scholarly journals Korelasi Ankle Brachial Indeks dengan Pulse Wave Handheld Doppler Penderita Kaki Diabetik

2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Johanes Berechmans Pranoto Rumaratu ◽  
Richard Sumangkut ◽  
Djony Tjandra ◽  
Billy Karundeng ◽  
Fima L. F. G. Langi

Tujuan: Untuk mengetahui hubungan antara hasil pemeriksaan Ankle Brachial Index (ABI) dengan gambaran spektral Doppler vaskular pada arteri poplitea, arteri tibialis posterior, dan arteri dorsalis pedis pada penderita kaki diabetik. Metode: 33 pasien kaki diabetes yang memenuhi kriteria inklusi dari RSUP Prof. Dr. R. D. Kandou. Pengukuran ABI dilakukan dan spektral arteri poplitea, tibialis posterior, dan dorsalis pedis diuji menggunakan Pulse Wave Handheld Doppler (PWHD). Hasilnya akan diproses secara statistik menggunakan desain potong lintang untuk mengetahui hubungan keduanya. Hasil: Sebagian dari jumlah pasien memiliki gelombang bifasik di 3 arteri. Gelombang trifasik terlihat dominan di arteri poplitea (56%) dan juga umumnya pada dua arteri lainnya (30%). Gelombang arteri menunjukkan adanya hubungan dengan ABI. Dibanding dengan gelombang bifasik, pasien dengan gelombang trifasik rata-rata memiliki ABI yang meningkat (0,15; p<0,001 pada arteri poplitea, dan 0,06; p=0,006 pada arteri tibialis posterior). Secara nyata, gelombang monofasik cenderung menurunkan ABI pada sejumlah pasien dibandingkan gelombang bifasik (-0,18; p<0,001 pada arteri tibialis posterior dan -0,15; p<0,0041 pada arteri dorsalis pedis). Simpulan: Didapatkan hubungan yang signifikan antara ABI dengan hasil gelombang spektral Doppler pada semua segmen arteri bawah lutut.  

VASA ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Christian Alexander Schaefer ◽  
Anna Katharina Blatzheim ◽  
Sebastian Gorgonius Passon ◽  
Kristin Solveig Pausewang ◽  
Nadjib Schahab ◽  
...  

Abstract. Background: The beneficial effect of statin therapy on the progress of atherosclerotic disease has been demonstrated by numerous studies. Vascular strain imaging is an arising method to evaluate arterial stiffness. Our study examined whether an influence of statin therapy on the vessel wall could be detected by vascular strain imaging. Patients and methods: 88 patients with recently detected atherosclerosis underwent an angiological examination including ankle-brachial index (ABI), pulse wave index (PWI), central puls ewave velocity and duplex ultrasound. Captures for vascular strain analysis were taken in B-mode during ultrasound examination of the common carotid artery and evaluated using a workstation equipped with a speckle tracking based software. A statin therapy was recommended and after six months a follow-up examination took place. Meanwhile, the non-adherence of a group of patients (N = 18) lead to a possibility to observe statin effects on the vascular strain. Results: In the statin non-adherent group the ABI decreased significantly to a still non-pathological level (1.2 ± 0.2 vs. 1.0 ± 0.2; p = 0.016) whereas it stagnated in the adherent group (1.0 ± 0.2 vs. 1.0 ± 0.2; p = 0.383). The PWI did not differ in the non-adherent group (180.5 ± 71.9 vs. 164.4 ± 75.8; p = 0.436) but under statin therapy it decreased significantly (261.8 ± 238.6 vs. 196.4 ± 137.4; p = 0.016). In comparison to the adherent group (4.2 ± 2.0 vs. 4.0 ± 1.8; p = 0.548) under statin therapy the radial strain decreased significantly in the non-adherent group (4.7 ± 2.0 vs. 3.3 ± 1.1; p = 0.014). Conclusions: Our findings reveal a beneficial influence of statin therapy on the arterial wall detected by vascular strain analysis.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Yu ◽  
J Teliewubai ◽  
X Fan ◽  
C Chi ◽  
H Ji ◽  
...  

Abstract Background Peripheral artery disease (PAD) is prevalent and substantially contributes to cardiovascular mortality particularly in the elderly, although the pathophysiological impact of PAD on heart itself still needs further investigation. In theory, PAD can increase pulse wave reflection which is an important determinant of subendocardial viability ratio (SEVR), a valuable estimate of myocardial perfusion as indicated by previous invasive studies. Thus, we hypothesize that PAD impairs myocardial perfusion through increasing pulse wave reflection. In this study, we aim to test this hypothesis in a large cohort from the Northern Shanghai Study. Methods A total of 2947 community-dwelling elderly Chinese (43.6% male, mean age: 71.3±5.9 years) were recruited. Ankle-brachial index were measured with the VP1000 device and used to diagnose PAD. Pulse wave reflection was estimated as aortic augmentation pressure (AP). Aortic BP, AP and SEVR were assessed by radial applanation tonometry. Multiple linear regression with SEVR and AP as dependent variable and PAD as independent variable, meanwhile adjusted for other covariates, were performed, respectively. Results 375 (12.7%) participants presented PAD. Compared to subjects without PAD, those with PAD showed significantly lower SEVR (126 vs. 132, P&lt;0.001) but higher AP (19 vs. 17 mmHg, P&lt;0.001). Multiple regression analysis revealed that both SEVR (regression coefficient [B] = −1.69, P=0.04, R2=0.61) and AP (B=1.19, P=0.04, R2=0.56) significantly associated with PAD, respectively. However, the association between SEVR and PAD was abolished when further adjusted for AP (B=−0.49, P=0.52). Similar results were obtained when inter-leg systolic BP difference was used to diagnose PAD. Conclusions PAD significantly and independently associates with myocardial perfusion; moreover, this association is mediated by increased pulse wave reflection. These findings provide a new dimension for understanding the pathophysiological mechanisms of cardiac damage of PAD. Funding Acknowledgement Type of funding source: None


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
John T Wilkins ◽  
Mary M McDermott ◽  
Kiang Liu ◽  
Cheeling Chan ◽  
Michael Criqui ◽  
...  

The association between tonometry-derived measures of arterial stiffness and peripheral arterial disease (PAD) is unclear. Using baseline data from 2847 female and 2614 male participants of the NHLBI-funded MESA study, we conducted linear regression analyses adjusted for age, demographics and risk factors. Ankle-brachial index (ABI) was the dependent variable and measures of large (C1) and small artery elasticity (C2) and total vascular impedance (TVI), all measured from radial artery tonometry, were the independent variables in separate models. In men and women, lower C1 and C2 values were associated with lower ABI. Higher TVI was associated with lower ABI in men and women [P<0.001]. Significant trends for C1, C2 and TVI were observed across clinical strata of ABI (Table ). In pairwise analyses, compared with participants with a normal ABI (1.1 to <1.3), those with ABI <1.1 tended to have significantly lower C2. Additionally, women with high ABI (1.3–1.5) tended to have significantly higher C2 values. Pairwise comparisons of lower and higher ABI groups compared with normal groups did not yield consistent findings for C1. Significantly higher TVI levels with lower ABI group were noted mostly in women (Table ). We observed a continuum of arterial mechanical characteristics across clinical ABI values, indicating that measures of arterial stiffness are significantly associated with ABI and severity of PAD. These results suggest that changes in C2 occur in patients with advanced lower extremity large-vessel atherosclerotic disease. Of note, female participants with high ABI between 1.3–1.5 had a significantly higher C2, arguing against the accepted “non-compressible” or “calcified arterial disease” explanation for high ABI in women. Associations Between ABI and Pulse Wave Analysis Measurements when adjusted for age, cigarette smoking, diabetes, hypertension, and creatinine level


2011 ◽  
Vol 18 (6) ◽  
pp. 790-796 ◽  
Author(s):  
Peter Wohlfahrt ◽  
Daniel Palouš ◽  
Michaela Ingrischová ◽  
Alena Krajčoviechová ◽  
Jitka Seidlerová ◽  
...  

Background: Ankle brachial index (ABI) has been increasingly used in general practice to identify individuals with low ABI at high cardiovascular risk. However, there has been no consensus on the clinical significance of high ABI. The aim of our study was to compare aortic stiffness as a marker of cardiovascular risk in individuals with low (<1.0), normal (1.0–1.4), and high ABI (>1.4). Methods: A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, aged 54 ± 13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device. Results: Of the 911 individuals, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in individuals with low and high ABI compared with the normal ABI group (11.1 ± 2.8, 8.3 ± 2.3, p < 0.001; 10.8 ± 2.5, 8.3 ± 2.3 m/s, p < 0.001, respectively). In a model adjusted for age, sex, systolic, diastolic, mean blood pressure and examiner, aPWV remained increased in both extreme ABI groups compared with the normal ABI group. In logistic regression analysis, aPWV together with glucose level, male sex, and a history of deep venous thrombosis were independent predictors of high ABI, while cholesterol was not. Conclusion: This is the first study showing increased aortic stiffness in individuals with high ABI, presumably responsible for increased left ventricular mass described previously in this group. These findings suggest increased cardiovascular risk of high ABI individuals.


2006 ◽  
Vol 49 (7) ◽  
pp. 769 ◽  
Author(s):  
Sun Young Joo ◽  
Ki Young Cho ◽  
Su Jin Cho ◽  
Young Mi Hong

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Zhizhen Liu ◽  
Hongqing Yang ◽  
Mozhu Zhang ◽  
Jing Cai ◽  
Zijie Huang

Objective. Blood stasis (BS) constitution represents a tendency to stagnation and positively associates with the severity of atherosclerosis. In this study, we have identified the interaction effect between BS constitution and atherosclerosis on cognitive impairment in the elderly people. Methods. Eligible elderly people ≥65 years old who attended physical examination in the Mawei community of Fuzhou city during 2015 were enrolled in this study. We explored the characteristics of Traditional Chinese Medicine (TCM) constitution and atherosclerotic factors in the normal and cognitive impairment groups and their interaction effect between participants’ Minimental State Examination (MMSE) scores in the elderly people. Results. The prevalence of cognitive impairment in the elderly people was 13.0%. Red blood cell (RBC), hemoglobin (HB), ankle brachial index (ABI), brachial-ankle pulse wave velocity (BaPWV), and blood stasis (BS) were significantly different between normal and cognitive impairment group (P<0.05). Logistic regression analysis indicated that RBC (odds ratio (OR)=0.530 (0.343-0.817), P=0.004), HB (OR=0.980 (0.967-0.993), P=0.003), ABI (OR=2.199(1.112-4.347), P=0.023), and blood stasis constitution (OR=1.808 (1.022-3.202), P=0.042) were correlated with cognitive impairment. The interactions of blood stasis with HB, ABI, and BaPWV significantly impacted the MMSE score (P<0.05). Conclusion. Elderly individuals with blood stasis may be at a higher risk of arterial stenosis and sclerosis, leading to susceptibility to cognitive impairment.


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