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. 2009 Sep;206(1):173-8.
doi: 10.1016/j.atherosclerosis.2009.02.003. Epub 2009 Feb 12.

Brachial-ankle pulse wave velocity is associated with walking distance in patients referred for peripheral arterial disease evaluation

Comfort A Amoh-Tonto  1 , A Rauoof Malik, Venkateswarlu Kondragunta, Zeenat Ali, Iftikhar J Kullo
Affiliations

Brachial-ankle pulse wave velocity is associated with walking distance in patients referred for peripheral arterial disease evaluation

Comfort A Amoh-Tonto et al. Atherosclerosis. 2009 Sep.

Abstract

Objective: Impaired functional capacity predicts morbidity and increased mortality in patients with PAD. We hypothesized that brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, is associated with functional capacity in patients undergoing noninvasive evaluation for peripheral arterial disease (PAD).

Methods: We studied 114 patients (age 68+/-10 years) referred to Mayo Clinic's noninvasive vascular laboratory. Functional capacity was estimated in terms of distance walked in 5 min on a treadmill at a speed of 1.0-2.0 mph. Ankle-brachial index (ABI) was obtained with Doppler method before and 1 min after exercise. baPWV was estimated noninvasively using an oscillometric device. The association of baPWV with walking distance was assessed using accelerated failure time and Cox proportional-hazards models.

Results: The mean baPWV was higher in patients who were unable to complete the walk test compared to those who successfully completed the test (P=0.008). Higher baPWV was associated with a lower walking distance after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P=0.017) and after additional adjustment for pulse pressure (P=0.034) and ABI (P=0.030). Higher baPWV was associated with failure to complete the treadmill walk test, after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P=0.025) and after additional adjustment for pulse pressure (P=0.041) and ABI (P=0.039).

Conclusion: Increased baPWV, a measure of arterial stiffness, is associated with impaired functional capacity in patients undergoing evaluation for PAD.

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Figures

Fig. 1
Fig. 1
Box plots showing brachial-ankle pulse wave velocity (baPWV) in patients with respect to their ability to complete the treadmill walk test. Patients who stopped before the completion of the test had significantly higher baPWV compared to the patients who were able to complete the test (P = 0.008).
Fig. 2
Fig. 2
Kaplan–Meier survival curves comparing ability to complete the 5-min treadmill walk test between patients with baPWV less than median (<17.8m/s) and those with baPWV equal to or above median. Patients with baPWV below median (n=57) were significantly more likely to complete the test compared to patients with baPWV equal to or above median (n = 58) (hazard ratio, 2.199; 95% confidence interval, 1.129–4.281).
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