Document Detail


Evaluation of the one-minute exercise test to detect peripheral arterial disease.
MedLine Citation:
PMID:  18380796     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Asymptomatic peripheral arterial disease (PAD) is common amongst the elderly and is a risk factor for cardiovascular morbidity and mortality. PAD can be assessed by non-invasive tests such as the ankle/brachial pressure index (ABPI) at rest and Doppler flow velocity (DFV) scanning, but these tests may underestimate the prevalence of PAD. The aim of this study was to estimate the added value, for the detection of PAD, of the one-minute exercise test, defined as positive if the drop of the ankle systolic pressure was more than 30 mmHg. We also investigated whether the combination of the ABPI at rest and the one-minute exercise test could replace DFV scanning. MATERIALS AND METHODS: We studied this in a random sample (n = 631) of a 50- to 75-year-old population. RESULTS: Of these subjects 11% (66/631) had an abnormal ABPI (< 0.9) and 16% (102/631) had an abnormal DFV curve. Of this sample 72% of the subjects performed a one-minute exercise test. Of all subjects 6% (27/451) had an abnormal ABPI (< 0.9) and 12% (54/451) had an abnormal DFV curve. The one-minute exercise test revealed seven cases of PAD (beyond the 67 already identified) which were not detected by an abnormal ABPI at rest and/or DFV scanning. As a result the prevalence of PAD increased by 2%. All patients with an aortoiliac or femoropopliteal obstruction had an ABPI at rest < 0.9. The sensitivity of the combination of the ABPI at rest and the one-minute exercise test to detect abnormal DFV curves was low for crural obstructions. CONCLUSION: The one-minute exercise test slightly improves the detection of peripheral arterial disease in the general population.
Authors:
E K Hoogeveen; A J C Mackaay; P J Beks; P J Kostense; J M Dekker; R J Heine; G Nijpels; J A Rauwerda; C D A Stehouwer
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  European journal of clinical investigation     Volume:  38     ISSN:  1365-2362     ISO Abbreviation:  Eur. J. Clin. Invest.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-02     Completed Date:  2008-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0245331     Medline TA:  Eur J Clin Invest     Country:  England    
Other Details:
Languages:  eng     Pagination:  290-5     Citation Subset:  IM    
Affiliation:
Vrije Universiteit University Medical Center, Amsterdam, and Jeroen Bosch Hospital, Den Bosch, The Netherlands. ellen.hoogeveen@planet.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Epidemiologic Methods
Exercise Test / methods*,  standards
Female
Humans
Male
Middle Aged
Netherlands
Peripheral Vascular Diseases / diagnosis*,  epidemiology

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