Kazuo Tsuyuki1, Kenji Kohno1, Miho Asaoka1, Kunio Ebine2, Susumu Tamura2, Yasuhiro Ohzeki2, Toshifumi Murase2, Kaoru Sugi3, Kenta Kumagai3, Itaru Yokouchi3, Kenji Yamazaki3, Satoru Tohi3, Mutsumi Sorimachi4, Shinichi Watanabe5. 1. Laboratory of Physiology, Odawara Cardiovascular Hospital, Odawara, Kanagawa, Japan. 2. Division of Cardiovascular Surgery, Odawara Cardiovascular Hospital, Odawara, Kanagawa, Japan. 3. Division of Cardiovascular Medicine, Odawara Cardiovascular Hospital, Odawara, Kanagawa, Japan. 4. Laboratory of Physiology, Odawara Cardiovascular Hospital, Odawara, Kanagawa, Japan; Department of Clinical Engineering, Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan. 5. Department of Clinical Engineering, Kanagawa Institute of Technology, Atsugi, Kanagawa, Japan.
Abstract
Objective: The objective of this study was to clarify whether or not pulse volume recoding (PVR) parameters have screening capability equivalent to ankle-brachial pressure index after walking (Ex-ABI) for patients with 0.91 or higher ABI. Patients and Methods: The subjects were 87 patients (147 limbs) with symptoms of lower extremities with 0.91 or higher ABI. In all patients, upstroke time (UT), percentage of mean artery pressure (%MAP) of PVR and Ex-ABI were measured, and computed tomographic angiography (CTA) was concomitantly performed. Results: Area under the curve (AUC) of receiver operating characteristics (ROC) curves of Ex-ABI, %MAP, and UT were 0.90, 0.70, and 0.81, respectively. A significant difference was noted in AUC between Ex-ABI and %MAP (p <0.001). When the cut-off values were set at %MAP ≥45% and UT ≥180 msec, the accuracies of %MAP and UT were markedly lower than that of Ex-ABI. When the cut-off values were corrected to the values determined from the ROC curves (%MAP ≥41, UT ≥164 msec), the diagnostic accuracy of UT increased markedly. Conclusion: In patients with 0.91 or higher ABI, screening capability of PVR parameters was markedly lower than that of Ex-ABI, but UT has screening capability close to that of Ex-ABI when the cut-off value is corrected downward.
Objective: The objective of this study was to clarify whether or not pulse volume recoding (PVR) parameters have screening capability equivalent to ankle-brachial pressure index after walking (Ex-ABI) for patients with 0.91 or higher ABI. Patients and Methods: The subjects were 87 patients (147 limbs) with symptoms of lower extremities with 0.91 or higher ABI. In all patients, upstroke time (UT), percentage of mean artery pressure (%MAP) of PVR and Ex-ABI were measured, and computed tomographic angiography (CTA) was concomitantly performed. Results: Area under the curve (AUC) of receiver operating characteristics (ROC) curves of Ex-ABI, %MAP, and UT were 0.90, 0.70, and 0.81, respectively. A significant difference was noted in AUC between Ex-ABI and %MAP (p <0.001). When the cut-off values were set at %MAP ≥45% and UT ≥180 msec, the accuracies of %MAP and UT were markedly lower than that of Ex-ABI. When the cut-off values were corrected to the values determined from the ROC curves (%MAP ≥41, UT ≥164 msec), the diagnostic accuracy of UT increased markedly. Conclusion: In patients with 0.91 or higher ABI, screening capability of PVR parameters was markedly lower than that of Ex-ABI, but UT has screening capability close to that of Ex-ABI when the cut-off value is corrected downward.