2* mapping and adiabatic pulse-acquire 31P-MR spectroscopy at 3T. Assessment: Blood pressure in the arms and ankles were measured to determine the ankle-brachial index (ABI). Subjects performed a plantar flexion exercise-recovery protocol. The gastrocnemius and soleus muscle BOLD responses were characterized using the T 2* maps. High-energy phosphate metabolite concentrations were quantified by fitting the series of 31P-MR spectra. The PCr recovery time constant (τ PCr) was derived as a measure of in vivo mitochondrial oxidative capacity. Statistical Tests: Comparisons between groups were performed using two-sided Mann–Whitney U-tests. Relations between variables were assessed by Pearson's r correlation coefficients. Results: The amplitude of the functional hyperemic BOLD response in the gastrocnemius muscle was higher in PAD patients compared with healthy subjects (–3.8 ± 1.4% vs. –1.4 ± 0.3%; P < 0.001), and correlated with the ABI (r = 0.79; P < 0.001). PCr recovery was slower in PAD patients (τ PCr = 52.0 ± 13.5 vs. 30.3 ± 9.7 sec; P < 0.0001), and correlated with the ABI (r = –0.64; P < 0.001). Moreover, τ PCr correlated with the hyperemic BOLD response in the gastrocnemius muscle (r = –0.66; P < 0.01). Data Conclusion: MR readouts of calf muscle tissue oxygenation and high-energy phosphate metabolism were acquired essentially simultaneously during a single exercise-recovery session. A pronounced hypoxia-triggered vasodilation in PAD is associated with a reduced mitochondrial oxidative capacity. Level of Evidence: 2. Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:98–107.
- Published
- 2019