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

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?

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.

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%).

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: