Ankle pressure and ankle brachial index after heavy load incremental exercise

2018 ◽  
Vol 28 (11) ◽  
pp. 2459-2459
Author(s):  
Raphael Godet ◽  
Antoine Bruneau ◽  
Bruno Vielle ◽  
Francois Vincent ◽  
Thierry Le Tourneau ◽  
...  
Keyword(s):  
Ankle Brachial Index ◽  
Incremental Exercise ◽  
Heavy Load ◽  
Ankle Pressure

Abstract W P143: Ankle-brachial Index Predicts Extracranial Vascular Events After Transient Ischemic Attacks. Data From The Promapa Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Francisco Purroy ◽  
Sara Porta ◽  
Pedro E Jiménez-Caballero ◽  
Juan María Jirón ◽  
Arantxa Gorospe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Cox Proportional Hazards ◽  
Stroke Recurrence ◽  
Large Artery ◽  
Vascular Events ◽  
Ankle Pressure ◽  
Peripheral Arterial

The ankle brachial index (ABI) is a known measure of lower-limb peripheral artery disease (PAD), as well as an independent predictor of vascular events. Various methods of ABI calculation have been described. The traditional method (ABI-TM) uses the higher ankle pressure as a numerator and it results in higher specificity. The alternative method (ABI-AM) takes the lower ankle pressure as numerator. It is associated with better sensitivity. Our goal was to compare the prognostic value of abnormal ABI (ABI <=0.9), determined by the two methods, in order to predict subsequent stroke and extracranial vascular events (EVE) in transient ischemic attack (TIA) patients from a multicenter study. Methods: We analyzed data from consecutive 1137 patients with TIA from the multicenter PROMAPA study in which ABI was determined. We determined risk of stroke recurrence (SR) and EVE (ischemic cardiopathy or peripheral arterial disease) at one year of follow up. Results: A total of 616 (54.2%) subjects fulfilled all inclusion criteria. The risk of SR and EVE was 4.7% and 2.1%, respectively. The proportion of abnormal ABI differed according to the method used: 11.5% ABI-TM versus 38.0 ABI-AM (p=0.001). In both situations, abnormal ABI was related to the association of >1 risk factors and large artery atherosclerosis. SR was not predicted by abnormal ABI. However, only abnormal ABI-AM was significantly associated with EVE (p=0.003). Cox proportional-hazards multivariate analyses identify the association of > 1 risk factors (Hazard Ratio [HR] 4.7, 95% CI 1.1-21.2. p=0.045) and abnormal ABI-AM (HR 4.0, 95% CI 1.1-14.6, p=0.035) as independent predictors of EVE. Conclusion: ABI using the lower ankle pressure as numerator is associated with EVE after TIA. The measurement of ABI using the lower ankle pressure as numerator among TIA patients appeared to be useful to identify patients with risk of EVE and to plan adequate prevention therapies or specific diagnostic protocols.

scholarly journals Accuracy of Ankle-Brachial Index Measurements in Evaluation of Critical Leg Ischemia

2013 ◽  
Vol 59 (2) ◽  
pp. 85-87
Author(s):  
Tímea Varga-Fekete ◽  
Katalin Felvinczi ◽  
Emese Kun-Bálint ◽  
A Puskás ◽  
E Nagy ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Critical Ischemia ◽  
Significant Difference ◽  
Ankle Pressure ◽  
The Mean ◽  
Artery Disease ◽  
Leg Ischemia

Abstract Aims: The ankle-brachial index is an efficient tool for objectively documenting the presence of lower extremity peripheral artery disease. However, its applicability for detection of critical leg ischemia is still controversial. We proposed to determine the diagnostic accuracy of the ankle-brachial index for critical ischemia. Materials and methods: Systolic blood pressure measurements for calculation of the ankle-brachial index were obtained in 90 patients with peripheral artery disease. Ankle-brachial index was computed in 3 different ways (using the lowest ankle pressure, the highest ankle pressure, and the mean of the ankle pressures), sensibility, specificity, positive and negative predictive value and overall accuracy for detecting critical ischemia were determined for each method. A value ≤ 0.4 was taken as cut-off point for critical leg ischemia. Prevalence of coronary and cerebrovascular atherosclerosis and conventional risk factors were also noted. Results: Using the lowest ankle pressure for computing ankle-brachial index provided higher sensitivity, and lower specificity for detecting critical leg ischemia, using the highest pressure was less sensitive, but more specific, and the mean pressure index gave intermediate results. Overall accuracy was highest for the latest method. The prevalence of generalized atherosclerosis was high in peripheral artery disease, but we found no significant difference between the intermittent claudication and the critical ischemia group. Conclusion: Ankle-brachial index measurements, regardless of the method used for calculation, cannot identify or rule out reliably critical leg ischemia. Peripheral artery disease confers an increased risk of cardiovascular disease regardless of symptom status or lower extremity perfusion severity.

scholarly journals CRT-201 Can Ankle-Brachial Index or Ankle Pressure Be Used to Predict Wound Healing in Critical Limb Ischemia Patients?

2014 ◽  
Vol 7 (2) ◽  
pp. S33
Author(s):  
David Cohen ◽  
Christos Theophanous ◽  
Nicole Holguin ◽  
Babak Yasmeh ◽  
Karen Woo ◽  
...  
Keyword(s):  
Wound Healing ◽  
Critical Limb Ischemia ◽  
Ankle Brachial Index ◽  
Limb Ischemia ◽  
Ankle Pressure

Abstract 3118: Different Calculations Of Ankle Brachial Index And Cardiovascular Risk Prediction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Christine Espinola-Klein ◽  
Hans J Rupprecht ◽  
Christoph Bickel ◽  
Karl Lackner ◽  
Claudica M Messow ◽  
...  
Keyword(s):  
Event Rate ◽  
Ankle Brachial Index ◽  
Heart Association ◽  
Continuous Variable ◽  
Prognostic Impact ◽  
Stroke Event ◽  
Screening Guidelines ◽  
Current Definition ◽  
Basic Model ◽  
Ankle Pressure

The quotient between ankle and brachial blood pressure (ankle brachial index =ABI) is widely used for peripheral arterial disease (PAD) screening. Guidelines on ABI measurement do not uniformly define whether the higher or the lower ankle pressure should be applied to the calculation. We hypothesized that considering the lowest ankle pressure as numerator and the highest brachial pressure as denominator would increase the prognostic impact. Methods: In 831 patients preceding coronary angiography, ABI was calculated for both legs according to the current definition of the American Heart Association (highest ankle pressure/ highest arm pressure) and according to an extended definition (lowest ankle pressure/ highest arm pressure). For each patient the lowest ABI from both legs was used for further evaluation. 15 patients with an ABI >1.5 were excluded. PAD was defined, if an ABI of less than 0.9 could be detected in one leg with each ABI definition. Results: Using the current ABI definition 204 patients (25.0%) and using the extended definition 292 patients (35.8%) with PAD could be identified. Follow-up data (median 6.6 years) was available for 812 patients (99.5%) and 157 patients (19.3%) suffered from cardiovascular events (death, infarction, stroke). Event rate was significantly higher in patients with PAD (current ABI definition: PAD yes / no=28.1% / 16.3%, P<0.0001; extended ABI definition: PAD yes / no=27.4% / 14.8%, P<0.0001). Event rate was 25.0% in 88 patients with an ABI >0.9 using the current and >0.9 using the extended ABI definition. Hazard ratio (95% confidence interval) was 1.5 (1.1–2.1) for patients with PAD using the current ABI definition (P=0.02) and 1.7 (1.2–2.3) for patients with PAD using the extended ABI definition (P=0.004) compared to patients without PAD. In addition, including ABI as continuous variable improved the area under the ROC curve from 0.68 (0.63– 0.73) for a basic model to 0.70 (0.65– 0.75) for a basic model plus ABI based on current definition and 0.71 (0.66 – 0.76) for a basic model plus ABI based on extended definition. Conclusion: Using the highest ankle pressure the real PAD prevalence is underestimated and a group of patients at risk is overlooked. Therefore we recommend the use of the lowest ankle pressure for ABI calculation.

scholarly journals Association of Diabetes and Hemodialysis With Ankle Pressure and Ankle-Brachial Index in Japanese Patients With Critical Limb Ischemia

Diabetes Care ◽  
2012 ◽  
Vol 35 (10) ◽  
pp. 2000-2004 ◽  
Author(s):  
M. Takahara ◽  
H. Kaneto ◽  
O. Iida ◽  
N. Katakami ◽  
T.-a. Matsuoka ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Ankle Brachial Index ◽  
Limb Ischemia ◽  
Japanese Patients ◽  
Ankle Pressure

Abstract P223: Vitamin D Supplementation Improves Measures Of Arterial Stiffness And Vascular Function In Adolescents Suffering From Orthostatic Intolerance

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Hossam A Shaltout
Keyword(s):  
Vitamin D ◽  
Vascular Function ◽  
Orthostatic Intolerance ◽  
Augmentation Index ◽  
Arterial Compliance ◽  
Ankle Brachial Index ◽  
Therapeutic Benefit ◽  
Vitamin D Supplementation ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Ankle Pressure

Background: In previous work we identified a group of adolescents with orthostatic intolerance (OI) presenting as postural orthostatic tachycardia syndrome or syncope with impairment in autonomic and vascular response upon head up tilt. Low vitamin D level correlated with the severity of symptoms. In this pilot study we hypothesized that vitamin D supplementation will improve the vascular function in these adolescents. Methods: A cohort of twenty Adolescents (mean age= 16.2 years, 4 males) who are vitamin D deficient had a non-invasive measurements of brachial BP, aortic BP, augmentation index at heart rate of 75 beats per minute (AIx75), and carotid-femoral pulse wave velocity (cf-PWV) using the SphygmoCor XCEL System at baseline and after two months of vitamin D supplementation (2000-5000 IU daily based on baseline level). Both right and left side ankle pressure and ankle brachial index (ABI) were assessed using COLIN VP-1000 vascular profiling system. Impedance Cardiography (ICG) was used to estimate total arterial compliance (TAC) and thoracic fluid content (TFC) in supine position at rest and after hand grip challenge. Results: As shown in the table. Compared to baseline, vitamin D supplementation increased vitamin D level, increased TAC and TFC at baseline and under stress challenge. It also tended to reduced AIx75 and cf-PWV and reduced both right and left ankle pressure and ABI Conclusions: Vitamin D supplementation improved different measures of vascular function in adolescent. These data provides evidence of potential therapeutic benefit of vitamin D supplementation for patients suffering from orthostatic intolerance who are vitamin D deficient.

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