title: New semiquantitative ultrasonographic score for peripheral arterial disease assessment and its association with cardiovascular risk factors.
abstract: The data concerning the distribution, extent and progression of peripheral arterial disease (PAD), as well as its association with traditional cardiovascular (CV) risk factors, have generally been obtained from studies of patients in advanced stages of the disease undergoing surgical or endovascular treatment. In this study, we have introduced a new semiquantitative ultrasonographic score (ultrasonographic lower limb atherosclerosis (ULLA) score) that is able to categorize lower limb atherosclerotic lesions at all stages of PAD. We then associated these ultrasonographic categories with a CV risk profile. We enrolled 320 consecutive subjects with symptoms suggestive of PAD or with known CV risk factors referring to our angiology unit between 1 July 2014 and 30 June 2015 for ultrasonographic evaluation of the lower limb arteries. Femoropopliteal and run-off segments were categorized together and separately based on their ultrasonographic characteristics. In univariate and multivariate analyses, the ULLA scores were significantly associated with the main CV risk factors, that is, age, male gender, cigarette smoking, arterial hypertension, diabetes, dyslipidemia, sedentary lifestyle, previous CV events and family history of CV disease, and also confirming the specific association of single risk factors with different segments of lower limb arteries. The proposed ULLA score enables a complete evaluation of the entire lower limb atherosclerotic burden, extending the results concerning the association of PAD with CV risk factors to all stages of the disease, including the early stages. It can be feasible that this new score will facilitate better evaluation of the progression of PAD and its prospective role in CV risk stratification.
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Santoro
authors.affiliation: Division of Nephrology and Dialysis, Catholic University of Rome, Rome, Italy.
authors.forename: Pietro Manuel
authors.initials: PM
authors.lastname: Ferraro
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Flex
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nesci
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Matteis
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Di Giorgio
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Zaccone
authors.affiliation: Division of Nephrology and Dialysis, Catholic University of Rome, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gambaro
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Department of Internal Medicine, Catholic University of Rome, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Santoliquido
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography / Q000379:methods*