Comparative study of pressure (ankle-brachial pressure index) and flow (strain gauge plethysmography and reactive hyperaemia) measurements in diagnosis of peripheral arterial disease in patients with severe aortic stenosis.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
04
03
2019
accepted:
17
07
2019
entrez:
31
7
2019
pubmed:
31
7
2019
medline:
11
3
2020
Statut:
epublish
Résumé
The measurement of the ankle-brachial pressure index is a straightforward method for the detection of peripheral disease in the lower limbs. Only a few old studies with small numbers of patients have been conducted comparing the gold standard, ankle-brachial pressure index measurement, with strain gauge plethysmography and reactive hyperaemia for detecting peripheral arterial disease. The purpose of this study was to evaluate the feasibility and accuracy of strain gauge plethysmography values compared with the Doppler ultrasound method, ankle-brachial pressure index, in the assessment of peripheral arterial disease, especially in patients with severe aortic stenosis. 221 ankle-brachial pressure index measurements and strain gauge plethysmography measurements of patients with suspected peripheral arterial disease, diagnosed peripheral arterial disease with or without aortic stenosis were compared. Irrespective of aortic stenosis in patients with and without peripheral arterial disease, the resting arterial blood flow was within the normal range. In patients with aortic stenosis, the time-to-peak flow couldn't detect peripheral arterial disease and was found to be a false negative. In patients without aortic stenosis, time-to-peak flow correlated well with the ankle-brachial pressure index for detecting peripheral arterial disease. Peak flow at 5 seconds was the one of the flow values that correlated with ankle-brachial pressure index and detected peripheral arterial disease in patients with and without aortic stenosis. Peak flow at 5 seconds is one of flow value that correlated well with ankle-brachial pressure index in detecting peripheral arterial disease in patients with and without aortic stenosis. Detection of peripheral arterial disease in patients with severe aortic stenosis seems to be less sensitive with flow measurements than with ankle-brachial pressure index.
Sections du résumé
BACKGROUND
The measurement of the ankle-brachial pressure index is a straightforward method for the detection of peripheral disease in the lower limbs. Only a few old studies with small numbers of patients have been conducted comparing the gold standard, ankle-brachial pressure index measurement, with strain gauge plethysmography and reactive hyperaemia for detecting peripheral arterial disease. The purpose of this study was to evaluate the feasibility and accuracy of strain gauge plethysmography values compared with the Doppler ultrasound method, ankle-brachial pressure index, in the assessment of peripheral arterial disease, especially in patients with severe aortic stenosis.
METHODS
221 ankle-brachial pressure index measurements and strain gauge plethysmography measurements of patients with suspected peripheral arterial disease, diagnosed peripheral arterial disease with or without aortic stenosis were compared.
RESULTS
Irrespective of aortic stenosis in patients with and without peripheral arterial disease, the resting arterial blood flow was within the normal range. In patients with aortic stenosis, the time-to-peak flow couldn't detect peripheral arterial disease and was found to be a false negative. In patients without aortic stenosis, time-to-peak flow correlated well with the ankle-brachial pressure index for detecting peripheral arterial disease. Peak flow at 5 seconds was the one of the flow values that correlated with ankle-brachial pressure index and detected peripheral arterial disease in patients with and without aortic stenosis.
CONCLUSION
Peak flow at 5 seconds is one of flow value that correlated well with ankle-brachial pressure index in detecting peripheral arterial disease in patients with and without aortic stenosis. Detection of peripheral arterial disease in patients with severe aortic stenosis seems to be less sensitive with flow measurements than with ankle-brachial pressure index.
Identifiants
pubmed: 31361765
doi: 10.1371/journal.pone.0220510
pii: PONE-D-19-02196
pmc: PMC6667209
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0220510Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
N Engl J Med. 2001 May 24;344(21):1608-21
pubmed: 11372014
Acta Med Scand. 1963 Jan;173:99-105
pubmed: 13984534
Angiology. 1964 Jul;15:293-304
pubmed: 14181196
Circulation. 2006 Mar 21;113(11):e463-654
pubmed: 16549646
Angiology. 2008 Jun-Jul;59(3):296-300
pubmed: 18388100
Diabetes Care. 2009 Apr;32(4):e44
pubmed: 19336632
Microcirculation. 2010 Jul;17(5):358-66
pubmed: 20618693
Vasc Med. 2010 Oct;15(5):361-9
pubmed: 20926495
N Engl J Med. 2010 Oct 21;363(17):1597-607
pubmed: 20961243
Eur Heart J. 2011 Nov;32(22):2851-906
pubmed: 21873417
Heart. 2013 Mar;99(6):396-400
pubmed: 22942293
J Vasc Surg. 2015 Mar;61(3 Suppl):2S-41S
pubmed: 25638515
Int J Cardiovasc Imaging. 2015 Jun;31(5):975-85
pubmed: 25805046
Cochrane Database Syst Rev. 2016 Sep 14;9:CD010680
pubmed: 27623758
Vasc Med. 2018 Apr;23(2):163-171
pubmed: 29458301
J Appl Physiol (1985). 1987 Feb;62(2):606-10
pubmed: 3558219
Angiologica. 1968;5(4):263-70
pubmed: 5699287
Angiology. 1981 Dec;32(12):840-5
pubmed: 7332112
Diabetologia. 1993 Jul;36(7):615-21
pubmed: 8359578
Circulation. 1996 Dec 1;94(11):3026-49
pubmed: 8941154