Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

Verberk, Willem J.; Κόλλιας, Αναστάσιος; Stergiou, George S.

doi:10.1038/hr.2012.83

Cited by 67 publications

(87 citation statements)

References 47 publications

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“…Moreover, they did not have a long history of smoking because Japanese law prohibits people under the age of 20 from smoking. Second, although the oscillometric method has been shown to have good correlations with the Doppler method in ABI measurement, 14,16) a rather high ABI value compared with the Doppler method might have been obtained particularly in arteries of the upper extremity less frequently than the arteries of the lower extremity. An age-related increase in PWV was also shown to be larger in the lower extremity than in the upper extremity.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…wave velocity (baPWV), which is a potentially powerful predictor of arteriosclerotic organ damage and cardiovascular events, as well as carotid-femoral PWV (cfPWV); 10) (2) % mean arterial pressure (%MAP) and upstroke time (UT) as the indexes of pulse volume recording (PVR). 11,12) Oscillometric blood pressure measurement is equally as reliable as Doppler pressure measurement at the ankles [13][14][15][16] and photoplethysmography at the toes. 17) Automated devices are expected to be fast, simple, and accurate vascular screening tools.…”

Section: Introductionmentioning

confidence: 99%

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Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

Watanabe

Hara

Yunoki

et al. 2015

Annals of Vascular Diseases

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Objective: To clarify the characteristics of ankle-brachial index (ABI), toe-brachial index (TBI), and pulse volume recording (PVR) of the ankle with brachial-ankle pulse wave velocity (baPWV) in healthy young adults. Material and Methods: We analyzed ABI, TBI, baPWV, and PVR in the ankle of healthy adults aged 20 to 25 years (median, 20 years) using an automatic oscillometric device between 2002 and 2013. The ABI, baPWV, and PVR in 1282 legs of 641 subjects (301 men and 340 women) and the TBI in 474 toes of 237 subjects (117 men and 120 women) were evaluated. Results:The measured values showed no bilateral differences. ABI and baPWV were higher in men than in women, but TBI was similar in both sexes. ABI <1.0 was observed in 18.1% of the legs in men and in 25.6% in women. TBI <0.7 was observed in 16.2% of the toes in men and 19.1% in women. For ankle PVR, the % mean arterial pressure was higher in women than in men. The upstroke time was <180 ms in most subjects. Conclusions: For young people, ABI <1.0 or TBI <0.7 may not always indicate vascular abnormalities. When evaluating circulatory indexes, age and sex should be considered.Keywords: ABI, TBI, baPWV, PVR, healthy young adults indications of ABI. The cut-off value of ABI for detecting PAD has been confirmed as 0.9 with high sensitivity and specificity. 2) Moreover, ABI is a strong predictor of cardiovascular events: the normal ABI range was revised as 1.00 to 1.40, because patients with ABI ranging from 0.91 to 0.99 have been shown to be at the borderline of cardiovascular risk. 2) On the other hand, TBI measurements are more cumbersome and are limited to special institutions (e.g., vascular laboratories) using different techniques including laser Doppler flowmetry, photoplethysmography, oscillometric plethysmography, and mercury strain gauge plethysmography. Thus, basic data on a uniform technique for a large population remain limited. Although the cut-off value of TBI for detecting PAD is set at 0.6 or 0.7, there has been no global consensus. 1,[3][4][5] Although the normal standard ranges of ABI and TBI are based on data obtained mostly from middle and senior adults, [3][4][5][6] young patients with lower limb complaints such as coldness, pain, or claudication are also primarily examined by ABI and TBI measurements because PAD including Buerger disease, Raynaud disease, Takayasu arteritis, and even arteriosclerotic diseases can occur in young patients, as the prevalence of PAD is estimated to be 1.2% to 4% of people in their late 20s. 7) However, they occasionally show ABI <1.0 or TBI <0.7 despite their normal physical findings, making the diagnosis confusing.The gold standard method for ABI measurement has been the Doppler method since the 1980s, 2) but on the other hand, automated oscillometric sphygmomanometers have come into use recently. Moreover, full-automated ABI/TBI measuring devices have been developed since the late 1990s. 8,9) We have used the automated ABI/TBI measuring devices in our clinical work. The form PWV/ABI ® (Colin Co., Aichi, Jap...

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Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

Watanabe

Hara

Yunoki

et al. 2015

Annals of Vascular Diseases

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“…Because oscillometric determination of ABI results in a slightly higher value than Doppler determination, some have suggested that to increase sensitivity in detection of PAD, a threshold of 1.0 might be preferable. 6 We speculate that the lower-than-expected frequency of low ABI detected in our study may be related to the oscillometric technique, given the known potential for overestimation of ABI by oscillometry as compared with Doppler. We suspect that some of the participants found to have borderline ABI in our study would have low ABI as measured by Doppler.…”

Section: Discussionmentioning

confidence: 61%

“…Based on a large meta-analysis, the specificity of PAD diagnosis as measured by oscillometry compared with Doppler is high, at 96%, whereas sensitivity is lower, at 69%. 6 Thus, patients identified as abnormal using oscillometric ABI are likely to be truly abnormal, though some patients with true PAD may be missed using this approach. Because oscillometric determination of ABI results in a slightly higher value than Doppler determination, some have suggested that to increase sensitivity in detection of PAD, a threshold of 1.0 might be preferable.…”

Section: Discussionmentioning

confidence: 99%

Ankle‐Brachial Index Testing at the Time of Stress Testing in Patients Without Known Atherosclerosis

Narula

Benenstein

Duan

et al. 2015

Clinical Cardiology

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BackgroundIndividuals referred for stress testing to identify coronary artery disease may have nonobstructive atherosclerosis, which is not detected by stress tests. Identification of increased risk despite a negative stress test could inform prevention efforts. Abnormal ankle‐brachial index (ABI) is associated with increased cardiovascular risk.HypothesisRoutine ABI testing in the stress laboratory will identify unrecognized peripheral arterial disease in some patients.MethodsParticipants referred for stress testing without known history of atherosclerotic disease underwent ABI testing (n = 451). Ankle‐brachial index was assessed via simultaneous arm and leg pressure using standard measurement, automated blood‐pressure cuffs at rest. Ankle‐brachial index was measured after exercise in 296 patients and 30 healthy controls. Abnormal postexercise ABI was defined as a >20% drop in ABI or fall in ankle pressure by >30 mm Hg.ResultsOverall, 2.0% of participants had resting ABI ≤0.90, 3.1% had ABI ≥1.40, and 5.5% had borderline ABI. No patient with abnormal or borderline ABI had an abnormal stress test. Participants who met peripheral arterial disease screening criteria (age ≥65 or 50–64 with diabetes or smoking) tended toward greater frequency of low ABI (2.9% vs 1.0%; P = 0.06) and were more likely to have borderline ABI (0.91 to 0.99; 7.8% vs 2.9%; P = 0.006). Postexercise ABI was abnormal in 29.4% of patients and 30.0% of controls (P not significant).ConclusionsAnkle‐brachial index screening at rest just before stress testing detected low ABI in 2.0% of participants, all of whom had negative stress tests.

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“…Todos los documentos revisados destacan la utilidad del ITB para realizar el diagnóstico de la AP. Cabe destacar que uno de los meta-análi-sis 19 le otorga una alta especificidad y sensibilidad (90%) mientras que en otro documento 20 se define el ITB como una herramienta útil para la predicción del riesgo cardiovascular haciendo hincapié en su facilidad de uso, su carácter no invasivo y su buena aceptabilidad por parte del paciente.…”

Section: Discussionunclassified

Grado de evidencia en la utilización del índice tobillo-brazo para el diagnóstico de la Arteriopatía Periférica en diabéticos tipo 2

Pittí

Fernández

Guerrero³

2015

Rev. Int. Cienc. Podol.

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Automated oscillometric determination of the ankle-brachial index: a systematic review and meta-analysis

Cited by 67 publications

References 47 publications

Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

Ankle-Brachial Index, Toe-Brachial Index, and Pulse Volume Recording in Healthy Young Adults

Ankle‐Brachial Index Testing at the Time of Stress Testing in Patients Without Known Atherosclerosis

Grado de evidencia en la utilización del índice tobillo-brazo para el diagnóstico de la Arteriopatía Periférica en diabéticos tipo 2

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