Format

Send to

Choose Destination
Int J Cardiol. 2005 Aug 3;103(1):41-6. Epub 2005 Jan 28.

Relationship of lower extremity skin blood flow to the ankle brachial index in patients with peripheral arterial disease and normal volunteers.

Author information

1
Department of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA. otahken@aol.com

Abstract

Changes in posture of the lower extremities induce changes in skin blood flow, known as veno-arteriolar response (VAR). We investigated the relationship between ankle brachial index (ABI) and VAR in patients (ABI<0.9) with peripheral arterial disease (PAD) and age-matched normal controls (ABI>1). We measured ankle pressure, ABI at rest, and post-exercise ABI. Using laser Doppler flowmetry, skin blood flow was measured with the lower extremity in extended and flexed positions and the fractional change (extended-flexed/extended) in blood flow (VAR) was calculated. With external pressure applied serially to the lower extremity in the extended position using a sphygmomanometer, the pressure (PVAR) at which the VAR was similar to that in the flexed position was recorded. Patients and controls did not differ by age or comorbidity, except higher cigarette smoking in patients (95.8% vs. 4.3%, p=0.001). VAR and PVAR were significantly lower in patients than controls (0.42+/-0.16 vs. 0.65+/-0.11 flux/min, p=0.001 and 29+/-8 vs. 48+/-9 mm Hg, p=0.001, respectively). There was significant correlation between ABI-post and VAR (r=0.6, p=0.01) and between the VAR and PVAR (r=0.8, p=0.001). VAR<0.3 flux/min was 100% sensitive, 80% specific, and area under curve of 0.88, p=0.001 for detecting PAD as defined by ABI<0.9. Similarly, PVAR of 22 mm Hg was 100% sensitive, 85% specific, and area under curve of 0.94, p=0.001 for detecting PAD. Skin blood flow by this method correlates with the presence and severity of an abnormal ABI. This may offer a method of monitoring the effect of therapy and regression of peripheral atherosclerosis.

PMID:
16061122
DOI:
10.1016/j.ijcard.2004.08.043
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center