Assessing Ankle-Brachial Index (ABI) by using automated oscillometric devices.
BACKGROUND
Assessing Ankle-Brachial Index is an essential procedure in clinical settings, but since its measurement by the gold standard Doppler Ultrasonic (DU) technique is impaired by technical difficulties, it is underperformed.


OBJECTIVE
The aim of this study was to assess the efficacy of an automated oscillometric device (AOD) by performing Ankle-Brachial Index (ABI) assessments and to suggest delta brachial-brachial (delta-BB) and delta-ABI as markers of cardiovascular risk.


METHODS
In this observational and descriptive study, 247 patients (56.2% females, mean age 62.0 years) had their arterial blood pressure (ABP) measured for ABI calculation. Two AOD (OMRON-HEM705CP) devices were used for simultaneous measurements of the ABP, first of the two arms and then of the arm with higher systolic ABP and a leg, first the left and then the right one. When leg ABP measurements were not possible, ABI determination was performed by using the standard Doppler Ultrasonic (DU) technique. Patients were designated to Group N (normal ABI: 0.91 to 1.30) or Group A (abnormal ABI: < or =0.90 or >1.30). Other indexes were also calculated: delta-BB (absolute difference in mmHg of systolic ABP between arms) and delta-ABI (absolute difference of ABI between legs) and the results were compared.


RESULTS
In most patients (90.7%), it was possible to determine the ABI. Group N data allowed calculation of the 95th percentile reference values (RV) of delta-BB (0 to 8 mmHg) and delta-ABI (0 to 0.13). When compared to Group N, Group A had a significantly higher prevalence of high values greater than the RVs of delta-ABI (30 of 52 and 10 of 195, respectively; Odds Ratio = 25.23; p<0.0001) and delta-BB (13 of 52 and 7 of 195, respectively; Odds Ratio = 8.95; p<0.0001).


CONCLUSIONS
In most patients, the ABI could be measured by AOD. Both indexes, delta-BB and delta-ABI greater than the RVs, were significantly more prevalent in patients with abnormal ABI values, and their usefulness as new markers of cardiovascular disease should be further appraised in epidemiological studies.
Kawamura
Takao
T
Cardioclínica Araçatuba, Araçatuba, SP - Brasil. takaok@terra.com.br
D000368:Aged; D000704:Analysis of Variance; D000842:Ankle / Q000098:blood supply* / Q000502:physiology; D001132:Arm / Q000098:blood supply* / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D001916:Brachial Artery / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009991:Oscillometry / Q000295:instrumentation / Q000379:methods*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012039:Regional Blood Flow