Arterial stiffness measurements for lower extremities arterial disease identification in general practice.

Anna Kamieńska, Aleksandra Danieluk, Sławomir Chlabicz

Keywords: pulse wave velocity, arterial stiffness, lower extremities arterial disease

Background:
Arterial stiffness is an established cardiovascular risk factor and implicates disturbances in circulation in many conditions, among others, in atherosclerosis. Comparing ankle-brachial index (ABI), a verified method of lower extremities arterial disease (LEAD) detection to pulse wave velocity (PWV) an established measurement of arterial stiffness could help to implement a new diagnostic and prognostic tool. The measurement of PWV is simple, non-invasive, and reproducible.

Research questions:
Do pulse wave velocity measurements correspond with abnormal ABI measurements?

Method:
A cross-sectional study performed among general practice patients over 50. Ankle-brachial index (ABI) measurements with Huntleigh Dopplex and pulse wave velocity (PWV) evaluation with Mobil-O-Graph Pulse Wave Analyser (PWA) were performed. The prevalence of lower ABI measurements among patients with elevated and normal values of PWV were compared.

Results:
The study included 158 participants. Overall, 72 (45,5%) had an elevated PWV over a fixed, based on literature threshold of 10m/s. Among those patients 42 out of 72 (58,3%) had ABI below a reference value.
When we considered individual PWV threshold calculated by Mobi-O-Graph PWA (taking into account gender, age and blood pressure) 63/158 patients (39,9%) had abnormal result. Of those 38/63 had abnormal ABI (60,3%).

Conclusions:
Patients with elevated PWV had considerably higher prevalence of LEAD as expressed by lowered ABI. PWV may be a useful parameter in identification of LEAD.

Points for discussion: