Literature DB >> 21723076

Relationship between ankle brachial index and arterial remodeling in pseudoxanthoma elasticum.

Georges Lefthériotis1, Pierre Abraham, Yannick Le Corre, Olivier Le Saux, Daniel Henrion, Pierre Henri Ducluzeau, Fabrice Prunier, Ludovic Martin.   

Abstract

OBJECTIVES: Pseudoxanthoma elasticum (PXE) is an inherited metabolic disease characterized by elastic fiber fragmentation and calcification in the cutaneous, ophthalmologic, and vascular tissues. Cardiovascular manifestations such as peripheral arterial disease (PAD) are frequent in PXE. Because of the changes in the elastic properties and medial calcification of the arterial wall in PXE, the impact of the arterial remodeling on the ankle brachial index (ABI), a well-established diagnostic method for the detection and follow-up of PAD, remains to be determined in this disease.
METHODS: This was a cross-sectional, comparative, open study, which took place at the PXE Consultation Center, University Hospital of Angers. The subjects were 53 patients (mean age, 49 ± 14 years; 35 females) with PXE clinically proven on the basis of established criteria (skin changes, angioid streaks, and skin biopsy). The ABI at rest, symptoms of intermittent claudication (IC), carotid intima-media thickness (IMT), carotid-femoral pulse wave velocity (c-f PWV), compliance (CC), and β stiffness index were measured in a single-center cohort.
RESULTS: Forty-five percent of the PXE patients had an ABI ≤0.90, but only one patient had an ABI >1.40. IC was found in 23% of the patients with an ABI ≤0.90. There were no significant differences between the patients with a low and normal ABI in terms of IMT (P = .566) or β stiffness index (P = .194), but differences were significant for c-f PWV (P = .010) and CC (P = .011). Adjusted multivariate linear regression for the Framingham-Laurier score showed that patients with a low ABI had less compliant carotid arteries (B = 0.318, P = .039).
CONCLUSIONS: PAD detected by a low ABI is very frequent in PXE, although with limited prevalence of symptomatic claudication. Unexpectedly, ABI was low in such calcifying PAD and associated with lower CC, independently of atherosclerosis risk factors. These findings demonstrate that PXE represents a unique monogenic model of PAD in which the specific arterial wall remodeling could change the diagnostic value of the ABI to detect PAD.
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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Year:  2011        PMID: 21723076      PMCID: PMC5529101          DOI: 10.1016/j.jvs.2011.04.041

Source DB:  PubMed          Journal:  J Vasc Surg        ISSN: 0741-5214            Impact factor:   4.268


  28 in total

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8.  The association between elevated ankle systolic pressures and peripheral occlusive arterial disease in diabetic and nondiabetic subjects.

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Authors:  K Miwa; T Higashikata; H Mabuchi
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5.  Carotid strain measurement in patients with pseudoxanthoma elasticum - Hint for a different pathomechanism?

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Review 7.  The ABCC6 Transporter as a Paradigm for Networking from an Orphan Disease to Complex Disorders.

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8.  The vascular phenotype in Pseudoxanthoma elasticum and related disorders: contribution of a genetic disease to the understanding of vascular calcification.

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10.  Pseudoxanthoma elasticum: cardiac findings in patients and Abcc6-deficient mouse model.

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