Key result
A physiological model of arterial spin labeling reactive hyperemia showed that 2-minute thigh cuffing is more sensitive to microvascular dysfunction than 5-minute cuffing, better differentiating peripheral arterial disease patients from healthy subjects.
Why the study?
Does ASL reactive hyperemia with model-based analysis improve the differentiation of microvascular dysfunction in PAD patients compared to standard peak and time-to-peak characterization?
Observational (n=16)
Does ASL reactive hyperemia with model-based analysis improve the differentiation of microvascular dysfunction in PAD patients compared to standard peak and time-to-peak characterization?
Answers are grounded in this paper and cite their sources.
A novel physiological model for ASL reactive hyperemia can differentiate microvascular dysfunction from arterial stenoses in PAD, potentially allowing for better noninvasive microvascular assessment.
To characterize and interpret arterial spin labeling (ASL) reactive hyperemia of calf muscles for a better understanding of the microcirculation in peripheral arterial disease (PAD), we present a physiological model incorporating oxygen transport, tissue metabolism, and vascular regulation mechanisms. The model demonstrated distinct effects between arterial stenoses and microvascular dysfunction on reactive hyperemia, and indicated a higher sensitivity of 2-minute thigh cuffing to microvascular dysfunction than 5-minute cuffing. The recorded perfusion responses in PAD patients (n = 9) were better differentiated from the normal subjects (n = 7) using the model-based analysis rather than characterization using the apparent peak and time-to-peak of the responses. The analysis results suggested different amounts of microvascular disease within the patient group. Overall, this work demonstrates a novel analysis method and facilitates understanding of the physiology involved in ASL reactive hyperemia. ASL reactive hyperemia with model-based analysis may be used as a noninvasive microvascular assessment in the presence of arterial stenoses, allowing us to look beyond the macrovascular disease in PAD. A subgroup who will have a poor prognosis after revascularization in the patients with critical limb ischemia may be associated with more severe microvascular diseases, which may potentially be identified using ASL reactive hyperemia.
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Chen et al. (2017) conducted an observational in Peripheral arterial disease (n=16). 2-minute thigh cuffing with model-based analysis vs. Healthy subjects / 5-minute cuffing was evaluated on Differentiation of microvascular dysfunction and arterial stenoses. A physiological model of arterial spin labeling reactive hyperemia showed that 2-minute thigh cuffing is more sensitive to microvascular dysfunction than 5-minute cuffing, better differentiating peripheral arterial disease patients from healthy subjects.
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