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. 2012 Dec;14(12):855-60.
doi: 10.1111/j.1751-7176.2012.00702.x. Epub 2012 Aug 27.

Severity of peripheral arterial disease is associated with aortic pressure augmentation and subendocardial viability ratio

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Severity of peripheral arterial disease is associated with aortic pressure augmentation and subendocardial viability ratio

Kathrin Mosimann et al. J Clin Hypertens (Greenwich). 2012 Dec.

Abstract

Peripheral arterial disease (PAD) is associated with increased cardiovascular mortality that correlates with peripheral perfusion impairment as assessed by the ankle-brachial arterial pressure index (ABI). Furthermore, PAD is associated with arterial stiffness and elevated aortic augmentation index (AIx). The purpose of this study was to investigate whether ABI impairment correlates with AIx and subendocardial viability ratio (SEVR), a measure of cardiac perfusion during diastole. AIx and SEVR were assessed by radial applanation tonometry in 65 patients with stable PAD (Rutherford stage I-III) at a tertiary referral center. AIx corrected for heart rate and SEVR were tested in a multivariate linear and logistic regression model to determine the association with ABI. Mean ABI was 0.8±0.2, AIx 31%±7%, and SEVR 141%±26%. Multiple linear regression with AIx as a dependent variable revealed that AIx was significantly negatively associated with ABI (β=-11.5; 95% confidence interval [CI], -18.6 to -4.5; P=.002). Other variables that were associated with AIx were diastolic blood pressure (β=0.2; 95% CI, 0.1-0.4; P<.001), height (β=-46.2; 95% CI, -62.9 to -29.4; P<.001), body mass index (β=-0.4; 95% CI, -0.8 to -0.1; P=.023), and smoking (β=3.6; 95% CI, 0.6-6.6; P=.019). Multiple regression with SEVR as a dependent variable showed a significant correlation with ABI (β=33.2; 95% CI, 2.3-64.1; P=.036). Severity of lower limb perfusion impairment is related to central aortic pressure augmentation and to subendocardial viability ratio. This may be a potential pathophysiologic link that impacts cardiac prognosis in patients with PAD.

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Figures

Figure 1
Figure 1
Schematic illustration of a central pulse wave profile in a patient with pathological ankle‐brachial arterial pressure index (ABI) (<0.9, dashed line) and a patient with normal ABI (solid line). The subendocardial viability ratio is expressed as the ratio of the diastolic pressure time index (DPTI) and systolic pressure time index (SPTI). The augmentation of central aortic systolic pressure is quantified as the increase of pressure from the first systolic shoulder (P1) to the systolic pressure peak (P2) and is expressed as augmentation index as a percentage of central aortic pulse pressure (PP). Pd indicates diastolic pressure; ts, systolic time; td, diastolic time.
Figure 2
Figure 2
Partial regression plot for aortic augmentation index (AIx) and ankle‐brachial arterial pressure index (ABI) in patients with peripheral arterial disease. Aortic AIx and ABI are centered by their means.
Figure 3
Figure 3
Partial regression plot for subendocardial viability ratio (SEVR) and ankle‐brachial arterial pressure index (ABI) in patients with peripheral arterial disease. Aortic augmentation index and ABI are centered by their means.

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References

    1. Criqui MH, Langer RD, Fronek A, et al. Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med. 1992;326:381–386. - PubMed
    1. Criqui MH. Peripheral arterial disease – epidemiological aspects. Vasc Med. 2001;6:3–7. - PubMed
    1. Aronow WS, Ahmed MI, Ekundayo OJ, et al. A propensity‐matched study of the association of peripheral arterial disease with cardiovascular outcomes in community‐dwelling older adults. Am J Cardiol. 2009;103:130–135. - PMC - PubMed
    1. Criqui MH, Coughlin SS, Fronek A. Noninvasively diagnosed peripheral arterial disease as a predictor of mortality: results from a prospective study. Circulation. 1985;72:768–773. - PubMed
    1. McDermott MM, Liu K, Criqui MH, et al. Ankle‐brachial index and subclinical cardiac and carotid disease: the multi‐ethnic study of atherosclerosis. Am J Epidemiol. 2005;162:33–41. - PubMed

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