title: Prognostic value of cardiovascular MR imaging biomarkers on outcome in peripheral arterial disease: a 6-year follow-up pilot study.
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.
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands. harrie.vd.bosch@catharinaziekenhuis.nl.
authors.forename: Harrie
authors.initials: H
authors.lastname: van den Bosch
authors.affiliation: Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Jos
authors.initials: J
authors.lastname: Westenberg
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Wikke
authors.initials: W
authors.lastname: Setz-Pels
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Kersten
authors.affiliation: Department of Radiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Tielbeek
authors.affiliation: Department of Radiology, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
authors.forename: Lucien
authors.initials: L
authors.lastname: Duijm
authors.affiliation: Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Post
authors.affiliation: Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Joep
authors.initials: J
authors.lastname: Teijink
authors.affiliation: Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: de Roos
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000209:etiology; D003925:Diabetic Angiopathies / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D018810:Magnetic Resonance Angiography; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012307:Risk Factors; D013318:Stroke Volume; D059289:Vascular Stiffness; D016277:Ventricular Function, Left
keywords: Follow-up studies; Magnetic resonance imaging; Peripheral arterial disease; Risk-factors