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Prognostic value of cardiovascular MR imaging biomarkers on outcome in peripheral arterial disease: a 6-year follow-up pilot study

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Abstract

The objective of this pilot study was to explore the prognostic value of outcome of cardiovascular magnetic resonance (MR) imaging biomarkers in patients with symptomatic peripheral arterial disease (PAD) in comparison with traditional risk factors. Forty-two consecutive patients (mean age 64 ± 11 years, 22 men) referred for contrast-enhanced MR angiography (CE-MRA) were included. At baseline a comprehensive cardiovascular MRI examination was performed: CE-MRA of the infra-renal aorta and run-off vessels, carotid vessel wall imaging, cardiac cine imaging and aortic pulse wave velocity (PWV) assessment. Patients were categorized for outcome at 72 ± 5 months follow-up. One patient was lost to follow-up. Over 6 years, six patients had died (mortality rate 14.6 %), six patients (14.6 %) had experienced a cardiac event and three patients (7.3 %) a cerebral event. The mean MRA stenosis class (i.e., average stenosis severity visually scored over 27 standardized segments) was a significant independent predictor for all-cause mortality (beta 3.0 ± standard error 1.3, p = 0.02). Descending aorta PWV, age and diabetes mellitus were interrelated with stenosis severity but none of these were significant independent predictors. For cardiac morbidity, left ventricular ejection fraction (LVEF) and mean MRA stenosis class were associated, but only LVEF was a significant independent predictor (beta −0.14 ± 0.05, p = 0.005). Diabetes mellitus was a significant independent predictor for cerebral morbidity (beta 2.8 ± 1.3, p = 0.03). Significant independent predictors for outcome in PAD are mean MRA stenosis class for all-cause mortality, LVEF for cardiac morbidity and diabetes mellitus for cerebral morbidity.

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Authors and Affiliations

  1. Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands

    Harrie van den Bosch, Wikke Setz-Pels, Erik Kersten & Alexander Tielbeek

  2. Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands

    Jos Westenberg & Albert de Roos

  3. Department of Radiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands

    Lucien Duijm

  4. Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands

    Johannes Post

  5. Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands

    Joep Teijink

Authors
  1. Harrie van den Bosch
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  2. Jos Westenberg
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  3. Wikke Setz-Pels
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  4. Erik Kersten
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  5. Alexander Tielbeek
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  9. Albert de Roos
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Correspondence to Harrie van den Bosch.

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None of the authors have any conflict of interest.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants.

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van den Bosch, H., Westenberg, J., Setz-Pels, W. et al. Prognostic value of cardiovascular MR imaging biomarkers on outcome in peripheral arterial disease: a 6-year follow-up pilot study. Int J Cardiovasc Imaging 32, 1281–1288 (2016). https://doi.org/10.1007/s10554-016-0908-y

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  • DOI: https://doi.org/10.1007/s10554-016-0908-y

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