MRI of Arterial Flow Reserve in Patients with Intermittent Claudication: Feasibility and Initial Experience

Objectives: The aim of this work was to develop a MRI method to determine arterial flow reserve in patients with intermittent claudication and to investigate whether this method can discriminate between patients and healthy control subjects. Methods: Ten consecutive patients with intermittent claudication and 10 healthy control subjects were included. All subjects underwent vector cardiography triggered quantitative 2D cine MR phase-contrast imaging to obtain flow waveforms of the popliteal artery at rest and during reactive hyperemia. Resting flow, maximum hyperemic flow and absolute flow reserve were determined and compared between the two groups by two independent MRI readers. Also, interreader reproducibility of flow measures was reported. Results: Resting flow was lower in patients compared to controls (4.961.6 and 11.163.2 mL/s in patients and controls, respectively (p,0.01)). Maximum hyperemic flow was 7.362.9 and 16.463.2 mL/s (p,0.01) and the absolute flow reserve was 2.461.6 and 5.361.3 mL/s (p,0.01), respectively in patients and controls. The interreader coefficient of variation was below 10 % for all measures in both patients and controls. Conclusions: Quantitative 2D MR cine phase-contrast imaging is a promising method to determine flow reserve measures in patients with peripheral arterial disease and can be helpful to discriminate patients with intermittent claudication fro

The role of exercise training in peripheral arterial disease

Peripheral arterial disease (PAD) is currently a major health problem affecting 8—12 million Americans, 15—40% of whom will have intermittent claudication that can lead to substantial impairment in their ability to carry out normal daily activities as well as perform the recommended cardiovascular exercise. Supervised exercise training is an effective tool in the treatment of claudication and is currently a recommended first-line therapy for patients with this condition. In addition to improving pain-free walking distance and quality of life, supervised exercise training can improve many cardiovascular risk factors, possibly reducing the risk for subsequent myocardial infarction, stroke, and death. This paper will review the benefits of supervised exercise training in patients with PAD

Ancestral Pueblo Archaeology: The Value of Synthesis

Archaeologists working in the Ancestral Pueblo region of the American Southwest have documented variability in sociopolitical and economic complexity, landscape use, community organization, mobility, and violence at a wide range of temporal and spatial scales from AD 500-1700. Recent studies have a strong synthetic orientation, employ methods that track material culture, mobility, and social networks at macroregional scales, and benefit from a renewed engagement with indigenous peoples. Much of this research relies on integrating vast amounts of data from numerous academic and cultural resource management projects and demonstrates the promise of an archaeology that relies on the cumulative acquisition and sharing of data. Given the scale and depth of this research, Ancestral Pueblo archaeology is an exceptional comparative case for archaeologists considering similar processes, especially at fine temporal and wide geographical scales, in ancient farming societies across the globe