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U.VA. AWARDED GRANT TO STUDY PERIPHERAL ARTERIAL DISEASE

Researchers at the University of Virginia Health System have been awarded a $3.7 million U.S. government grant to study diagnostic tools and drug treatment for peripheral arterial disease (PAD).

The grant is from the National Heart Lung and Blood Institute of the National Institutes of Health (NIH). It will fund a five-year study at U.Va. of PAD’s physiology and whether cholesterol-lowering statins can help PAD sufferers.

Peripheral arterial disease is caused by blockages in the arteries that deliver blood to the legs, usually because of atherosclerosis, a buildup of fatty material in the arterial wall. Patients with PAD have an increased risk of heart attack and stroke due to associated atherosclerosis in coronary (heart) and carotid (brain) arteries. Eight to 12 million people in the U.S. may be living with the disease, according to the NIH.

“Much more can be learned about peripheral arterial disease than we know now,” said Dr. Christopher Kramer, principal investigator of the study, associate professor of radiology and internal medicine and head of cardiac magnetic resonance imaging (MRI) at U.Va. “First, we plan to develop new ways to image PAD and its physiology using magnetic resonance imaging of the arterial wall and atherosclerotic plaque. We also plan to image blood flow to the calf muscle during exercise as a measure of the extent of PAD,” Kramer said. “Second, one hundred patients at U.Va. will be started on a high dose of a statin, a cholesterol-lowering drug, to find out how the drug affects the arterial wall. We hope to determine, using sophisticated imaging techniques, whether statins improve PAD symptoms, especially mobility, and quality of life.” Statins have shown to benefit patients with coronary artery disease, but little is known about their direct effects on peripheral arterial disease, according to Kramer.

Classic symptoms of PAD sometimes go unrecognized. They include painful cramping in the leg or hip muscles, especially when walking, numbness or weakness in the leg or a burning pain in the foot or toes. A cooling or color change can also happen in the legs or feet and hair loss on the legs can also occur. In extreme cases, untreated PAD can lead to gangrene, which could require amputation. However, many people have no symptoms or pain with PAD.

Mild to moderate disease is usually treated with medication. Advanced disease is often treated with angioplasty and the placement of a metal stent in the artery. Other treatments include bypassing the diseased artery surgically.

In 1999, there were 1.3 million hospitalizations in the U.S. in which PAD was a primary or secondary diagnosis, according to the NIH.  The death rate of people with peripheral arterial disease at five years is about 28 percent, according to the American Cancer Society, greater than Hodgkins disease or breast cancer.

October 28, 2003