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Contrast-Enhanced Ultrasound of Muscle Perfusion May Indicate Patient Response to Left Ventricular Assist Device Therapy
- Source :
- J Ultrasound Med
- Publication Year :
- 2021
-
Abstract
- PURPOSE—: Left ventricular assist device (LVAD) support is associated with peripheral vascular abnormalities beyond those associated with heart failure (HF). These abnormalities are associated with persistent functional impairments that adversely impact quality of life (QoL). Methods for measuring peripheral vascular function in this population are needed. METHODS—: This pilot study investigated the use of contrast-enhanced ultrasound (CEUS) using standardized protocols to estimate changes in peripheral (quadriceps) muscle perfusion among patients with HF (INTERMACS profile 3) undergoing LVAD implantation (n = 7). Patients were then stratified by those who did (“responders”, n = 4) and did not (“nonresponders”, n = 3) report QoL improvement with LVAD support. RESULTS—: Serial measurements obtained preoperatively and 3 months following LVAD implantation showed no significant change (P > .23) in muscle perfusion by all CEUS-based measures at rest or with an exercise stimulus for the overall population. Responders exhibited improved muscle perfusion at rest (P = .043) and decreased time to peak contrast enhancement (P = .010) at 3 months compared with baseline, suggesting improved delivery of blood to the extremities post-LVAD. Nonresponders showed unchanged resting muscle perfusion (P > .99), time to peak contrast enhancement (P = .59), and response to exercise stimulus (P > .99) following LVAD therapy. CONCLUSION—: Our findings suggest that CEUS evaluation is a promising noninvasive, quantitative modality for real-time assessment of peripheral vasculature and muscle perfusion as an indication of treatment response in LVAD recipients and that this modality may capture perfusion measures important to QoL following LVAD implantation.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Population
Pilot Projects
Article
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Quality of life
Internal medicine
Medicine
Humans
Radiology, Nuclear Medicine and imaging
education
Heart Failure
education.field_of_study
030219 obstetrics & reproductive medicine
Radiological and Ultrasound Technology
business.industry
Muscles
Ultrasound
medicine.disease
equipment and supplies
Peripheral
Perfusion
Heart failure
Ventricular assist device
Cardiology
Quality of Life
Heart-Assist Devices
business
Contrast-enhanced ultrasound
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- J Ultrasound Med
- Accession number :
- edsair.doi.dedup.....be025306a1039baafbbf480428fca468