TY - JOUR
T1 - Superficial femoral artery plaque and functional performance in peripheral arterial disease
T2 - Walking and leg circulation study (Walcs III)
AU - McDermott, Mary M.
AU - Liu, Kiang
AU - Carroll, Timothy J.
AU - Tian, Lu
AU - Ferrucci, Luigi
AU - Li, Debiao
AU - Carr, James
AU - Guralnik, Jack M.
AU - Kibbe, Melina
AU - Pearce, William H.
AU - Yuan, Chun
AU - McCarthy, Walter
AU - Kramer, Christopher M.
AU - Tao, Huimin
AU - Liao, Yihua
AU - Clark, Elizabeth Talley
AU - Xu, Dongxiang
AU - Berry, Jarett
AU - Orozco, Jennifer
AU - Sharma, Leena
AU - Criqui, Michael H.
N1 - Funding Information:
Dr. Li is currently affiliated with the Department of Radiology and Bioengineering, Cedars Sinai Medical Center, Los Angeles, California. Supported by funding from the National Heart, Lung, and Blood Institute (R01-HL083064), by the Intramural Research Program of the National Institute on Aging, and by the Jesse Brown VA Medical Center. Dr. Yuan receives research support from VP Diagnostics and from Philips Healthcare. Dr. Kramer receives research support from Siemens Healthcare. Dr. Xu is a technical consultant for VP Diagnostics and owner of Imaging Biomarker Solutions. All other authors have reported that they have no relationships to disclose. Eike Nagel, MD, PhD, served as Guest Editor for this article.
PY - 2011/7
Y1 - 2011/7
N2 - Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. Methods: A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Results: Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Conclusions: Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms.
AB - Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease. Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established. Methods: A total of 454 participants with an ankle brachial index <1.00 underwent magnetic resonance cross-sectional imaging of the proximal superficial femoral artery and completed a 6-min walk test, measurement of 4-m walking velocity at usual and fastest pace, and measurement of physical activity with a vertical accelerometer. Results: Adjusting for age, sex, race, body mass index, smoking, statin use, comorbidities, and other covariates, higher mean plaque area (1st quintile [least plaque]: 394 m, 2nd quintile: 360 m, 3rd quintile: 359 m, 4th quintile: 329 m, 5th quintile [greatest plaque]: 311 m; p trend <0.001) and smaller mean percent lumen area (1st quintile [greatest plaque]: 319 m, 2nd quintile: 330 m, 3rd quintile: 364 m, 4th quintile: 350 m, 5th quintile: 390 m; p trend <0.001) were associated with shorter distance achieved in the 6-min walk test. Greater mean plaque area was also associated with slower usual-paced walking velocity (p trend = 0.006) and slower fastest-paced 4-m walking velocity (p trend = 0.003). Associations of mean plaque area and mean lumen area with 6-min walk distance remained statistically significant even after additional adjustment for the ankle brachial index and leg symptoms. Conclusions: Among participants with peripheral arterial disease, greater plaque burden and smaller lumen area in the proximal superficial femoral artery are associated independently with poorer functional performance, even after adjusting for the ankle brachial index and leg symptoms.
KW - atherosclerotic plaque intermittent claudication
KW - peripheral arterial disease
KW - physical functioning
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U2 - 10.1016/j.jcmg.2011.04.009
DO - 10.1016/j.jcmg.2011.04.009
M3 - Article
C2 - 21757163
AN - SCOPUS:79960333815
SN - 1936-878X
VL - 4
SP - 730
EP - 739
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 7
ER -