title: Brachial-ankle pulse wave velocity is associated with walking distance in patients referred for peripheral arterial disease evaluation.
abstract: OBJECTIVE
  Impaired functional capacity predicts morbidity and increased mortality in patients with PAD. We hypothesized that brachial-ankle pulse wave velocity (baPWV), a measure of arterial stiffness, is associated with functional capacity in patients undergoing noninvasive evaluation for peripheral arterial disease (PAD).
  
  
  METHODS
  We studied 114 patients (age 68+/-10 years) referred to Mayo Clinic's noninvasive vascular laboratory. Functional capacity was estimated in terms of distance walked in 5 min on a treadmill at a speed of 1.0-2.0 mph. Ankle-brachial index (ABI) was obtained with Doppler method before and 1 min after exercise. baPWV was estimated noninvasively using an oscillometric device. The association of baPWV with walking distance was assessed using accelerated failure time and Cox proportional-hazards models.
  
  
  RESULTS
  The mean baPWV was higher in patients who were unable to complete the walk test compared to those who successfully completed the test (P=0.008). Higher baPWV was associated with a lower walking distance after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P=0.017) and after additional adjustment for pulse pressure (P=0.034) and ABI (P=0.030). Higher baPWV was associated with failure to complete the treadmill walk test, after adjustment for heart rate, mean arterial pressure, and cardiovascular risk factors (P=0.025) and after additional adjustment for pulse pressure (P=0.041) and ABI (P=0.039).
  
  
  CONCLUSIONS
  Increased baPWV, a measure of arterial stiffness, is associated with impaired functional capacity in patients undergoing evaluation for PAD.
authors.affiliation: George Washington University School of Medicine, Washington DC, USA.
authors.forename: Comfort A
authors.initials: CA
authors.lastname: Amoh-Tonto
authors.forename: A Rauoof
authors.initials: AR
authors.lastname: Malik
authors.forename: Venkateswarlu
authors.initials: V
authors.lastname: Kondragunta
authors.forename: Zeenat
authors.initials: Z
authors.lastname: Ali
authors.forename: Iftikhar J
authors.initials: IJ
authors.lastname: Kullo
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply / Q000503:physiopathology; D055109:Ankle Brachial Index; D001783:Blood Flow Velocity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology*; D011673:Pulsatile Flow; D016138:Walking