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Quantifying in vivo hemodynamic response to exercise in patients with intermittent claudication and abdominal aortic aneurysms using cine phase‐contrast MRI
Authors:Adam S. Tenforde  Christopher P. Cheng  Ga‐Young Suh  Robert J. Herfkens  Ronald L. Dalman  Charles A. Taylor
Abstract:

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. J. Magn. Reson. Imaging 2010; 31: 425–429. © 2010 Wiley‐Liss, Inc.
Keywords:exercise imaging  blood flow  vascular disease  abdominal aortic aneurysm  phase‐contrast MRI
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