title: Echocardiographic evaluation of external iliac artery Doppler waveform in patients with coronary artery disease.
abstract: Visual interpretation of the Doppler waveform in the common femoral or distal external iliac artery (EIA) was reported to be useful in screening for proximal peripheral artery occlusive disease (PAOD) in patients with lower limb ischemia. Commonly patients with coronary artery disease (CAD) referred for echocardiography have coexistent arterial pathology. Therefore, we decided to study whether echocardiographic evaluation of the distal EIA flow can be useful for detection of PAOD in patients with CAD. We studied 150 consecutive patients (pts) with CAD referred for echocardiography. At the end of an echocardiographic examination, evaluation of the flow in the distal EIA with an echocardiographic probe was performed. The Doppler waveform was classified as normal-with early diastolic flow reversal or abnormal-without early diastolic flow reversal. Echocardiographic findings were compared in a blinded fashion with the results of the ankle brachial index measurements (ABI). Based on the ABI ≤ 0.9, peripheral artery disease was diagnosed in 54 pts (36%) and abnormal external iliac Doppler waveform was found in 27 pts (18%). Sensitivity of abnormal external iliac Doppler waveform in predicting PAOD was 48%, specificity 99%, positive predictive value (PPV) 96%, and negative predictive value 77%. Peripheral arterial occlusive disease is common in patients with CAD referred for echocardiographic study. Echocardiographic assessment of distal EIA Doppler waveform has low sensitivity, but high specificity and high PPV in the diagnosis of peripheral arterial occlusive disease.
authors.affiliation: Department of Internal Medicine, Hypertension and Vascular Diseases, The Medical University of Warsaw, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Styczynski
authors.forename: Cezary
authors.initials: C
authors.lastname: Szmigielski
authors.forename: Anna
authors.initials: A
authors.lastname: Kaczynska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kuch-Wocial
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Doppler echocardiography; atherosclerosis; coronary artery disease; peripheral arterial occlusive disease