The Ankle Brachial Index Is Associated with Leg Function and Physical Activity: The Walking and Leg Circulation Study

McDermott, Mary McGrae; Greenland, Philip; Liu, Kiang; Guralnik, Jack M.; Celic, Lillian; Criqui, Michael H.; Chan, Cheeling; Martin, Gary J.; Schneider, Joseph R.; Pearce, William H.; Taylor, Lloyd M.; Clark, Elizabeth T.

doi:10.7326/0003-4819-136-12-200206180-00008

Cited by 467 publications

(540 citation statements)

References 36 publications

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“…McDermott et al29 have shown that an ABI between 0.90 and 1.10 was associated with reduced functional capacity measured by 6‐meter walking speed. Furthermore, an ABI of 0.90 to 1.10 was prospectively associated with a greater decline in 6‐minute walk performance as well as a greater risk for developing mobility loss over 5 years, when compared with an ABI of 1.11 to 1.40 9.…”

Section: Discussionmentioning

confidence: 99%

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low‐Normal Ankle‐Brachial Index

AlGhatrif

Zane

Oberdier

et al. 2017

JAHA

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BackgroundLower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle‐brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher ABI. We hypothesized that in the absence of peripheral arterial disease, lower ABI is associated with lower mitochondrial energy production.Methods and ResultsWe examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an ABI between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post‐exercise phosphocreatine recovery rate constant (kPCr) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post‐exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an ABI of 1.11 to 1.40, those with an ABI of 0.90 to 1.10 had significantly lower post‐exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms−1, P=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (P=0.028). Similarly, post‐exercise phosphocreatine recovery rate constant was linearly associated with ABI as a continuous variable, both in the ABI ranges of 0.90 to 1.40 (standardized coefficient=0.15, P=0.003) and 1.1 to 1.4 (standardized coefficient=0.12, P=0.0405).ConclusionsAn ABI of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an ABI of 1.11 to 1.40. These data demonstrate adverse associations of lower ABI values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal ABI. Further study is needed to determine whether interventions in persons with ABIs of 0.90 to 1.10 can prevent subsequent functional decline.

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Section: Discussionmentioning

confidence: 99%

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low‐Normal Ankle‐Brachial Index

AlGhatrif

Zane

Oberdier

et al. 2017

JAHA

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“…The 6MWT is widely used and provides important prognostic information in several chronic cardiopulmonary disease states [13][14][15][16]. The primary outcome measurement of the 6MWT is the distance walked during a period of 6 min, which may include periods of rest.…”

Section: Discussionmentioning

confidence: 99%

“…A practical and simple measurement of functional status that is widely used as a clinical tool and outcome measure of patients with heart [13], obstructive lung disease [14], vascular [15], and neuromuscular disease [16] is the 6-min walk test (6MWT). However, the physiological abnormalities associated with disease severity and progression in IPF are not fully characterised by the distance of the 6MWT [7,9,12].…”

mentioning

confidence: 99%

The timed walk test as a measure of severity and survival in idiopathic pulmonary fibrosis

Hallstrand

Boitano

Johnson

et al. 2005

European Respiratory Journal

164

112

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Idiopathic pulmonary fibrosis (IPF) is a relentlessly progressive disease with a median survival of ,3 yrs. Measurements of airflow and lung volumes at rest are generally used to monitor the clinical course in this disorder. This study was designed to determine if a modified version of the 6-min walk test, called the timed walk test, accurately characterises disease severity and survival in IPF.The study population consisted of 28 patients with well-characterised progressive IPF. The timed walk test and concurrent measures of disease severity were assessed at baseline. Participants were prospectively followed for o4 yrs to determine the relationship between parameters of the timed walk test and survival.There were strong correlations between the end-exercise saturation and walk-velocity parameters of the timed walk test and diffusing capacity, and arterial oxygen tension at rest. In univariate Cox proportional-hazards models, end-exercise saturation, change in saturation with exercise, walk distance and walk velocity were associated with survival. In unadjusted logistic regression models, odds of death at 2 yrs were associated with the same parameters.In conclusion, the timed walk test relates to disease severity and long-term outcome in progressive idiopathic pulmonary fibrosis.

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“…As the disease progresses, patients with PAD may develop intermittent claudication and critical limb ischemia (a condition including ischemic rest pain, ulcers, or gangrene, with up to 25% risk of amputation within 1 year of diagnosis),8 leading to the reduction of health‐related QOL. Indeed, several studies have evaluated the impact of PAD on QOL measures,9, 10, 11, 12, 13, 14, 15, 16, 17, 18 but most of these studies have been conducted in small clinic‐based populations with symptomatic PAD9, 10, 11, 12, 13, 14 or in selected populations with specific cardiovascular disease risk profiles 16, 17. The impact of clinical and subclinical PAD on QOL in the general population is thus yet to be characterized.…”

Section: Introductionmentioning

confidence: 99%

Lower Extremity Peripheral Artery Disease and Quality of Life Among Older Individuals in the Community

Coresh

Selvin

et al. 2017

JAHA

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BackgroundEvidence regarding the association of lower extremity peripheral arterial disease with quality of life (QOL) is mainly from selected clinical populations or relatively small clinical cohorts. Thus, we investigated this association in community‐derived populations.Methods and ResultsUsing data of 5115 participants aged 66 to 90 years from visit 5 (2011‐2013) of the Atherosclerosis Risk in Communities Study, we quantified the associations of ankle‐brachial index (ABI) with several QOL parameters, including 12‐item Short‐Form Health Survey (SF‐12), after accounting for potential confounders using linear and logistic regression models. Peripheral arterial disease defined by an ABI <0.90 (n=402), was independently associated with a low SF‐12 Physical Component Summary score (−3.26 [95% CI −5.60 to −0.92]), compared to the ABI reference 1.10 to 1.19 (n=1900) but not with the Mental Component Summary score (−0.07 [−2.21 to 2.06]). A low ABI was significantly associated with poorer status of all SF‐12 physical domains (physical functioning, role‐physical, bodily pain, and general health) but only vitality out of 4 mental domains. Similarly, low ABI values were more consistently associated with other physically related QOL parameters (leisure‐time exercise/activity/walking) than mentally related parameters (significant depressive symptoms and hopeless feeling). Lower physical QOL was observed even in individuals with borderline low ABI (0.90 to 0.99; n=426).ConclusionsLow ABI (even borderline) was independently associated with poor QOL, especially for physical components, in community‐dwelling older adults. QOL is a critical element for older adults, and thus, further studies are warranted to assess whether peripheral arterial disease‐specific management can improve QOL in older populations.

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The Ankle Brachial Index Is Associated with Leg Function and Physical Activity: The Walking and Leg Circulation Study

Cited by 467 publications

References 36 publications

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low‐Normal Ankle‐Brachial Index

Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low‐Normal Ankle‐Brachial Index

The timed walk test as a measure of severity and survival in idiopathic pulmonary fibrosis

Lower Extremity Peripheral Artery Disease and Quality of Life Among Older Individuals in the Community

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