Key result
Upright cycling exercise significantly increased mean blood flow at the supraceliac level in AAA participants compared to rest (5.8 vs 2.6 L/min, P<0.001).
Why the study?
Does upright cycling exercise alter abdominal aortic hemodynamics in patients with AAA and claudication as measured by phase-contrast MRI?
Observational
Does upright cycling exercise alter abdominal aortic hemodynamics in patients with AAA and claudication as measured by phase-contrast MRI?
Absolute Event Rate: 5.8% vs 2.6%
p-value: p=<0.001
Phase-contrast MRI can effectively quantify significant and distinct hemodynamic redistributions during lower extremity exercise in patients with AAA and claudication.
Phase-contrast MRI quantifies exercise flow changes in AAA; hypothesis-generating for hemodynamic effects on stability, no practice change yet.
PURPOSE: To evaluate rest and exercise hemodynamics in patients with abdominal aortic aneurysms (AAA) and peripheral occlusive disease (claudicants) using phase-contrast MRI. MATERIALS AND METHODS: Blood velocities were acquired by means of cardiac-gated cine phase-contrast in a 0.5 Tesla (T) open MRI. Volumetric flow was calculated at the supraceliac (SC), infrarenal (IR), and mid-aneurysm (MA) levels during rest and upright cycling exercise using an MR-compatible exercise cycle. RESULTS: Mean blood flow increased during exercise (AAA: 130%, Claudicants: 136% of resting heart rate) at the SC and IR levels for AAA participants (2.6 +/- 0.6 versus 5.8 +/- 1.6 L/min, P < 0.001 and 0.8 +/- 0.4 versus 5.1 +/- 1.7 L/min, P < 0.001) and claudicants (2.3 +/- 0.5 versus 4.5 +/- 0.9 L/min, P < 0.005 and 0.8 +/- 0.2 versus 3.3 +/- 0.9 L/min, P < 0.005). AAA participants had a significant decrease in renal and digestive blood flow from rest to exercise (1.8 +/- 0.7 to 0.7 +/- 0.6 L/min, P < 0.01). The decrease in renal and digestive blood flow during exercise correlated with daily activity level for claudicants (R = 0.81). CONCLUSION: Abdominal aortic hemodynamic changes due to lower extremity exercise can be quantified in patients with AAA and claudication using PC-MRI. The redistribution of blood flow during exercise was significant and different between the two disease states.
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Tenforde et al. (2010) conducted an observational in Abdominal aortic aneurysms (AAA) and peripheral occlusive disease (claudication). Upright cycling exercise vs. Rest was evaluated on Mean blood flow at the supraceliac (SC) level in AAA participants (p=<0.001). Upright cycling exercise significantly increased mean blood flow at the supraceliac level in AAA participants compared to rest (5.8 vs 2.6 L/min, P<0.001).
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