Author + information
- Received October 29, 2010
- Revision received March 29, 2011
- Accepted April 7, 2011
- Published online July 1, 2011.
- Mary M. McDermott, MD⁎,†,⁎ (, )
- Kiang Liu, PhD†,
- Timothy J. Carroll, PhD‡‡,
- Lu Tian, ScD§§,
- Luigi Ferrucci, MD, PhD¶¶,
- Debiao Li, PhD‡,
- James Carr, MD‡,
- Jack M. Guralnik, MD, PhD##,
- Melina Kibbe, MD§,¶,
- William H. Pearce, MD∥,¶,
- Chun Yuan, PhD⁎⁎⁎,
- Walter McCarthy, MD#,
- Christopher M. Kramer, MD‡‡‡,
- Huimin Tao, MS†,
- Yihua Liao, MS†,
- Elizabeth Talley Clark, MD††,
- Dongxiang Xu, PhD†††,
- Jarett Berry, MD§§§,
- Jennifer Orozco, MMS, PA⁎⁎,
- Leena Sharma, MD⁎ and
- Michael H. Criqui, MD, MPH∥∥
- ↵⁎Reprint requests and correspondence:
Dr. Mary M. McDermott, Departments of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, 750 North Lake Shore Drive, 10th Floor, Chicago, Illinois 60611
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.
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.
- Received October 29, 2010.
- Revision received March 29, 2011.
- Accepted April 7, 2011.
- American College of Cardiology Foundation