The Increase of The Relative Amount of Nodular Calcification In Femoral Plaques is Associated With Milder Lower Extremity Arterial Disease

Vascular calcification exists in different forms that reflect variable clinical and histological implications. Categories of calcification have not been quantified in relation to the clinical presentation of lower extremity arterial disease. The study analyzed 51 femoral plaques collected during femoral endarterectomy, characterized by > 90% stenosis. The plaques were longitudinally sectioned, stained with Hematoxylin and Eosin and digitized for a deep learning platform for quantification of the relative area of nodular calcification to the plaque section area. Vessel measurements and quantity of each calcification category was compared to the clinical risk factors and outcomes. nodular calcification area proportion is associated with reduced risk of severely lowered toe pressure (< 30mmHg) (OR=0.910, 95%CI =0.835-0992, p<0.05), severely lowered ankle brachial index (<0.4), (OR=0.912, 95%CI=0.84-0.986, p<0.05), and semi-urgent operation (OR=0.882, 95%CI=0.797-0.976, p<0.05). The analysis was adjusted by age, gender, hypertension, diabetes and dyslipidaemia. Increase of the relative amount of nodular calcification in femoral plaques with over 90% stenosis is associated with protection against severe LEAD, identified by severely lowered toe pressure and ankle brachial index and semi-urgent operations. Nodular calcification may contribute to a slower obstruction, hence milder obstructive ischaemic presentation.

NGHIÊN CỨU MỐI LIÊN QUAN GIỮA CHỈ SỐ ABI, TỐC ĐỘ LAN TRUYỀN SÓNG MẠCH VỚI MỨC ĐỘ TỔN THƯƠNG ĐỘNG MẠCH VÀNH THEO THANG ĐIỂM SYNTAX II Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP

Mục tiêu: Tìm hiểu mối liên quan giữa chỉ số huyết áp tâm thu cổ chân-cánh tay (Ankle Brachial Index – ABI), tốc độ lan truyền sóng mạch (pulse wave velocity - PWV) với mức độ tổn thương động mạch vành (ĐMV) ở bệnh nhân (BN) nhồi máu cơ tim (NMCT) cấp. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 2 nhóm: nhóm bệnh gồm 60 người bị NMCT cấp và nhóm chứng gồm 33 người có cùng độ tuổi và các yếu tố nguy cơ và chụp ĐMV không tổn thương. Cả 2 nhóm đều được đo ABI, PWV, chụp ĐMV, nhóm bệnh được đánh giá mức độ tổn thương theo thang điểm SYNTAX II. Kết quả: Tuổi trung bình của nhóm bệnh và nhóm chứng tương ứng là 67,05 ± 12,04 và 67,67 ± 6,80 năm. ABI của nhóm bệnh (1,04 ± 0,10) thấp hơn nhóm chứng (1,12 ± 0,13), p<0,01. PWV của nhóm bệnh (15,90 ±1,49 m/s) cao hơn nhóm chứng (13,32 ± 1,98 m/s), p<0,01. PWV ở nhóm tổn thương 1 nhánh và ≥2 nhánh tương ứng là 15,25 ± 1,09 m/s và 16,22 ± 1,57 m/s. Có sự tương quan chặt chẽ giữa PWV với điểm SYNTAX (r = 0,477; p<0,01). Kết luận: ở nhóm NMCT cấp PWV cao hơn và ABI thấp hơn nhóm chứng có ý nghĩa. PWV tương quan chặt chẽ với mức độ tổn thương ĐMV theo thang điểm SYNTAX II.

Short-term outcomes of endovascular therapy for chronic lower extremity arterial disease

Background: Chronic lower extremity arterial disease, mostly caused by atherosclerotic etiology, has been increasing in recent years. Currently, there has been a shift in the treatment chronic lower extremity arterial disease from open surgical treatment to endovascular intervention. According to the TASC classification, surgical treatment is preferred for patients with complex lesions of TASC C, D but recent studies have shown that endovascular intervention has had good results for high-grade lesions. Objective: To determine the efficacy, short-term results of endovascular intervention in patients with symptomatic lower extremity artery disease Methods: From January to December 2021, the cross sectional, descriptive study was carried out on 38 patients with lower limb artery disease, treated by endovascular intervetion in Interventional Department, Hanoi Heart hospital. All patients were evaluated by clinical symptoms, ankle- brachial index and lesion characteristic before and after the intervention to determine the initial success Results: Majority of lesions belong to TASC II C and D (78,9%). Injured arteries can be isolated in the aortoiliac (21,1%), femoropopliteal (21,1%), below-knee artery (21,1%) or combine aortoiliac and femoropopliteal (10,5%), femoropopliteal and BTK (15,8%). The ankle- brachial index before and after the intervention respectively 0,57 and 0.83 (p<0,001). The technical successful rate was 94,7%. Balloon angioplasty and stent placement were in 21 patients (55,3%) and balloon angioplasty in 17 patients (44,7%). Post-procedural complications included stent thrombosis (2.6%), amputation (2.6%), pseudoaneurysm at the puncture site (2.6%). Conclusion: Endovascular intervention is a safe, effective, minimally invasive method in the treatment of chronic lower extremity arterial disease

Supervised Cycling Training Improves Erythrocyte Rheology in Individuals With Peripheral Arterial Disease

Peripheral arterial disease (PAD) results in insufficient flow to lower extremities. Aerobic exercise provides health benefits for individuals with PAD, but basic science behind it is still debated. Twenty-one PAD patients aged about 70 years with female/male as 7/14 were recruited. Among them, 11 were randomized to have supervised cycling training (SCT) and 10 to receive general healthcare (GHC) as controls. SCT participants completed 36 sessions of SCT at the first ventilation threshold within 12 weeks and the controls received GHC for 12 weeks. Ankle-brachial index (ABI), 6-min walk test (6MWT), peak oxygen consumption (V˙O2peak), minute ventilation (V˙E), minute carbon dioxide production (V˙CO2), erythrocyte rheology, including the maximal elongation index (EImax) and shear stress at 50% of maximal elongation (SS1/2), and the Short Form-36 (SF-36) questionnaire for quality of life (QoL) were assessed before and 12 weeks after initial visit. SCT significantly decreased the SS1/2 as well as SS1/2 to EImax ratio (SS1/2/EImax) and increased the erythrocyte osmolality in the hypertonic region as well as the area under EI-osmolality curve. The supervised exercise-induced improvement of erythrocyte deformability could contribute to the increased peripheral tissue O2 delivery and was possibly related with increased V˙O2peak. The physiological benefit was associated with significantly increased ABI, 6-min walking distance, cardiorespiratory fitness, and SF-36 score. However, no significant changes in aerobic capacity and erythrocyte rheological properties were observed after 12-week of GHC. In conclusion, SCT improves aerobic capacity by enhancing erythrocyte membrane deformability and consequently promotes QoL in PAD patients.

Pengaruh Foot Massage dan Pergerakan Sendi Ekstremitas Bawah terhadap Nilai Ankle Brachial Index (ABI) pada Pasien DM Tipe 2 di Wilayah Kerja Puskesmas Peukan Baro, Kab. Pidie

Diabetes mellitus Type 2 (DM Type 2) is the risk factor for the incidence of vascular. Diabetic neuropathy and/or peripheral arterial disease, are common and represent major causes of morbidity and mortality in people with diabetes. Physical exercises is have been done to prevent from diabetes complication, and one of them is by foot massage and lower extremity joint movement. Measuring the value of ankle brachial index (ABI) is one of non-invasive actions to evaluate the risk for peripheral vascular in primary treatment. The objective of this research was to determine the influence of foot massage and joint movement exercise on ABI value in DM Type 2 patients. The research used quasi experiment method with pretest-posttest group design and two intervention groups. The samples were 40 DM Type 2 patients, taken by using consecutive sampling technique. Intervention was given by conducting foot massage and lower extremity joint movement exercise. Wilcoxon Signed Ranks statistic test showed that there was the difference in pre and post intervention of foot massage and lower extremity joint movement from ABI value, for (p=0.00). The conclusion was that foot massage and lower extremity joint movement exercise could increase ABI value if it was done continuously. It could also increase blood flow to artery. This research could bean input for nursing care to make physical exercises such as foot massage and lower extremity joint movement as prevention from risk of longterm Complications in DM Type 2 patients.

Screening Peripheral Artery Disease using the Systolic Rise Time Measured with Photoplethysmography

Screening for Peripheral Artery Occlusive Disease (PAOD) remains a challenge in the prevention and care of patients with arteriosclerosis. The Ankle Brachial Index (ABI) is currently the gold standard. However, ABI is time consuming and requires some expertise to perform which is a limiting factor for global screening. The measurement of the Systolic Rise Time (SRT) of the pulse wave of the lower limb may provide an easier alternative to detect PAOD. In a retrospective pilot study, we analyzed the possibility of detecting PAOD using the SRT of the toe waveform using the Photo-PlethysmoGraphic signal (PPG).

A cross-sectional study on the tea consumption effects of ankle–brachial index

Objectives This thesis aims to explore the relationship between tea consumption and ankle–brachial index (ABI) and further studies the relationship between tea consumption and lower extremity atherosclerosis. Methods This is a cross-sectional, epidemiological survey of 17,373 subjects selected from the staff of Kailuan Group who had come to Kailuan General Hospital for a health examination from January 2016 to December 2017. Tea consumption was obtained by questionnaires. ABI was measured using an automated analyzer. The other data, such as age, gender, body mass index (BMI), and so on, was collected on the same day of the health examination results. The relationship between tea drinking habits and ABI was studied using logistic regression and multivariate linear regression analysis. Results Among the 17,373 analyzed subjects, the difference in age, gender, BMI, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), C-reactive protein (CRP), fasting blood-glucose (Fbg), and ABI was statistically significant in the tea-drinking group and the nontea-drinking group ( p < 0.05). Multiple logistic regression models revealed that tea consumption was a positive predictor for ABI (odds ratio (OR) = 0.782, confidence interval (CI), 0.615–0.994) ( p < 0.05). Multivariate linear regression analysis of the ABI value showed that frequent tea-drinking has a positive correlation with the ABI value ( p < 0.05). Conclusions The higher tea consumption is significantly associated with higher ABI which means less risk for lower extremity atherosclerosis.

Ankle-brachial index: more than a diagnostic test?

The ankle-brachial index (ABI) is the relationship between the systolic blood pressure taken at the ankle level and the brachial artery. A pathological ABI (<0.90 or >1.40) indicates the presence of peripheral artery disease (PAD). Many studies indicate the great utility of this test in the diagnosis of PAD due to its ease of use, reproducibility, low cost, and high cost-effectiveness. This evaluation can be directly correlated with cardiovascular morbidity and mortality; however, it has recently been confirmed that a low ABI can be a predictor of major cardiovascular events, as it is related to diabetes mellitus, chronic coronary disease, stroke, and more. The objective of this work was to review the current evidence on the importance of ABI in the diagnosis of PAD and its main role as a predictor of cardiovascular morbidity and mortality.

Penerapan Perawatan Kaki untuk Meningkatkan Sirkulasi Darah pada Penderita Diabetes Melitus Tipe 2

Diabetes mellitus is a chronic disease characterized by an increase in blood sugar exceeding 140 mg/dL. The purpose of this case study is to describe a foot care intervention with type 2 diabetes mellitus to improve blood circulation. The design of this scientific paper uses a case study method with the subject of two clients who have type 2 diabetes mellitus with blood sugar above 140 mg/dL in Sidorejo Comal Village. The intervention provided was daily foot care, and it was carried out for four days. Evaluation of this intervention has been proven to reduce blood sugar and increase blood circulation which can be measured by glucometer and Ankle Brachial Index (ABI). The results of this study showed a decrease in blood sugar and an increase in ABI in both clients, client 1 experienced a decrease in blood sugar from 256 mg/dL to 197 mg/dL, the ABI value from 0.81 increased to 0.90 and the second client experienced a decrease in blood sugar. from 318 mg/dL to 195 mg/dL, the ABI value from 0.77 increased to 0.92. The conclusion of this case study shows that foot care can reduce blood sugar and increase ABI in patients with type 2 diabetes mellitus. Suggestions for health workers are expected to provide foot care interventions to reduce blood sugar and increase ABI, in the form of foot care interventions in people with diabetes mellitus. type 2.Keywords: Ankle brachial index, Blood circulation, Diabetes mellitus, Foot care AbstrakDiabetes melitus merupakan penyakit kronis yang ditandai dengan kenaikan gula darah melebihi 140 mg/dL. Tujuan studi kasus ini adalah untuk menggambarkan tindakan perawatan kaki dengan diabetes melitus tipe 2 untuk meningkatkan sirkulasi darah. Rancangan karya tulis ilmiah ini menggunakan metode studi kasus dengan subyek dua klien yang mengalami diabetes melitus tipe 2 dengan gula darah diatas 140 mg/dL di Desa Sidorejo Comal. Intervensi yang dilakukan adalahmelakukan perawatan kaki setiap hari dan dilakukan selama empat hari Evaluasi dari tindakan tersebut terbukti dapat menurunkan gula darah dan meningkatkan sirkulasi darah yang dapat diukur dengan glukometer dan Ankle Brachial Index (ABI). Hasil studi ini menunjukan adanya penurunan gula darah dan peningkatkan ABI pada kedua klien,klien 1 mengalami penurunan gula darah dari 256 mg/dL menjadi 197 mg/dL, nilai ABI dari 0,81 meningkat menjadi 0,90 dan klien kedua mengalami penurunan gula darah dari 318 mg/dL menjadi 195 mg/dL, nilai ABI dari 0,77 meningkat menjadi 0,92. Simpulan studi kasus ini menunjukan bahwa perawatan kaki mampu menurunkan gula darah dan meningkatkan ABI pada penderita diabetes melitus tipe 2. Saran bagi tenaga kesehatan diharapkan dapat memberikan tindakan untuk menurunkan gula darah dan meningkatkan ABI berupa tindakan perawatan kaki pada penderita diabetes melitus tipe 2.Kata kunci: Ankle brachial index, diabetes melitus,perawatan kaki, sirkulasi darah