Key result
In diabetic patients with calcified lower limb arteries, the diastolic ankle-brachial index (1.07) was significantly lower than the falsely elevated systolic index (1.30, P<0.001).
Why the study?
Does diastolic ABI provide a more reliable measure than systolic ABI in diabetic patients with calcified lower limb arteries?
Cross-Sectional (n=76)
No
Does diastolic ABI provide a more reliable measure than systolic ABI in diabetic patients with calcified lower limb arteries?
Diastolic ABI may serve as a useful complementary measure to systolic ABI in diabetic patients with calcified lower limb arteries where systolic ABI is falsely elevated.
Answers are grounded in this paper and cite their sources.
Diastolic ABI may avoid systolic false elevation in calcified diabetic arteries; hypothesis-generating, requiring prospective validation before any clinical adoption.
BACKGROUND: Ankle-brachial pressure index-systolic (ABI-s) can be falsely elevated in the presence of calcified lower limb arteries in some diabetic patients and therefore loses its value in this cohort of patients. We aim at investigating the feasibility of using the diastolic (ABI-d) instead of ABI-s to calculate the ABI in diabetic patients with calcified limb arteries. METHODS: A total of 51 patients were chosen from the diabetic foot clinic. Twenty six of these patients had calcified leg arteries by Duplex scan (Group A) and 25 patients did not have calcifications in their leg arteries (Group B). Twenty five healthy volunteers were enrolled in the study for group C and they were matched with other participants from group B and A in age and sex. ABI measurement was performed using "boso ABI-system 100 machine". Systolic ABI (ABI-s) and diastolic ABI (ABI-d) were calculated based on bilateral brachial and ankle oscillometric pressures. ABI is considered normal when it is ≥0.9. Repeated measures ANOVA test was used to test for comparing mean scores for ABI-s and ABI-d across the three groups. Statistical significance is considered when P < .05. RESULTS: The mean age of all participants (±SD) was 64.30 ± 7.1 years (range, 50-82 years). ABI-s mean ± SD was 1.3 ± 0.10 (range, 1.18-1.58) in group A patients, 1.07 ± 0.05 (range, 1-1.16) in group B patients, and 1.06 ± 0.05 (range, 1-1.16) in group C volunteers. While ABI-d mean ± SD was 1.07 ± 0.05 (range, 1.1-1.17) in group A patients, 1.06 ± 0.05 (1-1.14) in group B patients, and 1.05 ± 0.04 (range, 1.01-1.14) in group C volunteers. In group A, repeated measures ANOVA test showed statistical significant difference between ABI-s and ABI-d (P < 0.001) whereas in group B & C was not (P > 0.05). CONCLUSIONS: ABI-d may be helpful and can be used as a complementary measure instead of ABI-s in falsely elevated ABI caused by partial incompressible vessel.
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Asbeutah et al. (2016) conducted a cross-sectional in Diabetes with and without calcified lower limb arteries (n=76). Diastolic ankle-brachial pressure index (ABI-d) vs. Systolic ankle-brachial pressure index (ABI-s) was evaluated on Difference between ABI-s and ABI-d in patients with calcified leg arteries (Group A) (p=<0.001). In diabetic patients with calcified lower limb arteries, the diastolic ankle-brachial index (1.07) was significantly lower than the falsely elevated systolic index (1.30, P<0.001).
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