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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
14:52

Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication

Published on: December 11, 2013

Episodes of ST-segment depression is related to changes in ambulatory blood pressure and heart rate in intermittent

P Svensson1, U Niklasson, J Ostergren

  • 1Department of Medicine, Karolinska Hospital, Stockholm, Sweden. persv@divmed.ks.se

Journal of Internal Medicine
|March 13, 2002
PubMed

Insights

Silent myocardial ischemia, indicated by ST-segment depression, was found in about one-third of intermittent claudication patients. These ischemic episodes correlated with elevated ambulatory blood pressure and heart rate.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Electrophysiology

Background:

  • Intermittent claudication (IC) is a common condition affecting peripheral circulation.
  • Ambulatory electrocardiographic monitoring (AECG) and ambulatory blood pressure (ABP) monitoring are valuable tools for assessing cardiovascular events.
  • The relationship between IC, silent myocardial ischemia, and hemodynamic parameters requires further investigation.

Purpose of the Study:

  • To determine the prevalence and circadian pattern of ST-segment depression in patients with IC using AECG.
  • To assess ambulatory blood pressure (ABP) and heart rate variations during ischemic episodes.
  • To explore the association between ischemic events and hemodynamic changes in IC patients.

Main Methods:

  • 24-hour AECG and simultaneous 24-hour ABP monitoring were performed in 40 patients with IC (ankle-brachial index <0.9).
  • An exercise treadmill test (ETT) was also conducted.
  • Ischemic episodes were defined as ST-segment deviation ≥1 mm lasting >1 minute; 29 patients were included in ECG analysis.

Main Results:

  • Fifteen episodes of ST-depression were detected in 8 out of 29 patients (approximately 27.6%).
  • The majority of episodes (11/15) occurred in the morning (6 a.m. - 12 p.m.).
  • During ST-depression, systolic blood pressure (178 vs. 166 mmHg), diastolic blood pressure (96 vs. 90 mmHg), and heart rate (103 vs. 87 bpm) were significantly higher compared to mean daytime values.

Conclusions:

  • Silent myocardial ischemia is prevalent in approximately one-third of patients with intermittent claudication.
  • Ischemic episodes in these patients are associated with increased ambulatory blood pressure and heart rate.
  • Further research is needed to determine if managing hypertension can reduce silent ischemia and improve outcomes in IC patients.
Abstract

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