The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

Brutto, Oscar H. Del; Mera, Robertino M.; Costa, Aldo F.; Zambrano, Mauricio; Sedler, Mark J.

doi:10.1155/2018/4735731

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Hence proper preventive strategies and early diagnosis help to eradicate this epidemic. [11][12] In our study we observe DELC is associated with coronary artery disease. The statistical analyses show higher incidence of Coronary Artery Disease in patients with bilateral DELC.…”

Section: Discussionsupporting

confidence: 58%

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Ear Lobe Crease: A Marker of Coronary Heart Disease

Johar¹,

Sunil²,

Taneja³

et al. 2021

MLU

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Aim and Objective-The clinical study was undertaken to evaluate the diagonal ear lobe crease (Frank sign) as an indicator of Chronic heart disease (CHD). However, there are certain studies have not found any correlation between Frank sign and CHD.Material and Method -Total of 10 patients aged >40years were enrolled in this study with prior medical history of heart disease. Patient with anatomical obliteration of ear excluded from the study. All the selected patient was initially screened and findings were recorded in patient Performa. Date were recorded, tabulated and analysed by using descriptive analysis for responses to each question.Result-DELC is observed in 80% of subjects with heart disease. The most frequently bilateral DELC is observe in 70% of subjects and without DELC in 20% of subjects. The mean age is within the range of 30-70 years. Unilateral and bilateral DELC was more among subject less than 50 years. Conclusion-DELC is uncommon and has a prevalence of correlation with CHD as indicated in the present study. It is suggested that DELC examination be recommended for detecting underlying heart disease.

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Section: Discussionsupporting

confidence: 58%

“…The statistical analyses show higher incidence of Coronary Artery Disease in patients with bilateral DELC. 11 There was significant relation with the advancement of age with DELC. This study comprises of a smaller number of subjects within the limitation this study the findings may not be generalizable.…”

Section: Discussionmentioning

confidence: 92%

Ear Lobe Crease: A Marker of Coronary Heart Disease

Johar¹,

Sunil²,

Taneja³

et al. 2021

MLU

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“…By contrast, an observational study found no significant association between FS and abnormal ankle‐branchial index 11 . Furthermore, a recent systematic review showed that the diagnostic accuracy of diagonal earlobe crease for detecting chronic coronary syndromes is insufficient 12 .…”

Section: Discussionmentioning

confidence: 96%

“…10 By contrast, an observational study found no significant association between FS and abnormal ankle-branchial index. 11 Furthermore, a recent systematic review showed that the diagnostic accuracy of diagonal earlobe crease for detecting chronic coronary syndromes is insufficient. 12 Additionally, the Fremantle Diabetes Study assessed the clinical usefulness of FS as a sign of coronary artery disease or retinopathy in type 2 diabetes.…”

Section: Discussionmentioning

confidence: 99%

The importance of inspection in clinical cardiology: Frank's sign

Bazoukis

Papadatos

Varrias

et al. 2022

Clinical Case Reports

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Frank's sign (FS) is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of approximately 45°. Sanders T. Frank first described it in 1973 as a dermatological finding predictive of coronary artery disease. 1 Researchers have described FS in Italian Renaissance Art 2 and in Greco-Roman sculptures. 3 FS has been associated with the presence and severity of cardiovascular disease. 4,5 The sensitivity and specificity of FS in predicting coronary artery disease were 80.65% and 44.15% in COPD patients, respectively. 6 In this case, we present a patient with FS and multiple risk factors for cardiovascular disease presenting with myocardial infarction. | CASE PRESENTATIONA 71-year-old male patient presented to the emergency department complaining of epigastric pain radiating in the left shoulder accompanied with diaphoresis. The medical history included type 2 diabetes mellitus, hypertension, dyslipidemia, paroxysmal atrial fibrillation/atrial flutter, a smoking history of >30 pack-years, and prior myocardial infarction requiring percutaneous coronary intervention in the left anterior descending artery 9 years ago. The medical treatment included dabigatran 150 mg bid, pravastatin/fenofibrate 40/160 mg od, metformin 1000 mg bid, furosemide 40 mg od, allopurinol 100 mg od, and ramipril 2,5 mg od. The clinical examination was unremarkable. His initial electrocardiogram showed sinus rhythm

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“…However, other studies have cast doubts on the strength of this association [14]. The same has occurred with studies attempting to assess the association between the ELC and other markers of atherosclerosis, including peripheral artery disease [15, 16].…”

Section: Discussionmentioning

confidence: 99%

On the association between earlobe crease and the carotid intima-media thickness: A population-based study

Brutto

Mera

Costa

et al. 2019

Heliyon

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The earlobe crease (ELC) has been linked to coronary artery disease, but there is limited information on the association between ELC and extracranial atherosclerosis. Using the Atahualpa Project cohort, we aimed to assess the association between ELC and increased carotid intima-media thickness (cIMT). Atahualpa residents aged ≥40 years underwent visual inspection of both earlobes to evaluate ELC presence, and ultrasound examinations of carotid arteries to calculate the cIMT. The association between both variables was assessed by logistic regression and predictive models, after adjusting for relevant confounders. Mean age of 570 enrolled individuals was 61.5 ± 12.4 years (58% women). ELC was present in 221 (39%) participants. The mean cIMT was 0.85 ± 0.19 mm, with 81 individuals (14%) having an increased cIMT (>1 mm). Univariate logistic regression showed a significant association between ELC presence and increased cIMT (OR: 1.67; 95% C.I.: 1.04–2.69), which disappeared when age (OR: 1.09; 95% C.I.: 0.65–1.85) and other covariables (OR: 1.06; 95% C.I.: 0.62–1.84) were added to the model. Predictive cIMT margins did not differ according to ELC presence or absence, with participants stratified in quartiles of age. This study shows that the effect of the increase in cIMT in subjects with ELC is related to aging.

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The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

Cited by 7 publications

References 11 publications

Ear Lobe Crease: A Marker of Coronary Heart Disease

Ear Lobe Crease: A Marker of Coronary Heart Disease

The importance of inspection in clinical cardiology: Frank's sign

On the association between earlobe crease and the carotid intima-media thickness: A population-based study

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