ArticleJACC. Cardiovascular imaging2008
Limb stress-rest perfusion imaging with contrast ultrasound for the assessment of peripheral arterial disease severity.
Article in JACC. Cardiovascular imaging, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 56 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Exercise and/or Liraglutide on Vascular Dysfunction and Insulin Sensitivity in Type 2 Diabetes ( ZQL007)
Effects of Nebivolol on Microvascular Perfusion in the Skeletal Muscles During Exercise in Hypertensive Patients
Who cites it
56 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.
- Utility of Contrast-Enhanced Ultrasound for the Assessment of Skeletal Muscle Perfusion in Diabetes Mellitus: A Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2019Pooled it
- Quantification of Skeletal Muscle Perfusion in Peripheral Artery Disease UsingJournal of the American Heart Association · 2024Trial
- Moderate dose of dietary nitrate improves skeletal muscle microvascular function in patients with peripheral artery disease.Microvascular research · 2023Trial
- Trial
- Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization.JACC. Cardiovascular imaging · 2021Trial
- Effect of treatment of peripheral arterial disease on the onset of anaerobic exercise during cardiopulmonary exercise testing.Physiological reports · 2021Trial
- Acute effects of leg heat therapy on walking performance and cardiovascular and inflammatory responses to exercise in patients with peripheral artery disease.Physiological reports · 2021Trial
- Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease.PloS one · 2019Trial
- Quantification of residual limb skeletal muscle perfusion with contrast-enhanced ultrasound during application of a focal junctional tourniquet.Journal of vascular surgery · 2016Trial
- Microvascular perfusion and intramuscular temperature of the calf during cooling.Medicine and science in sports and exercise · 2012Trial
- Article
- New horizons in nuclear cardiology: Imaging of peripheral arterial disease.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2025Review
- Contrast-enhanced magnetic resonance imaging based calf muscle perfusion and machine learning in peripheral artery disease.Scientific reports · 2025Article
- Emerging Photoacoustic Imaging Techniques for Peripheral Arterial Disease.Current treatment options in cardiovascular medicine · 2025Review
- An exercise stress test for contrast-enhanced duplex ultrasound assessment of lower limb muscle perfusion in patients with peripheral arterial disease.Journal of vascular surgery · 2024Article
- Critical limb-threatening ischaemia and microvascular transformation: clinical implications.European heart journal · 2024Article
- Contrast-free ultrasound imaging for blood flow assessment of the lower limb in patients with peripheral arterial disease: a feasibility study.Scientific reports · 2023Article
- Perfusion imaging techniques in lower extremity peripheral arterial disease.The British journal of radiology · 2022Review
- Contrast-Enhanced Ultrasound Reveals Partial Perfusion Recovery After Hindlimb Ischemia as Opposed to Full Recovery by Laser Doppler Perfusion Imaging.Ultrasound in medicine & biology · 2022Article
- Contrast Ultrasound Assessment of Skeletal Muscle Recruitable Perfusion after Permanent Left Ventricular Assist Device Implantation: Implications for Functional Recovery.Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesWe hypothesized that stress-rest perfusion imaging of skeletal muscle in the lower extremity with contrast-enhanced ultrasound (CEU) could evaluate the severity of peripheral arterial disease (PAD).
backgroundPerfusion imaging may provide valuable quantitative information on PAD, particularly in patients with diabetes in whom microvascular functional abnormalities are common.
methodsStudy subjects included 26 control subjects and 39 patients with symptomatic PAD, 19 of whom had type 2 diabetes mellitus. A modified treadmill exercise test was performed to determine exercise time to development of claudication. Multilevel pulse-volume recordings and ankle-brachial index (ABI) at rest and post-exercise ABI were measured in both extremities. Microvascular blood flow in the gastrocnemius and soleus muscles was measured at rest and after 2 min of calibrated plantar-flexion exercise.
resultsDuring exercise, claudication did not occur in normal subjects and occurred earlier in PAD patients with diabetes than without (median time 1.2 min [95% confidence interval (CI) 0.6 to 2.5] vs. 3.0 min [95% CI 2.1 to 6.0], p < 0.01). Compared to control subjects, patients with PAD had lower skeletal muscle blood flow during plantar-flexion exercise and lower flow reserve on CEU. After adjusting for diabetes, the only diagnostic tests that predicted severity of disease by claudication threshold were CEU exercise blood flow and flow reserve (odds ratios 0.67 [95% CI 0.51 to 0.88; p = 0.003] and 0.64 [95% CI 0.46 to 0.89, p = 0.008], respectively). A quasi-likelihood information analysis incorporating all non-invasive diagnostic tests indicated that the best models for predicting severity of disease were the combination of diabetes and either exercise blood flow or flow-reserve on CEU.
conclusionsPerfusion imaging of limb skeletal during exercise and measurement of absolute flow reserve can provide valuable information on the severity PAD. This strategy may be useful for evaluating the total impact of disease in patients with complex disease or those with coexisting functional abnormalities of flow regulation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.