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New Test to Diagnose the Peripheral Arterial Disease (PAD)

According to a new survey nearly 12 million Americans are affected by peripheral arterial disease, or PAD. PAD is a condition where the arteries are blocked that brings blood to the legs due to atherosclerotic plaque//. The number of people affected by PAD is likely to increase in the coming decades and it’s time to diagnose the severity of PAD and develop new drugs to treat it.

By examining the physiology of patients who exercised under a magnetic resonance imaging scanner (MRI), doctors at the University of Virginia Health System have devised a new test to diagnose and follow peripheral arterial disease. This test shows promise in helping drug companies test new PAD medications and, perhaps in the near future, may give doctors the ability to tell which patients are at risk for developing PAD-related complications and require stenting, bypass surgery or even amputation of a leg.

A UVa cardiologist, Dr. Christopher Kramer, and his colleagues, measured how fast the leg muscles of patients with PAD, and people without PAD, recovered a phosphorus substance called phosphocreatine (PCr), the major energy “store” in muscle cells. Tests at UVa on 20 patients with mild to moderate PAD and 14 people without PAD, showed that the median time to recover phosphocreatine at the end of exercise in PAD patients was three times slower, 91 seconds in the PAD group versus 35 seconds in the normal group.

What was unusual is that the UVa doctors stepped back in time and used a measurement technique developed in the 1970’s called MR spectroscopy, the forerunner to modern MR imaging. 'We were somewhat surprised that of all new tests for PAD that we have been developing, the one that seemed to work the best is spectroscopy. It’s relatively simple and not particularly sexy, but very accurate physiologically,' Kramer said.

All of the patients tested exercised to exhaustion on a special push-pedal machine in an MRI scanner. A spectroscopy coil i
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