COMPREHENSIVE MAGNETIC RESONANCE IN PERIPHERAL ARTERIAL DISEASE

外周动脉疾病的综合磁共振

• 批准号: 7718538
• 负责人: CHRISTOPHER M. KRAMER
• 金额: $ 24.04万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-01 至 2009-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7718538
• 关键词: Angiography; Ankle; Arterial Fatty Streak; Arteries; Arteriogram; Atherosclerosis; Biomedical Engineering; Biometry; Blood; Blood Vessels; Cardiology; 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; improved; indexing; novel

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 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.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 周围动脉疾病（PAD）的特征是下肢动脉粥样硬化引起的下肢阻塞。在美国，大多数有1000万人的垫子都是老年人，而且患病率正在增加。与患有冠状动脉疾病的患者相比，患有PAD的患者因可能挽救生命的危险因素而造成的危险因素不足。目前使用的诊断方法是有限的，显然需要研究疾病进展和消退的方式。一支来自心脏病学，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组装，以开发和完善此类方法。 AIM＃1是开发和测试磁共振成像（MRI）方法，以对动脉壁进行成像并表征PAD中的动脉粥样硬化斑块。高分辨率的多层黑血螺旋MRI将在正常受试者中开发，并在患者中进行测试，以快速调查血管壁和浅表股动脉中的动脉粥样硬化斑块。多光谱MRI将表征特定区域中的斑块成分。目标＃2是在定量动脉粥样硬化周围动脉提供的灌注和骨骼肌能量时开发和测试MRI和MR光谱方法。 将进行标准化的Plantarflexion运动，以进行MRI中的特定功率输出。峰值运动中的第一级对比增强的MRI将量化小腿肌肉灌注的严重程度。运动恢复期间获得的磷光谱将确定缺血的代谢证据。 MR血管造影将评估管腔障碍。功能研究将包括6分钟的步行测试和跑步机运动，并进行V02峰值的测量。通过以下假设：他汀类药物疗法将减轻牙菌斑负担，稳定牙菌斑成分并改善终端功能的度量，目标＃3是使用多模式磁共振来测试他汀类药物治疗在容器壁上的效果，动脉粥样硬化斑块和骨骼肌肉灌注和骨骼肌肉灌注和垫子中的疗效。在基线时，将研究90例患有脚踝 - 扶手指数在0.4到0.9之间的患者，并在高剂量他汀类药物治疗4年期间使用全面的MR进行研究。这些研究将增强对他汀类药物介导的斑块回归和稳定的理解，并改善PAD中的最终器官功能，并为研究其他新型疗法的研究奠定基础。