title: Clinical value of ankle-brachial index in asymptomatic aortic stenosis patients.
abstract: OBJECTIVE
  The study aim was to assess the prevalence and clinical value of the pathological ankle-brachial index (ABI) in asymptomatic aortic stenosis (AS) patients.
  
  
  METHODS
  This prospective study included 203 asymptomatic AS patients, with a mean follow up of 18 ± 10.6 months. Six-minute walk tests (6MWT) and ABI measurements were performed when patients were included in the study. Study events were defined as death, hospital admission due to related symptoms, or a need for surgery.
  
  
  RESULTS
  A total of 198 patients (95 females, 103 males; mean age 74.6 ± 9.5 years) completed the study. An abnormal ABI was found in 35.8%. Mean (± SD) values were: peak velocity Vmax 4.1 ± 0.8 m/s; maximum/mean gradient 70.5 ± 25.1/43.3 ± 16.3 mmHg; aortic valve area 0.8 ± 0.7 cm2; indexed aortic valve area 0.4 ± 0.1 cm2/m2. A pathological ABI was associated with diabetes (p = 0.01), previous peripheral vascular disease (p = 0.04) and previous stroke (p = 0.04). In multivariate analyses, diabetes was an independent factor related to pathological ABI (relative risk 1.71, 95% CI 1.22-2.19). Patients with a pathological ABI walked less in the 6MWT (263.9 m versus 328.3; p = 0.002), but did not present a worse prognosis at follow up (p = NS).
  
  
  CONCLUSIONS
  Among asymptomatic AS patients, 35.8% had an abnormal ABI and this was related to previous diabetes. These patients walked less in the 6MWT but did not have a worse prognosis at follow up.
authors.forename: Miquel
authors.initials: M
authors.lastname: Gomez
authors.forename: Cristina
authors.initials: C
authors.lastname: Roqueta
authors.forename: Lluis
authors.initials: L
authors.lastname: Molina
authors.forename: Mercedes
authors.initials: M
authors.lastname: Cladellas
authors.forename: Mireia
authors.initials: M
authors.lastname: Ble
authors.forename: Josep
authors.initials: J
authors.lastname: Comin-Colet
authors.forename: Cristina
authors.initials: C
authors.lastname: Soler
authors.forename: Jordi
authors.initials: J
authors.lastname: Bruguera
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000401:mortality; D058070:Asymptomatic Diseases; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D011446:Prospective Studies