Document Detail

Relationship between ankle brachial index and arterial remodeling in pseudoxanthoma elasticum.
MedLine Citation:
PMID:  21723076     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Pseudoxanthoma elasticum (PXE) is an inherited metabolic disease characterized by elastic fiber fragmentation and calcification in the cutaneous, ophthalmologic, and vascular tissues. Cardiovascular manifestations such as peripheral arterial disease (PAD) are frequent in PXE. Because of the changes in the elastic properties and medial calcification of the arterial wall in PXE, the impact of the arterial remodeling on the ankle brachial index (ABI), a well-established diagnostic method for the detection and follow-up of PAD, remains to be determined in this disease.
METHODS: This was a cross-sectional, comparative, open study, which took place at the PXE Consultation Center, University Hospital of Angers. The subjects were 53 patients (mean age, 49 ± 14 years; 35 females) with PXE clinically proven on the basis of established criteria (skin changes, angioid streaks, and skin biopsy). The ABI at rest, symptoms of intermittent claudication (IC), carotid intima-media thickness (IMT), carotid-femoral pulse wave velocity (c-f PWV), compliance (CC), and β stiffness index were measured in a single-center cohort.
RESULTS: Forty-five percent of the PXE patients had an ABI ≤0.90, but only one patient had an ABI >1.40. IC was found in 23% of the patients with an ABI ≤0.90. There were no significant differences between the patients with a low and normal ABI in terms of IMT (P = .566) or β stiffness index (P = .194), but differences were significant for c-f PWV (P = .010) and CC (P = .011). Adjusted multivariate linear regression for the Framingham-Laurier score showed that patients with a low ABI had less compliant carotid arteries (B = 0.318, P = .039).
CONCLUSIONS: PAD detected by a low ABI is very frequent in PXE, although with limited prevalence of symptomatic claudication. Unexpectedly, ABI was low in such calcifying PAD and associated with lower CC, independently of atherosclerosis risk factors. These findings demonstrate that PXE represents a unique monogenic model of PAD in which the specific arterial wall remodeling could change the diagnostic value of the ABI to detect PAD.
Georges Lefthériotis; Pierre Abraham; Yannick Le Corre; Olivier Le Saux; Daniel Henrion; Pierre Henri Ducluzeau; Fabrice Prunier; Ludovic Martin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-07-01
Journal Detail:
Title:  Journal of vascular surgery     Volume:  54     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-26     Completed Date:  2011-12-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1390-4     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
University Hospital of Angers, PXE Consultation Centre, Angers, France.
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MeSH Terms
Ankle Brachial Index*
Aorta* / physiopathology,  ultrasonography
Carotid Arteries* / physiopathology,  ultrasonography
Chi-Square Distribution
Cross-Sectional Studies
Hospitals, University
Linear Models
Middle Aged
Peripheral Arterial Disease / diagnosis*,  etiology,  physiopathology,  ultrasonography
Predictive Value of Tests
Prospective Studies
Pseudoxanthoma Elasticum / complications,  diagnosis*,  physiopathology,  ultrasonography
Pulsatile Flow
Regional Blood Flow
Risk Assessment
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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