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Surrogates of Large Artery versus Small Artery Stiffness and Ankle-Brachial Index.
MedLine Citation:
PMID:  22942632     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Peripheral artery tonometry (PAT) is a novel method for assessing arterial stiffness of small digital arteries. Pulse pressure can be regarded as a surrogate of large artery stiffness. When ankle-brachial index (ABI) is calculated using the higher of the two ankle systolic pressures as denominator (ABI-higher), leg perfusion can be reliably estimated. However, using the lower of the ankle pressures to calculate ABI (ABI-lower) identifies more patients with isolated peripheral arterial disease (PAD) in ankle arteries. We aimed to compare the ability of PAT, pulse pressure, and different calculations of ABI to detect atherosclerotic disease in lower extremities. We examined PAT, pulse pressure, and ABI in 66 cardiovascular risk subjects in whom borderline PAD (ABI 0.91 to 1.00) was diagnosed 4 years earlier. Using ABI-lower to diagnose PAD yielded 2-fold higher prevalence of PAD than using ABI-higher. Endothelial dysfunction was diagnosed in 15/66 subjects (23%). In a bivariate correlation analysis, pulse pressure was negatively correlated with ABI-higher (r = -0.347, p = 0.004) and with ABI-lower (r = -0.424, p < 0.001). PAT hyperemic response was not significantly correlated with either ABI-higher (r = -0.148, p = 0.24) or with ABI-lower (r = -0.208, p = 0.095). Measurement of ABI using the lower of the two ankle pressures is an efficient method to identify patients with clinical or subclinical atherosclerosis and worth performing on subjects with pulse pressure above 65 mm Hg. The usefulness of PAT measurement in detecting PAD is vague.
Authors:
Päivi Korhonen; Kari Syvänen; Pertti Aarnio
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of angiology : official publication of the International College of Angiology, Inc     Volume:  20     ISSN:  1615-5939     ISO Abbreviation:  Int. J. Angiol.     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  2012-09-06     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  9504821     Medline TA:  Int J Angiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  167-72     Citation Subset:  -    
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