The resistive and pulsatility indices of the dorsal metatarsal artery for the screening of peripheral lower artery disease in patients with and without diabetes
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引用次数: 0
Abstract
Background
In lower extremity peripheral artery disease (PAD), the ankle-brachial index (ABI) is an easily reproducible diagnostic tool for PAD, but it loses reliability when > 1.4 due to calcification of the vessel wall. Patients with diabetes are at higher risk for wall calcification. In order to overcome the limitation and reliability of ABI, particularly in patients with diabetes, we decided to assess resistive (RI) and pulsatility index (PI) by ultrasound doppler of the dorsal metatarsal artery (DMA).
Results
We therefore analyzed 51 legs (32 patients), evaluating the correlation between PI, RI, and ABI. Patients with diabetes were 21 (65.6 %), accounting for 33 legs (64.7 %). Out of 51 legs assessed, 37 (72.5 %) cases had compressible arteries, whereas in 14 legs (27.5 %) ABI was not calculable due to wall calcification. PAD was significantly associated with lower both RI and PI of the DMA (both p < 0.000). RI, but not PI, showed a significant correlation (r = 0.535) with ABI, when ABI was less than 1.4, but not when ABI > 1.4. When analyzed separately, patients with diabetes showed a similar figure in comparison with those without diabetes (r = 0.600), RI, but not PI, showed a significant correlation with ABI.
Conclusion
Dorsal metatarsal artery resistive index (MARI) showed a significant inverse correlation with PAD, similarly to ABI, irrespective of the presence of diabetes. MARI seems to be an effective screening tool for PAD even in patients with wall calcification. Further studies are needed for confirming the results of the present pilot study.
背景:在下肢外周动脉疾病(PAD)中,踝肱指数(ABI)是一种易于重复的 PAD 诊断工具,但由于血管壁钙化,当 ABI > 1.4 时就会失去可靠性。糖尿病患者血管壁钙化的风险更高。为了克服 ABI 的局限性和可靠性,尤其是在糖尿病患者中,我们决定通过跖背动脉(DMA)的超声多普勒来评估阻力(RI)和搏动指数(PI):因此,我们分析了 51 条腿(32 名患者),评估了 PI、RI 和 ABI 之间的相关性。糖尿病患者有 21 人(65.6%),占 33 条腿(64.7%)。在接受评估的 51 条腿中,37 条腿(72.5%)的动脉可压缩,而 14 条腿(27.5%)的 ABI 因动脉壁钙化而无法计算。PAD 与 DMA 的 RI 和 PI 均较低明显相关(均为 p 1.4)。单独分析时,糖尿病患者与非糖尿病患者的数据相似(r = 0.600),RI 与 ABI 有明显相关性,但 PI 没有:结论:无论是否患有糖尿病,跖背动脉阻力指数(MARI)都与 PAD 呈显著的负相关,与 ABI 相似。即使是动脉壁钙化的患者,MARI 似乎也是筛查 PAD 的有效工具。要证实本试验研究的结果,还需要进一步的研究。
期刊介绍:
Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.