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Some interrelations between blood pressure parameters and claudication distances
V Puchmayer1, V Albrecht, J Herdová
1IV Medical Department, Faculty of Medicine, Charles University, Prague, Czechoslovakia.
Insights
Peripheral artery disease significantly impacts walking ability. This study found a strong correlation between ankle pressure measurements and claudication distance in patients with lower extremity atherosclerotic lesions.
Area of Science:
- Vascular Medicine
- Medical Diagnostics
- Biomedical Engineering
Background:
- Peripheral artery disease (PAD) is a common condition characterized by atherosclerotic lesions in the arteries of the lower extremities.
- Symptoms of PAD, such as claudication, significantly impair patients' quality of life and mobility.
- Accurate assessment of disease severity is crucial for effective management and treatment planning.
Purpose of the Study:
- To investigate the relationship between hemodynamic parameters and claudication distance in patients with lower extremity PAD.
- To determine the predictive value of Doppler ultrasound measurements for functional limitations in PAD patients.
- To establish correlations between ankle pressure gradients and patient-reported walking impairment.
Main Methods:
- Sixty-two patients (60 males, 2 females, mean age 58.1 years) with atherosclerotic lesions of lower extremity arteries were enrolled.
- Claudication distance was assessed in two segments: onset of pain and cessation of walking due to pain.
- Systemic systolic pressure and poststenotic ankle pressure were measured using Doppler ultrasound, and pressure gradients were calculated.
Main Results:
- Both initial and final claudication distances were significantly related to poststenotic ankle pressure and pressure gradients.
- Stepwise regression analysis revealed a significant association between walking distances and the lowest ankle pressure measurements across four tibial arteries.
- A very high correlation (R = 0.98) was observed between initial and final claudication distances, persisting even after excluding pressure parameters.
Conclusions:
- Ankle pressure measurements, particularly the lowest values, are reliable indicators of functional limitations in patients with lower extremity PAD.
- Doppler ultrasound assessment of pressure gradients provides valuable information for evaluating PAD severity and predicting claudication.
- The strong correlation between different measures of claudication distance highlights the consistent impact of PAD on walking ability.
Abstract:
Sixty males and 2 females with the mean age of 58.1 years ranging from 39 to 80 years with atherosclerotic lesions of the arteries of lower extremities were studied. The claudication distance was subdivided into two segments: the first included the distance up to the onset of pain and the second one when the patients had to stop walking because of the severity of pain. The systemic systolic pressure and the poststenotic ankle pressure over both arteries on both calves by a Doppler ultrasound apparatus were measured and the individual pressure gradients were calculated. It was demonstrated that both claudication intervals were related to the poststenotic pressure as well as to the pressure gradient. The stepwise regression analysis showed a significant relationship between both distances and the lowest value of all ankle pressure measurements over four tibial arteries. The closest correlation (R = 0.98) was recorded between the initial and final claudication distance and it persisted even after the elimination of all pressure parameters.