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Pearson SJ, Sindall P, Caldow E, Taberner P. The effect of resistance training on functional capacity in middle-aged to elderly individuals with peripheral artery disease: a meta-analysis. INT ANGIOL 2022; 41:525-532. [PMID: 36194384 DOI: 10.23736/s0392-9590.22.04922-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Peripheral artery disease (PAD) is an ischemic disease of the lower limbs, caused by atherosclerotic plaques, leading to impairments in functional capacity and reduced quality of life. This meta-analysis aimed to assess the effect of 12-week and 24-week resistance training (RT) interventions on 6-minute walking distance (6WMD) and initial claudication distance (ICD) measured during a 6-minute walk test (6MWT). EVIDENCE ACQUISITION A meta-analysis was conducted in accordance with PRISMA guidelines, with an electronic search conducted using the online database of PUBMED. Methodological quality of all included studies was completed using a modified version of the Newcastle Ottawa Scale (NOS). The effect sizes (ES) of 6MWD and ICD were calculated, with the 12-week and 24-week interventions analyzed separately. EVIDENCE SYNTHESIS An initial literature search yielded 1973 results that were consequently reduced to 7 studies to be included in the final meta-analysis. The pooled effect size for 6MWD for 12-week and 24-week interventions was ES=0.189 [95% CI: -0.074 to 0.451] P=0.159 and ES=0.298 [95% CI: -0.036 to 0.631] P=0.080 respectively. For ICD, ES=0.498 [95% CI: 0.000 to 0.995] P=0.050 and ES: 1.106 [95% CI: 0.120 to 0.428] P=0.001 respectively. CONCLUSIONS Short-term RT interventions have a positive effect on functional capacity in middle-aged to elderly individuals with PAD. There was a greater effect on ICD compared to 6MWD, with 24-week interventions showing larger effects for both measures. Improvements in functional capacity in such populations confers significant potential for positive health outcomes.
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Affiliation(s)
- Stephen J Pearson
- Department of Health and Social Care, University of Salford, Salford, UK -
| | - Paul Sindall
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Edward Caldow
- Department of Health and Social Care, University of Salford, Salford, UK
| | - Patrick Taberner
- Department of Health and Social Care, University of Salford, Salford, UK
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Ling Z, Li X, Wu G, Fadoul H. Radiomics of CTA is feasible in identifying muscle ischemia. Acta Radiol 2022; 64:1469-1475. [PMID: 36050936 DOI: 10.1177/02841851221119884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Advanced models based on computed tomography angiography (CTA) radiomics features in discriminating muscle ischemia from normal condition are lacking. PURPOSE To investigate the feasibility of radiomics of CTA in discriminating ischemic muscle from normal muscle. MATERIAL AND METHODS A total of 102 patients (51 ischemia and 51 non-ischemia) were analyzed using a CTA radiomics method. The radiomics features of muscle were compared between ischemic and normal cases. The maximum relevance minimum redundancy (mRMR) algorithm and least absolute shrinkage and selection operator (LASSO) logistic regression model were used. The receiver operating characteristic (ROC) curve was used to determine the performance of radiomics signature. RESULTS Thirty-nine CTA radiomics features were significantly different between the two groups (P < 0.05). By LASSO, six features were used to construct a model. The signature area under the curve was 0.92 and 0.91 in the training and validation cohorts, respectively. The sensitivity and specificity of the signature were 92% and 86% for the training cohort, and 80% and 94% for the validation cohort, respectively. CONCLUSION CTA radiomics signature is useful in identifying ischemic muscle in selected patients.
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Affiliation(s)
- Zhiyu Ling
- Department of Radiology, The first People's Hospital of Yongkang, Yongkang, Zhejiang, PR China
| | - Xiaoming Li
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Gang Wu
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
| | - Hissein Fadoul
- Department of Radiology, 66375Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, PR China
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Güneş M, Özmen T, Güler TM. The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication. Korean J Pain 2021; 34:471-478. [PMID: 34593665 PMCID: PMC8494951 DOI: 10.3344/kjp.2021.34.4.471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023] Open
Abstract
Background The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.
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Affiliation(s)
- Musa Güneş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Tarık Özmen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Tuğba Moralı Güler
- Department of Neurosurgery, Faculty of Medicine, Karabuk University, Karabuk, Turkey
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Harwood AE, Pymer S, Ibeggazene S, Ingle L, Caldow E, Birkett ST. Provision of exercise services in patients with peripheral artery disease in the United Kingdom. Vascular 2021; 30:874-881. [PMID: 34348503 PMCID: PMC9485155 DOI: 10.1177/17085381211035259] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives Supervised exercise programmes (SEPs) are a vital treatment for people with intermittent claudication, leading improvements in walking distance and quality of life and are recommended in multiple national and international guidelines. We aimed to evaluate the use and structure of SEPs in the United Kingdom (UK). Design We conducted an anonymous online survey using the Jisc platform comprising of 40 questions. The survey was designed to address key areas such as access, provision, uptake and delivery of SEPs in the United Kingdom. Ethical approval was obtained from Coventry University (P108729). Methods The list of trusts providing vascular services was obtained from the National Vascular Registry (NVR) report. The survey was disseminated via social media, The Vascular Society of Great Britain and Ireland and the Society for Vascular Technology. Data were exported to a Microsoft Excel document and analysed using simple descriptive statistics. Results Of 93 vascular units identified, we received response from 48. Of these, 23 had access to an exercise programme (48%). The majority of SEPs were exclusively for PAD patients (77%), with 21% using integrated services. 67% of respondents were providing a circuit-based programme, and 5 out of 23 were meeting the dose recommendations in the UK National Institute for Health and Care Excellence (NICE) guidelines. Respondents felt that programmes were moderately to extremely important to patients, slightly to very important to clinicians and not at all important to slightly important to commissioning/funding bodies. Conclusion SEPs are a well-established first-line treatment for patients with IC and they are recommended by NICE guidelines. Despite this, many patients still do not have access to an exercise programme, and clinicians do not feel that they have support from commissioning/funding bodies to develop them. There is an urgent need for funding, development and delivery of SEPs in the United Kingdom.
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Affiliation(s)
- Amy E Harwood
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Science and Health Building, Whitefriars Street, RinggoldID:120958Coventry University, Coventry, UK
| | - Sean Pymer
- Academic Vascular Surgical Unit, 12195Hull York Medical School, Hull, UK
| | - Said Ibeggazene
- College of Health, Wellbeing and Life Sciences, 7314Sheffield Hallam University, Sheffield, UK
| | - Lee Ingle
- Department of Sport, Health and Exercise Sciences, Faculty of Health Sciences, 4019University of Hull, Hull, UK
| | - Eddie Caldow
- School of Health and Society, 7046University of Salford, Salford, UK
| | - Stefan T Birkett
- School of Sport and Health Sciences, 6723University of Central Lancashire, Preston, UK
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Guilleron C, Abraham P, Beaune B, Pouliquen C, Henni S, Durand S. Location of ischemia and ischemic pain intensity affect spatiotemporal parameters and leg muscles activity during walking in patients with intermittent claudication. Sci Rep 2021; 11:6809. [PMID: 33762658 PMCID: PMC7990938 DOI: 10.1038/s41598-021-86351-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 03/07/2021] [Indexed: 12/31/2022] Open
Abstract
The ways in which locations of ischemia and ischemic pain affect spatiotemporal gait parameters and leg electromyographic activity during walking have never been investigated in patients with peripheral arterial disease presenting intermittent claudication. Two groups were classified according to unilateral location of ischemia (distal, n = 10, or proximo-distal, n = 12). Patients described pain and three gait phases-initial pain-free, onset of pain and maximum pain-were analyzed. Patients with proximo-distal ischemia walked less (230 ± 111 m vs 384 ± 220 m), with increased step length, step time (+ 5.4% and + 5.8%) and reduced cadence (- 8.2%), than patients with distal ischemia. In both, the peaks of vertical ground reaction force were reduced in maximum pain (Peak1-distal: - 11.4%, Peak1-proximo-distal: - 10.3%; Peak2-distal: - 11.8%, Peak2-proximo-distal: - 9.0%). In the proximo-distal group, tibialis anterior activation peak and time were lower than in the distal group (- 4.5% and - 19.7%). During the maximum pain phase, this peak decreased only in the proximo-distal group (- 13.0%), and gastrocnemius medialis activation peak and time decreased in both groups (- 2.5% in distal and - 4.5% in proximo-distal). Thus, proximo-distal ischemia leads to more adverse consequences in gait than distal ischemia only. Increasing ischemic pain until maximum, but not onset of pain, induced gait adaptations.
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Affiliation(s)
- Céline Guilleron
- Le Mans Université, Movement-Interactions-Performance, MIP, EA 4334, 72000, Le Mans, France.,UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France.,Department of Vascular Medicine, University Hospital of Angers, 4 rue Larrey, 49100, Angers, France
| | - Pierre Abraham
- Sports Medicine, University Hospital of Angers, 4 rue Larrey, 49100, Angers, France.,UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France
| | - Bruno Beaune
- Le Mans Université, Movement-Interactions-Performance, MIP, EA 4334, 72000, Le Mans, France
| | - Camille Pouliquen
- Le Mans Université, Movement-Interactions-Performance, MIP, EA 4334, 72000, Le Mans, France
| | - Samir Henni
- UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France.,Department of Vascular Medicine, University Hospital of Angers, 4 rue Larrey, 49100, Angers, France
| | - Sylvain Durand
- Le Mans Université, Movement-Interactions-Performance, MIP, EA 4334, 72000, Le Mans, France. .,Laboratory "Movement, Interactions, Performance", MIP, EA 4334, Le Mans University, Avenue Olivier Messiaen, 72085, Le Mans Cedex 9, France.
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Harwood AE, Pugh CJ, Steward CJ, Menzies C, Thake CD, Cullen T. A systematic review of the role of heat therapy for patients with intermittent claudication due to peripheral artery disease. Vasc Med 2021; 26:440-447. [PMID: 33587690 PMCID: PMC8358540 DOI: 10.1177/1358863x20983475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intermittent claudication (IC) is associated with impairments in quality of life and walking ability. Heat therapy is an emerging cardiovascular therapy, which may improve walking in patients with IC. We undertook a systematic review to establish current evidence for heat therapy for patients with IC. We searched five databases (Ovid Medline / PubMed, Embase, Scopus / Web of Science, Cochrane Library and Health Technology Assessment Databases). A total of 6751 records were screened with 76 full-text articles assessed for eligibility. We included three randomised control trials and three acute interventions. For chronic interventions, three different heat therapy interventions were used. The 6-minute walk distance significantly improved following whole-body immersion (p = 0.03; ES 0.94, 95% CI: 0.06-1.82), but not after Waon therapy or a water-perfused garment. Ankle-brachial pressure indices were significantly improved following whole-body immersion (p = 0.01; ES 1.10, 95% CI: 0.20-1.99) but not after other therapies. No form of heat therapy demonstrated statistical improvements in quality of life or brachial blood pressure. Acute interventions were characterised by large increases in limb blood flow and core temperature, and transient reductions in blood pressure post-heating. At present there are only three randomised controlled trials assessing heat therapy for patients with IC. Moreover, each of those randomised controlled trials utilised different heat therapies. There is also very limited study of the acute physiological responses to different heat therapy interventions in these populations. Future research should establish appropriate heat therapy protocols and implement more randomised trials to understand its effectiveness. PROSPERO: CRD42020187941.
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Affiliation(s)
- Amy E Harwood
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Christopher Ja Pugh
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Charles J Steward
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Campbell Menzies
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - C Doug Thake
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Tom Cullen
- Centre for Sport, Exercise and Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Guilleron C, Maktouf W, Beaune B, Henni S, Abraham P, Durand S. Coactivation pattern in leg muscles during treadmill walking in patients suffering from intermittent claudication. Gait Posture 2021; 84:245-253. [PMID: 33383535 DOI: 10.1016/j.gaitpost.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 10/26/2020] [Accepted: 12/08/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND In patients with peripheral arterial disease and presenting intermittent claudication (PAD-IC), the pain due to ischemia impacts gait parameters, particularly in cases of unilateral disease. Deterioration of gait parameters in a pathological context is frequently associated with increased coactivation (simultaneous activation of agonist and antagonist muscles around a joint). RESEARCH QUESTION Does unilateral PAD-IC affect the coactivation pattern during walking? Does the coactivation pattern change with increasing pain intensity? METHOD We evaluated symptomatic and asymptomatic legs in 17 subjects with unilateral PAD-IC and 16 without PAD-IC (control group), during walking. Tibialis anterior (TA) and gastrocnemius medialis (GM) electromyographic activity, and peaks of vertical ground reaction force were recorded in this prospective study. We analyzed the coactivation index (CI(GM/TA)) during three periods (pain-free, pain and maximum pain) and phases of the gait cycle. Statistical analysis was carried out using the ANOVA procedure. RESULTS During single support, CI(GM/TA) increases in the symptomatic leg during the pain period (+28 %) and in the asymptomatic leg during the maximum pain period (+29 %). During second double support, CI(GM/TA) increases in the symptomatic leg only (+49 %). In these gait phases, pain elicits differences in CI(GM/TA) between legs (p < 0.05). Second peak force decreases in the symptomatic leg only (-9%) and is negatively correlated with CI(GM/TA) during the three periods (r = -0.57; -0.76 and -0.78 respectively, p < 0.05). No difference is found in the control group. SIGNIFICANCE The appearance and development of pain in the lower limbs is associated with a higher level of CI(GM/TA), revealing a compensatory gait pattern in PAD-IC patients. Optimal prevention, rehabilitation and re-training strategies for PAD-IC patients should take into consideration neuromuscular compensatory mechanisms between asymptomatic and symptomatic legs.
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Affiliation(s)
- Céline Guilleron
- Le Mans Université, Movement - Interactions - Performance, MIP, EA 4334, F-72000, Le Mans, France; UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France; Department of Vascular Medicine, University Hospital of Angers, 4 rue Larrey, 49100 Angers, France
| | - Waël Maktouf
- Le Mans Université, Movement - Interactions - Performance, MIP, EA 4334, F-72000, Le Mans, France
| | - Bruno Beaune
- Le Mans Université, Movement - Interactions - Performance, MIP, EA 4334, F-72000, Le Mans, France
| | - Samir Henni
- UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France; Department of Vascular Medicine, University Hospital of Angers, 4 rue Larrey, 49100 Angers, France
| | - Pierre Abraham
- Sports Medicine, University Hospital of Angers, 4 rue Larrey, 49100, Angers, France; UMR CNRS 6015 INSERM 1083, University of Angers, 4 rue Larrey, 49100, Angers, France
| | - Sylvain Durand
- Le Mans Université, Movement - Interactions - Performance, MIP, EA 4334, F-72000, Le Mans, France.
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The hidden side of calf claudication: Hemodynamic and clinical results of treadmill testing in 584 patients complaining of isolated exertional calf pain. Atherosclerosis 2020; 314:41-47. [DOI: 10.1016/j.atherosclerosis.2020.10.891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/07/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022]
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Rodrigues E, Silva I. Supervised exercise therapy in intermittent claudication: a systematic review of clinical impact and limitations. INT ANGIOL 2020; 39:60-75. [DOI: 10.23736/s0392-9590.19.04159-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Morris DR, Skalina TA, Singh TP, Moxon JV, Golledge J. Association of Computed Tomographic Leg Muscle Characteristics With Lower Limb and Cardiovascular Events in Patients With Peripheral Artery Disease. J Am Heart Assoc 2019; 7:e009943. [PMID: 30371256 PMCID: PMC6474956 DOI: 10.1161/jaha.118.009943] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Poor lower extremity physical performance is an independent predictor of unfavorable outcome in patients with peripheral artery disease ( PAD ); however, few studies have assessed muscle characteristics on imaging directly. Method and Results A novel 3-dimensional semi-automated protocol was developed to estimate leg muscle volume and density (mean attenuation) from computed tomography images. Patients with PAD who underwent a lower extremity computed tomography scan at a tertiary vascular surgery center were included, and were followed up using hospital records and linked data as part of a retrospective cohort study. The primary outcomes were lower limb events (major amputation or peripheral revascularization) and cardiovascular events (myocardial infarction, stroke, or cardiovascular death). Two hundred and twenty-three patients with PAD were included (median age 69.0 years; 73% men) and followed for a median of 4.9 [2.6-7.0] years. During this time there were 99 index lower limb events and 97 cardiovascular events. Low leg muscle density was associated with increased risk of lower limb (rate ratio 1.41 [1.11-1.80] per SD reduction) and cardiovascular events (rate ratio 1.60 [1.29-1.99] per SD reduction). Low muscle density remained an independent predictor of cardiovascular (but not lower limb) events, after adjusting for age, sex, traditional cardiovascular risk factors, and angiographic PAD severity (rate ratio 1.39 [1.09-1.77] per lower SD ). In contrast, leg muscle volume was not associated with outcomes after adjusting for risk factors and PAD severity. Conclusions Low leg muscle density, but not volume, is a strong, independent predictor of major cardiovascular events among people with PAD . Further research is needed to understand the mechanisms underlying these associations.
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Affiliation(s)
- Dylan R Morris
- 1 Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia
| | - Tristan A Skalina
- 1 Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia
| | - Tejas P Singh
- 1 Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia
| | - Joseph V Moxon
- 1 Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia
| | - Jonathan Golledge
- 1 Queensland Research Centre for Peripheral Vascular Disease College of Medicine and Dentistry James Cook University Townsville Queensland Australia.,2 Department of Vascular and Endovascular Surgery The Townsville Hospital Townsville Queensland Australia
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Engelke K, Museyko O, Wang L, Laredo JD. Quantitative analysis of skeletal muscle by computed tomography imaging-State of the art. J Orthop Translat 2018; 15:91-103. [PMID: 30533385 PMCID: PMC6260391 DOI: 10.1016/j.jot.2018.10.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 02/06/2023] Open
Abstract
The radiological assessment of muscle properties-size, mass, density (also termed radiodensity), composition, and adipose tissue infiltration-is fundamental in muscle diseases. More recently, it also became obvious that muscle atrophy, also termed muscle wasting, is caused by or associated with many other diseases or conditions, such as inactivity, malnutrition, chronic obstructive pulmonary disorder, cancer-associated cachexia, diabetes, renal and cardiac failure, and sarcopenia and even potentially with osteoporotic hip fracture. Several techniques have been developed to quantify muscle morphology and function. This review is dedicated to quantitative computed tomography (CT) of skeletal muscle and only includes a brief comparison with magnetic resonance imaging. Strengths and limitations of CT techniques are discussed in detail, including CT scanner calibration, acquisition and reconstruction protocols, and the various quantitative parameters that can be measured with CT, starting from simple volume measures to advanced parameters describing the adipose tissue distribution within muscle. Finally, the use of CT in sarcopenia and cachexia and the relevance of muscle parameters for the assessment of osteoporotic fracture illustrate the application of CT in two emerging areas of medical interest.
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Affiliation(s)
- Klaus Engelke
- FAU, Department of Medicine 3, University Hospital, Erlangen, Germany
- Friedrich-Alexander University Erlangen-Nuremberg, Institute of Medical Physics, Erlangen, Germany
| | - Oleg Museyko
- Friedrich-Alexander University Erlangen-Nuremberg, Institute of Medical Physics, Erlangen, Germany
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Jean-Denis Laredo
- AP-HP, Department of Radiology, Hôpital Lariboisière, Assistance Publique des Hôpitaux de Paris & Université Paris Diderot, Paris, France
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