Best reproducibility of the ankle–arm index was calculated using Doppler and dividing highest ankle pressure by highest arm pressure

Atsma, Femke; Bartelink, Marie-Louise; Grobbee, Diederick E.; Schouw, Yvonne T. van der

doi:10.1016/j.jclinepi.2005.04.005

Cited by 21 publications

(16 citation statements)

References 32 publications

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“…147 Similarly, the intraobserver and interobserver reproducibilities are poorer for the auscultation than for the Doppler method. 197 No reproducibility data are available for the plethysmographic method.…”

Section: Are the Different Methods Of Abi Measurement Similarly Repromentioning

confidence: 99%

Measurement and Interpretation of the Ankle-Brachial Index

Aboyans

Criqui²,

Ábrahám³

et al. 2012

Circulation

1,369

827

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T he ankle-brachial index (ABI) is the ratio of the systolic blood pressure (SBP) measured at the ankle to that measured at the brachial artery. Originally described by Winsor 1 in 1950, this index was initially proposed for the noninvasive diagnosis of lower-extremity peripheral artery disease (PAD). 2,3 Later, it was shown that the ABI is an indicator of atherosclerosis at other vascular sites and can serve as a prognostic marker for cardiovascular events and functional impairment, even in the absence of symptoms of PAD. 4 -6 Rationale for Standardization of the ABIThe current lack of standards for measurement and calculation of the ABI leads to discrepant results with significant impact from clinical, public health, and economic standpoints. Indeed, the estimated prevalence of PAD may vary substantially according to the mode of ABI calculation. [7][8][9] In a review of 100 randomly selected reports using the ABI, multiple variations in technique were identified, including the position of the patient during measurement, the sizes of the arm and leg cuffs, the location of the cuff on the extremity, the method of pulse detection over the brachial artery and at the ankles, whether the arm and ankle pressures were measured bilaterally, which ankle pulses were used, and whether a single or replicate measures were obtained. 10 There is controversy about what ABI threshold should be used to diagnose PAD. The ABI threshold most commonly used is Յ0.90 based on studies reporting Ͼ90% sensitivity and specificity to detect PAD compared with angiography. 2,3 These studies were limited in that they included mostly older white men with PAD or who were at high risk for PAD and compared them with a younger healthy group. A recent metaanalysis of 8 studies of diverse populations, including diabetic patients, confirmed a high specificity but lower sensitivity (at best Ͻ80%) than that reported in earlier studies. 11 Similar to other vascular markers such as carotid intimamedia thickness 12 or coronary artery calcium score, 13 standardization of the techniques used to measure the ABI and the calculation and interpretation of its values is necessary. Aims and ScopeThe goals for this document are to provide a comprehensive review of the relevant literature on the measurement of the The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 10, 2012. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional repri...

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Section: Are the Different Methods Of Abi Measurement Similarly Repromentioning

confidence: 99%

Measurement and Interpretation of the Ankle-Brachial Index

Aboyans

Criqui²,

Ábrahám³

et al. 2012

Circulation

1,369

827

View full text Add to dashboard Cite

show abstract

“…Para a medida da pressão arterial em MMSS e MMII foi usado aparelho de tensiômetro de adulto com adequação do manguito ao biotipo do paciente e seguindo as orientações da Sociedade Brasileira de Hipertensão (32) . O ITB foi calculado de maneira habitual, razão entre a maior pressão sistólica (PS) no tornozelo e a maior PS braquial, obedecendo-se a seguinte interpretação: > 1,3 artérias incompressíveis; 0,9 a 1,3 normal; 0,75 a 0,9 doença arterial periférica bem compensada; 0,4 a 0,75 moderadamente compensada; < 0,4 grave (29,36) . No presente estudo o ponto de corte definido para o ITB foi menor que 0,9 para detecção de doença arterial periférica, com sensibilidade de 95% e especificidade de 100%, quando comparados à arteriografia, padrão-ouro de diagnóstico (13) .…”

Section: Study Of Macrovasculature By Doppler Ultrasound In Systemic unclassified

Estudo da macrovasculatura por ultra-sonografia Doppler na esclerose sistêmica

Godoi¹,

Barbosa²,

Godoi³

et al. 2008

Rev. Bras. Reumatol.

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“…7,10 Information has been published about the variability of ABI measurements. [10][11][12][13][14][15][16][17][18][19][20][21][22] In general, in these studies, the variability is expressed as a percentage of the average observed ABI values ranging from 8% to 16%, whereas in absolute values the standard deviation of the difference of repeated ABI measurements was between ±0.10 and ±0. 15.…”

Section: Introductionmentioning

confidence: 99%

Interobserver variability of ankle–brachial index measurements at rest and post exercise in patients with intermittent claudication

2009

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The ankle-brachial index (ABI) post exercise is claimed to play a complementary role in the diagnosis or exclusion of intermittent claudication (IC). The interobserver variability of ABI measurements at rest and post exercise in patients with typical symptoms of IC is the subject of this study with emphasis on ABI post exercise. ABI at rest and post exercise were measured in both legs of 20 patients with typical symptoms of IC. After 15 minutes of rest these measurements were repeated by another observer. Analysis according to Bland-Altman was performed on 40 paired leg measurements at rest and 40 paired leg measurements post exercise. The average ABI at rest for the first observer was 0.84 (standard deviation ±0.18) and for the second was 0.84 (±0.17). Post-exercise averages were 0.73 (±0.25) and 0.74 (±0.27), respectively. The standard deviation of the ABI difference between observers was 0.08 at rest and 0.15 post exercise. The interobserver variability of the ABI was 10% at rest and 21% post exercise. The interobserver variability post exercise is an important given when rules are defined about how the ABI post exercise translates into a more reliable and objective diagnosis of IC.

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Best reproducibility of the ankle–arm index was calculated using Doppler and dividing highest ankle pressure by highest arm pressure

Cited by 21 publications

References 32 publications

Measurement and Interpretation of the Ankle-Brachial Index

Measurement and Interpretation of the Ankle-Brachial Index

Estudo da macrovasculatura por ultra-sonografia Doppler na esclerose sistêmica

Interobserver variability of ankle–brachial index measurements at rest and post exercise in patients with intermittent claudication

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