COMPREHENSIVE MAGNETIC RESONANCE IN PERIPHERAL ARTERIAL DISEASE

外周动脉疾病的综合磁共振

基本信息

批准号：
7951458
负责人：
CHRISTOPHER M. KRAMER
金额：
$ 15.21万
依托单位：
UNIVERSITY OF VIRGINIA
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-03-01 至 2010-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7951458
关键词：
Angiography Ankle Arterial Fatty Streak Arteries Arteriogram Atherosclerosis Biomedical Engineering Biometry Blood Blood Vessels Cardiology Clinical Research Clinical Trials Computer Retrieval of Information on Scientific Projects Database Coronary heart disease Diagnostic Procedure Disease regression Dose Elderly Exercise Funding Grant Institution Ischemia Life Lower Extremity Magnetic Resonance Magnetic Resonance Imaging Measures Mediating Metabolic Methods Modality Modification Muscle Obstruction Operative Surgical Procedures Organ Output Patients Perfusion Peripheral Peripheral arterial disease Phosphorus Prevalence Radiology Specialty Recovery Research Research Personnel Resolution Resources Risk Factors Science Severities Skeletal Muscle Source Superficial Femoral Artery Surveys Testing Treadmill Tests United States National Institutes of Health Walking artery occlusion efficacy testing imaging modality improved indexing novel

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Peripheral arterial disease (PAD) is characterized by lower limb arterial obstruction due to atherosclerosis. Most of the over 10 million in the U.S. with PAD are elderly and the prevalence is increasing. Patients with PAD are undertreated with potentially life-saving risk factor modification when compared to those with coronary disease. Presently used diagnostic methods are limited and modalities that will allow study of progression and regression of disease are clearly needed. A multi-disciplinary team from cardiology, radiology, vascular surgery, biomedical engineering, exercise science, biostatistics and clinical trials management has been assembled to develop and refine such methods. Aim #1 is to develop and test magnetic resonance imaging (MRI) methods to image the arterial wall and characterize atherosclerotic plaque in PAD. High-resolution multislice black-blood spiral MRI will be developed in normal subjects and tested in patients to rapidly survey the vessel wall and atherosclerotic plaque in the superficial femoral artery. Multi-spectral MRI will characterize plaque components in specific regions. Aim #2 is to develop and test MRI and MR spectroscopic methods in the quantification of perfusion and energetics of skeletal muscle supplied by atherosclerotic peripheral arteries. Standardized plantarflexion exercise to a specific power output in the MRI will be performed. First-pass contrast-enhanced MRI at peak exercise will quantify the severity of calf muscle hypoperfusion. Phosphorus spectra acquired during exercise recovery will identify the metabolic evidence for ischemia. MR angiography will assess luminal obstruction. Functional studies will include a 6-minute walk test and treadmill exercise with measures of V02 peak. With the hypothesis that statin therapy will reduce plaque burden, stabilize plaque components, and improve measures of end-organ function, Aim #3 is to use multi-modality magnetic resonance to test the efficacy of statin therapy on the vessel wall, atherosclerotic plaque, and skeletal muscle perfusion and energetics in PAD. 90 patients with PAD with an ankle-brachial index between 0.4 and 0.9 will be studied with comprehensive MR at baseline and yearly during 4 years of therapy with a high-dose statin. These studies will enhance the understanding of statin-mediated plaque regression and stabilization and improved end organ function in PAD and lay the groundwork for the study of other novel therapies.

该子项目是利用该技术的众多研究子项目之一资源由 NIH/NCRR 资助的中心拨款提供。子项目及研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金，因此可以在其他 CRISP 条目中表示。列出的机构是对于中心来说，它不一定是研究者的机构。外周动脉疾病（PAD）的特征是动脉粥样硬化导致的下肢动脉阻塞。美国超过 1000 万 PAD 患者中大多数是老年人，而且患病率正在上升。与冠心病患者相比，外周动脉疾病患者在可能挽救生命的危险因素修正方面的治疗不足。目前使用的诊断方法是有限的，显然需要能够研究疾病进展和消退的模式。来自心脏病学、放射学、血管外科、生物医学工程、运动科学、生物统计学和临床试验管理的多学科团队已经组建起来，以开发和完善此类方法。目标#1 是开发和测试磁共振成像 (MRI) 方法，对动脉壁进行成像并表征 PAD 中的动脉粥样硬化斑块。高分辨率多层黑血螺旋 MRI 将在正常受试者中开发并在患者中进行测试，以快速检查股浅动脉的血管壁和动脉粥样硬化斑块。多光谱 MRI 将表征特定区域的斑块成分。目标 #2 是开发和测试 MRI 和 MR 波谱方法，以量化动脉粥样硬化外周动脉供应的骨骼肌的灌注和能量。将进行 MRI 中特定功率输出的标准化跖屈运动。运动高峰时的首轮对比增强 MRI 将量化小腿肌肉灌注不足的严重程度。运动恢复期间获得的磷光谱将识别缺血的代谢证据。磁共振血管造影将评估管腔阻塞。功能研究将包括 6 分钟步行测试和跑步机锻炼，并测量 V02 峰值。假设他汀类药物治疗将减少斑块负荷、稳定斑块成分并改善终末器官功能的测量，目标#3是使用多模态磁共振来测试他汀类药物治疗对血管壁、动脉粥样硬化斑块、以及 PAD 中的骨骼肌灌注和能量学。 90 名踝臂指数在 0.4 至 0.9 之间的 PAD 患者将在基线时和在高剂量他汀类药物治疗的 4 年期间每年进行全面 MR 研究。这些研究将增强对他汀类药物介导的斑块消退和稳定以及改善 PAD 终末器官功能的理解，并为其他新型疗法的研究奠定基础。