{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:42Z","timestamp":1789013322498,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Lower limb peripheral artery disease (PAD) involves localized atherosclerosis with disturbed hemodynamics. V\u2010flow imaging is a vector Doppler technique enabling real\u2010time assessment of wall\u2010specific hemodynamic parameters such as wall shear stress (WSS) and oscillatory shear index (OSI). This study included a case\u2013control diagnostic evaluation and a prospective observational component for exploratory prognostic assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The study enrolled 95 patients with PAD and 100 controls with plaque\u2010free lower limb arteries. V\u2010flow imaging measured WSSmax, WSSmean, and OSI across major lower limb arteries. Multivariate logistic regression and receiver operating characteristic analysis identified PAD predictors. A nomogram combining V\u2010flow and clinical parameters was developed. V\u2010flow analysis of 25 femoral plaques assessed upstream\u2010downstream WSS\/OSI variation. A total of 28 patients with Fontaine IV PAD were followed for 6 months to exploratorily assess preoperative V\u2010flow parameters in relation to major adverse limb events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with PAD exhibited globally lower WSS and higher OSI in plaque\u2010free segments compared with controls. Combined V\u2010flow and clinical parameters showed moderate discriminative performance for PAD diagnosis (area under the curve, 0.87; sensitivity 80.1%; specificity 79.3%), with an optimism\u2010corrected area under the curve of 0.86. Femoral plaques exhibited lower downstream WSS and higher OSI. Preoperative V\u2010flow parameters were exploratorily assessed for 6\u2010month major adverse limb events in 28 patients with Fontaine IV PAD (optimism\u2010corrected area under the curve, 0.73); given the limited sample size, these findings were preliminary and require external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">V\u2010flow imaging identified wall\u2010specific hemodynamic disturbances that may precede morphological changes. These parameters may aid PAD diagnosis. The major adverse limb events analysis was secondary and exploratory due to the small sample size, and its predictive utility requires further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045928","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:16:04Z","timestamp":1785496564000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Wall\u2010Specific V\u2010Flow Hemodynamics in Lower\u2010Limb Peripheral Artery Disease: Diagnostic Nomogram and Periplaque Mapping"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3456-2899","authenticated-orcid":false,"given":"Yijie","family":"Ning","sequence":"first","affiliation":[{"name":"The Second Hospital of Shanxi Medical University","place":["Taiyuan, China"]},{"name":"Vascular Institute of Shanxi Medical University","place":["Taiyuan, 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