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Correlation of hemodynamic and functional variables with the angiographic extent of peripheral arterial occlusive
U Müller-Bühl1, A Wiesemann, B Oser
1Department of General Medicine, University of Heidelberg, Germany.
Insights
Ankle systolic blood pressure (SBP) and ankle-brachial index (ABI) reliably assess lower limb atherosclerosis extent. However, walking capacity in patients with intermittent claudication is not linked to disease severity.
Area of Science:
- Vascular Medicine
- Diagnostic Imaging
- Exercise Physiology
Background:
- Lower limb atherosclerosis significantly impacts patient mobility and quality of life.
- Accurate assessment of atherosclerosis extent is crucial for effective treatment planning.
- Intermittent claudication is a common symptom, necessitating reliable diagnostic tools.
Purpose of the Study:
- To investigate the relationship between hemodynamic and functional variables and the angiographic extent of lower limb atherosclerosis.
- To evaluate the predictive value of Doppler pressure measurements and treadmill exercise tests for atherosclerosis severity.
- To determine if walking capacity correlates with the angiographic findings in patients with stable intermittent claudication.
Main Methods:
- 150 patients with stable intermittent claudication underwent assessment.
- Angiographic extent of atherosclerosis was quantified using the Bollinger angiogram score.
- Resting Doppler pressure values (SBP, ABI) and treadmill exercise parameters (initial claudication distance - ICD, absolute claudication distance - ACD) were recorded.
Main Results:
- Angiogram scores correlated with patient age and claudication duration.
- Angiogram scores showed a negative correlation with SBP and ABI.
- ABI was the strongest predictor of angiographic disease severity; ICD and ACD did not correlate with the overall angiogram score.
Conclusions:
- SBP and ABI serve as dependable indirect measures for assessing the angiographic extent of lower limb atherosclerosis.
- Walking capacity, as measured by ICD and ACD, appears independent of the angiographic severity of the disease in claudicant patients.
Abstract:
The aim of the study was to determine whether hemodynamic and functional variables are related to the angiographic extent of lower limb atherosclerosis. In 150 patients with stable intermittent claudication, the Bollinger angiogram score was compared with the resting Doppler pressure values, and the initial claudication distance (ICD) and absolute claudication distance (ACD) with treadmill exercise. The extent of lower limb atherosclerosis correlated significantly with the age of the patients and the duration of the claudication. The angiogram scores of the patients were negatively correlated with the ankle systolic blood pressure (SBP) and the ankle/brachial index (ABI). In a multiple regression analysis, ABI was the most predictive variable for the angiographic severity of disease. ICD, ACD and work on the treadmill failed to correlate with the angiogram summation score. If patients were classified into groups for those with iliac or femoropopliteal disease, a weak correlation between ACD and femoropopliteal angiogram score was found. The comparison between Doppler measurements and treadmill exercise testing showed no significant correlation between SBP/ABI of the more diseased limb and ICD. However, both SBP and ABI did correlate significantly with ACD (r = 0.16, p < 0.05 and r = 0.20, p < 0.01, respectively). In conclusion, SBP and ABI are reliable parameters for indirect assessment of the angiographic extent of lower limb atherosclerosis. In contrast, the walking capacity of claudicant patients is independent of the angiographic severity of the disease.