Association between arterial stiffness and peripheral artery disease as measured by radial artery tonometry

Abstract

Objective Arterial stiffness and peripheral artery disease (PAD) are both associated with an elevated risk of major adverse cardiac events (MACE); however, the association between arterial stiffness and PAD is less well characterized. The goal of the present study was to examine the association between parameters of radial artery tonometry, a non-invasive measure of arterial stiffness, and PAD. Methods We conducted a cross-sectional study of 134 vascular surgery outpatients (controls=33, PAD=101) using arterial applanation tonometry. Central augmentation index normalized to 75bpm (central AIX) and peripheral augmentation index (peripheral AIX) were measured using radial artery pulse wave analysis (PWA). Pulse wave velocity (PWV) was recorded at the carotid and femoral arteries. PAD was defined as symptomatic claudication with an ankle-brachial index (ABI) of <0.9 or a history of peripheral revascularization. Controls had no history of atherosclerotic vascular disease and an ABI≥0.9. Results Among the 126 participants with high quality tonometry data, compared to controls (n=33), patients with PAD (n=93) were older, with higher rates of hypertension, hyperlipidemia, diabetes, and smoking (P<.05). Patients with PAD also had greater arterial stiffness as measured by central AIX, peripheral AIX, and PWV (P<.05). In a multivariable model, each 10-unit increase in central and peripheral AIX was associated with significantly increased odds of PAD (OR 2.1, 95% CI 1.1–3.9, P=.03 and OR 1.9, 95% CI 1.2–3.2, P=.01, respectively). Additionally, central and peripheral AIX were highly correlated (r(120)=.76, P<.001). Conclusions In a cross-sectional analysis, arterial stiffness as measured by the augmentation index is independently associated with PAD, even when adjusting for several atherosclerotic risk factors. Further prospective data is needed to establish whether radial artery tonometry could be a tool for risk stratification in the PAD population.

Peripheral arterial stiffness is correlated with intrarenal arteriolosclerosis according to biopsies from patients with kidney disease

“…The ratio is calculated from the peripherally reflected pulse wave, the amplitude and speed of which are dependent upon arterial stiffness; thus, the AIx reflects systemic arterial stiffness . Previous studies have reported that the AIx derived from PAT was not only reproducible but also closely correlated with the aortic AIx or radial AIx, and central and peripheral AI are also highly correlated . The AIx has been used to evaluate peripheral vascular lesions in many studies.…”

“…Lim et al evaluated the relationship between DR and peripheral AIx in 95 patients and found that patients with more severe DR had greater peripheral vascular stiffness . Zahner et al conducted a study of 101 patients with peripheral artery disease (PAD) and found that patients with PAD had a significantly higher central AIx and peripheral AIx than the control group after adjusting for several atherosclerotic risk factors . Several noninvasive techniques have been studied to evaluate the grade of intrarenal arteriosclerosis, such as the renal Doppler resistive index (RI); what has been found is that the higher the RI is, the more severe the atherosclerosis .…”

“…24 Previous studies have reported that the AIx derived from PAT was not only reproducible but also closely correlated with the aortic AIx or radial AIx, and central and peripheral AI are also highly correlated. [25][26][27] The AIx has been used to evaluate peripheral vascular lesions in many studies.…”

“…23 Zahner et al conducted a study of 101 patients with peripheral artery disease (PAD) and found that patients with PAD had a significantly higher central AIx and peripheral AIx than the control group after adjusting for several atherosclerotic risk factors. 26 intrarenal arteriosclerosis, such as the renal Doppler resistive index (RI); what has been found is that the higher the RI is, the more severe the atherosclerosis. 29 Bigé et al reported that the AUC for RI to discriminate severe arteriosclerosis was 0.740 (P = .039) in 58 chronic kidney disease patients.…”

Lipid Profile and Hemorheology Dynamics in Patients With Lower Extremity Peripheral Artery Disease in the Preoperative and Postoperative Period

“…Вместе с тем, проблема тромботических ок клюзий и стенозов зоны артериальной реконструкции остается актуальной и существенно ограничивает широкое внедрение хирургических методов. Очень важную роль в развитии этих осложнений играют факторы риска, ассоциированные с атеросклерозом, которые хорошо известны и освещены во многих работах [7][8][9][10][11][12][13][14]. Неудовлетворительные отдаленные результаты лечения связывают, прежде всего, с высокой степенью активности атеросклеротического процесса, особенно у больных молодого возраста.…”