Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease

Jonathan Lindner, Todd Belcik, Michael Widlansky, Leanne M. Harmann, Matthew S. Karafin, Nancy J. Wandersee, Maneka Puligandla, Donna Neuberg, Joel Linden, Joshua J. Field

    Research output: Contribution to journalArticle

    Abstract

    In patients with sickle cell disease (SCD), poor outcome measures compromise the potential success of clinical trials. Contrast-enhanced ultrasound (CEUS) is a technique that can non-invasively quantify deep tissue microvascular blood flow. We tested the hypothesis that CEUS of forearm skeletal muscle could be used to: 1) assess microvascular abnormalities that occur during vaso-occlusive crisis; and 2) test new therapies for SCD that are targeted to improving the status of the microcirculation. We performed a prospective study, CEUS perfusion imaging of resting forearm muscle was performed in adults with SCD: 1) during and after a pain episode, and 2) before, during, and after a 24-hour infusion of the investigative agent, regadenoson, an adenosine A2A agonist. CEUS destruction-replenishment time-intensity data were analyzed to measure microvascular blood flow, as well as its components, microvascular blood volume and flux rate. Serial CEUS measurements were obtained in 32 adults with SCD. For the studies during crisis, there was a 30% reduction in microvascular blood flow compared to steady-state (p = 0.031), a reduction that was largely due to microvascular flux rate. For the regadenoson group, a non-significant 25% increase in flux rate and 9% increase in microvascular blood flow compared to baseline were detected during infusion. In a study of adults with SCD, CEUS detected changes in microvascular blood flow associated with vaso-occlusive crises. No changes were found during an infusion of the adenosine A2A agonist, regadenoson. This study provides preliminary evidence that CEUS could detect blood flow changes consistent with SCD physiology.

    Original languageEnglish (US)
    Article numbere0218783
    JournalPloS one
    Volume14
    Issue number7
    DOIs
    StatePublished - Jan 1 2019

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    sickle cell anemia
    Sickle Cell Anemia
    blood flow
    Blood
    Ultrasonics
    adenosine
    Forearm
    Adenosine
    agonists
    Fluxes
    Muscle
    Cell Physiological Phenomena
    Perfusion Imaging
    blood volume
    Microcirculation
    Blood Volume
    prospective studies
    Physiology
    ultrasonography
    skeletal muscle

    ASJC Scopus subject areas

    • Biochemistry, Genetics and Molecular Biology(all)
    • Agricultural and Biological Sciences(all)

    Cite this

    Lindner, J., Belcik, T., Widlansky, M., Harmann, L. M., Karafin, M. S., Wandersee, N. J., ... Field, J. J. (2019). Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease. PloS one, 14(7), [e0218783]. https://doi.org/10.1371/journal.pone.0218783

    Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease. / Lindner, Jonathan; Belcik, Todd; Widlansky, Michael; Harmann, Leanne M.; Karafin, Matthew S.; Wandersee, Nancy J.; Puligandla, Maneka; Neuberg, Donna; Linden, Joel; Field, Joshua J.

    In: PloS one, Vol. 14, No. 7, e0218783, 01.01.2019.

    Research output: Contribution to journalArticle

    Lindner, J, Belcik, T, Widlansky, M, Harmann, LM, Karafin, MS, Wandersee, NJ, Puligandla, M, Neuberg, D, Linden, J & Field, JJ 2019, 'Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease', PloS one, vol. 14, no. 7, e0218783. https://doi.org/10.1371/journal.pone.0218783
    Lindner, Jonathan ; Belcik, Todd ; Widlansky, Michael ; Harmann, Leanne M. ; Karafin, Matthew S. ; Wandersee, Nancy J. ; Puligandla, Maneka ; Neuberg, Donna ; Linden, Joel ; Field, Joshua J. / Contrast-enhanced ultrasound detects changes in microvascular blood flow in adults with sickle cell disease. In: PloS one. 2019 ; Vol. 14, No. 7.
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