Spectroscopy in Functional Assessment of Peripheral Artery Disease (spectroAMI)

  • STATUS
    Recruiting
  • days left to enroll
    5
  • participants needed
    40
  • sponsor
    Centre Hospitalier Universitaire de Saint Etienne
Updated on 27 November 2021
arterial occlusive disease
peripheral artery disease
angiography

Summary

To explore the reliability of P-31 MR spectroscopy mitochondrial function in patients with peripheral arterial occlusive disease.

Description

Peripheral arterial occlusive disease (PAOD) is defined as the partial or total obstruction of one or more lower extremity arteries, most often of atherosclerotic origin. It is a common disease whose 5-years mortality is near 30%.The positive diagnosis is based on clinical examination and measurement of the ankle-brachial index (ABI), which is the ratio of systolic pressure of ankle and brachial systolic pressure. The threshold value for the diagnosis is <0.90. Physiopathologically, mitochondria have the predominant role of providing the ATP necessary for the energetic needs of myocytes, which increase drastically during muscle contraction during exercise. This energy production is of course conditioned by the availability of oxygen. In patients with PAOD, the decrease in blood flow secondary to significant stenosis has the direct consequence of disrupting oxygen delivery to distal muscles and thus limiting muscular performance. Because mitochondrial respiration is the only metabolic pathway capable of providing the energy needed to sustain an effort of several minutes, intermittent claudication in PAOD has logically been related to a hemodynamic mechanism of intermittent muscle hypoperfusion. Recently, an increasing number of histological or functional studies have suggested that episodes of ischemia-reperfusion could induce mitochondrial dysfunction. Medical treatment of patients frequently includes statins while a direct deleterious effect on mitochondrial function has been suspected, inducing a deterioration of the muscular oxidative capacity which would increase the factors hemodynamics and may accumulate in mitochondrial myopathy. In the light of these elements, it is clear that there would be a benefit in being able to distinguish and quantify 1) the part of the reduction of mitochondrial activity secondary to the hemodynamic factor alone due to a decreased muscle perfusion 2) the mitochondrial involvement (mitochondriopathy) potentially induced by oxidative stress in PAOD. 2 sub-groups are distinguished to identify the statin-induced mitochondrial dysfunction.

Details
Condition Vascular Diseases, arterial obstructive disease, Arterial Occlusive Disease, Occlusions
Treatment Magnetic Resonance Imaging (MRI)
Clinical Study IdentifierNCT03723473
SponsorCentre Hospitalier Universitaire de Saint Etienne
Last Modified on27 November 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Peripheral arterial occlusive disease (PAOD) with claudication and surgery planning with proximal lesion (iliac or femoral (x-ray angiography or CT or MRA) and no distal lesions (doppler)
ABI<0.90 or >1.30
signed consent form
health insurance coverage

Exclusion Criteria

Contraindication in the practice of MRI: pacemaker, metallic cardiac valve, intra-ocular metal part, claustrophobia
critical ischemia >15 days
Type 1 or 2 diabetes
weight >200kg
non stabilized hypertension
beta-blockers
non-atherosclerotic vascular occlusive disease (Buerger disease, Takayasu disease, venous disease, trapped popliteal artery etc..)
Neurological pathology/non-voluntary contraction
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